Dr. Sam Lam Plastic Surgery Forum

Hello Dr. Lam,

I am a 19 year old male. I have a slightly deficient mandible, but I do not want to undergo any major surgery such as orthognathic surgery. I have had braces for 2 years and my overbite has been fixed. I know that I need a chin implant, but I also have a narrow jaw, especially the back part, right under my ears. I was thinking about jaw implants, but I have talked to some doctors about it and they said it might affect my involvement in martial arts so that is certainly not an option for me. Recently, I was reading about artefill or fat grafting being used to augment and widen the back of jaw. I wanted to know your opinion on whether a filler can widen the back of the jaw and if you do this procedure.

Thx,
Shan.

Hi,
I understand your situation. Here are my feelings as far as injectable fillers:
1. Artefill: I don't believe in using Artefill. For a detailed reason why, please watch my video log on "Why I don't Use Artefill." I also want you to understand that injecting the jawline in a 19 year old with a permanent filler is not a smart thing. You will have a decent amount of soft tissue aging and changes that will occur during your lifetime. It is far too risky to inject a permanent filler there.
2. Fat Grafting: As you probably know, I do a ton of fat grafting. However, you are NOT a candidate for fat transfer for several reasons. The first reason is the same as described in #1 above. Second, similarly, fat is a live graft. Being so young, there will be changes over your lifetime of weight, etc., the fat transplanted there can get bigger or smaller and not be what you wanted at your age now. Plus, I do not use fat to transplant a select area. I use it to blend the entire face. Why? For exactly the reason that I described above. If you transplant only a small area of the face (especially at your age), you can notice unevenness over your lifetime. It is not a good idea, and that is coming from a guy who has literally written the book on the subject.
best,
sml