Hello,

I was wondering if anyone had any recommendations on what I should do with the lower part of my face.  Currently, I am planning on a neck lift (hate how fat my neck looks even though I'm actually skinny), face lift, trachea shave, and possibly a masseter reduction.  I will also be getting rhinoplasty along with the upper face work. 

The thing is, I do not want any implants so I won't plan on getting anything for my cheeks or chin.  I thought about sliding genioplasty but decided against it, mainly due to my fear of complications with the titanium screws.  As for my jaw, I feel as though they aren't big but still doesn't look feminine.  I don't really know if I actually need it or not but I do hate how wide my jaw looks sometimes.

I have already read Dr. Ousterhout's book but feel some of the info is a bit dated and have sent my photos to virtual-ffs but that will be awhile since she is so swamped with requests.  Also, as point of reference, I've been on hrt for about a year and a half.

This is a current lower half photo shot http://imgur.com/IBzSp09

Any recommendations from you awesome ladies would be great!

In my opinion, I would leave the jaw alone.  Already looks feminine.  It can be narrowed a bit.  Botox to the masseter muscle can help with the wideness.  If you are wanting a more dramatic jaw change, the jaw can be contoured without an osteotomy or titanium plates and the masseter muscle can be reduced with partial removal through the same incision used for jaw contouring.

A lip lift with feminizing rhinoplasty would help.   Would recommend against any neck lift at this point.  You could consider Kybella which is a nonsurgical way to reduce the submental fat or can do a submental liposuction through a small chin incision. 

Thank you keojampamd for the recommendations, may I ask you don't think I need a neck lift?  I'm generally pretty lean with little body fat but have that weird fatty neck that looks really awful during a side profile.  Also, I wasn't 100% sure about getting a lip lift, may I ask as to why you think I might benefit from it?

Thank you again!

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