I Underwent More Than a Dozen Cosmetic Procedures in Pursuit of My Ideal Jawline
Tyler Williams is a publicist, writer and the CEO of Nouveau Communications. He is based in New York City.
Trigger warning: This article contains references to weight loss and fatphobia.
"I really want to fix my jawline, do you think I should get an implant or something?" I demanded of the plastic surgeon my colleagues and I had conversed with for approximately 90 seconds outside a bar on 54th Street in 2009. "I am not going to answer that," he responded as he took a big drag from his cigarette. Thanks for nothing, I thought to myself as he stamped out the rest of his cigarette and returned to the happy hour inside. Best not to take advice from someone who received a whole medical degree and still smokes, I reasoned. I'd figure something out for my jawline someday.
One of my earliest memories is walking down the small hallway of my childhood home in upstate New York, and carefully averting my eyes from the silhouette portrait of my profile at five years old hanging on the wall. Sometimes known as "shadow portraits," the hallmark of these common frame-your-child's-face drawings is the lack of detail; the solid black profile images resemble those on vintage cameo pins, the only distinguishable features delineated by the edges matching the outline of the side of the subject's head.
In the moments when I'd occasionally slip up and my five-year-old outline came into focus, I had a tendency to fixate on what I perceived as a double chin jutting out from my young head, turned down slightly. Growing up, whenever I'd accidentally catch sight of the portrait, it may as well have been a giant, neon sign with a flashing arrow pointing directly at the one facial feature I really hated: my chin.
I don't recall the exact origins of when my insecurity about my jawline began — maybe it was from growing up in the fatphobic climate of the '90s; perhaps it was a pointed comment from a childhood bully, or maybe my anxious mind simply noticed that my features didn't match the aesthetics of celebrated men of the era, like Brad Pitt and Dean Cain — but this deep-seated self-consciousness about my chin has been with me for as long as I can remember. Despite being chronically underweight throughout my adolescence and young adulthood, I'd even try to lose weight in an effort to minimize the appearance of my submental fullness.
Despite my brash line of questioning to the unsuspecting plastic surgeon trying to enjoy a smoke break, the thought of surgery always seemed... extreme. At the time, I didn't know anyone who had undergone elective plastic surgery, and growing up as the child of a nurse, I was keenly aware that there are potential complications with any kind of surgery.
The beginning of my jawline journey
In adulthood, after years spent living in New York City, I met a number of people who had undergone CoolSculpting — a fat-reduction procedure that uses a device to target and kill fat cells near the surface of skin with cold temperatures — on different areas of the body, albeit to mixed results. I was briefly tempted to try it after perusing before-and-after photo galleries online, but I ultimately decided this wasn't a solution for me when I heard several horror stories from friends who complained about the procedure's pain and being left with permanent dimples or divots in their skin.
In 2016, Kybella hit the market with a splashy launch featuring Khloé Kardashian as its spokesperson. Touted as a "nonsurgical" approach to double chins, the treatment involves a series of deoxycholic acid injections to destroy fat cells and prevent them from storing or accumulating fat. I was immediately intrigued: I watched all of Kardashian's interviews, read all of the materials and poured over before-and-after photos. Given that the treatment was new, I decided to give it a little time before formally exploring treatment for myself, in case of any longer term issues.
In 2018, I began working as a social media consultant for famed New York City dermatologist Dr. Dendy Engelman. Once I became familiar with her aesthetic and bedside manner, I mustered the courage to inquire about Kybella. The treatment itself is relatively easy and much more accessibly priced than surgery. (It can come in at around $1,200 per treatment, depending on your provider.) The doctor uses a numbing cream on the treatment site for about 30 minutes, and places a series of targeted injections in the submental area. The treatment site immediately begins to feel heavy, and there's a slight stinging sensation that lasts for about 20 minutes.
Within a few hours, the area swells up – and I mean swells up to an alarming degree, to the point where you almost have no choice but to believe that the treatment has gone horribly wrong. (There's something uniquely cruel about a treatment causing your insecurity to be 100x worse before it improves, but this is actually pretty standard across many cosmetic procedures.)
After a few days, the swelling subsides and the submental area is significantly reduced — for most people, that is. In my case, I underwent four rounds of treatment, with marginal improvements each time. But after our fourth course (and an unusually long swelling period of three weeks), even Dr. Engelman admitted that I had officially become her "only Kybella failure story." This is not to say I was totally unhappy in the overall results, but we both were hoping for and expecting something a bit more impactful.
After my Kybella journey, Dr. Engelman would use Juvéderm fillers off-label to help define my jawline a bit more, which was always a big help in carving out that area and creating a more chiseled effect. I'd also visit her office for treatments of Nuera Tight, a painless, non-invasive radiofrequency treatment that tightens skin and can have some impact on fat as well. If there was a special event coming up or a time when I knew I'd be photographed, I'd run to her office for Nuera, and enjoy the temporary results.
My decision to get chin liposuction
Eventually, I decided that if I wanted to really change my jawline, I would have to undergo chin liposuction. After hours of research (and a lot of time spent watching videos of the procedure on Instagram), I decided to consult with Dr. David Shafer, a double-board certified plastic surgeon in New York City, who I began working with (again, in my capacity as a publicist) in 2021.
As far as surgery goes, chin liposuction is actually surprisingly approachable: It's done under a local anesthetic, recovery is pretty quick (you wear a bandage for 24 hours, then you have to wear a compression garment as often as possible for a few weeks, which was a piece of cake while I worked from home) and it's virtually painless. The cost of chin liposuction, though, can be significantly more prohibitive: Undergoing the procedure with a top surgeon in New York City typically starts around $8,500, and can increase depending on the type of anesthesia used or if it's combined with other treatments. In my consultation with Dr. Shafer, he confirmed that I was an ideal candidate and even offered to do it the very next day. (We landed on a day the following week.)
Before my surgery, I was a mixture of nerves and excitement. The nerves came mainly from worrying that I'd again be left disappointed by my results. But Dr. Shafer's team helped reassure me; his nurse, Amy, had also undergone the procedure previously, so she was able to walk me through every single aspect of it.
My chin liposuction experience
I was given Fentanyl shortly before my procedure to make administering the local anesthetic easier (they have to inject quite deeply).
Because I'd watched so many surgery videos, I knew to expect the use of the cannula to remove the fat from the area. My only surprise during the surgery happened early in the procedure: I'd accumulated a lot of scar tissue throughout my submental area due to my prior Kybella treatments. Dr. Shafer had to physically break through them, and he quickly assured me that this was actually a positive thing, as the presence of scar tissue would promote better healing in the area, but it made for some moments where he had to use a bit more force with the cannula. But truth be told, I was so thrilled to be getting the procedure done, none of this bothered me. I channeled my excitement into chatting and joking with Dr. Shafer and the attendings who were observing the procedure.
The very worst of this procedure is the 24 hours that follow: Your entire head is wrapped in a tight bandage, mummy-style, and the swelling all comes out in your face. I looked like I'd had brain surgery or something.
There was also an issue with my local pharmacy, so they didn't give me the strongest pain medication, and I had a little bit of trouble sleeping the first night just using Tylenol, but after that, there was no pain. The area does go numb at first, and feeling came back over the following weeks as the swelling gradually went down. Thanks to my experiences with Kybella, nothing in the recovery process surprised or bothered me too much.
The writer, seven months post-chin liposuction
The first time I took the bandage off to shower and switch to a compression garment, I looked in the mirror and cried. It was like I was seeing the version of myself I had always hoped to see in the mirror. I texted photos to Dr. Shafer and Amy, and Dr. Shafer quickly replied with "remember how this looks, because you're about to swell like crazy, and it's going to take several weeks to get back to this." Determined to be a gold star patient, I immediately put on the compression garment.
Patients can expect to wear compression pretty much 24/7 for around two weeks, then just at night for an additional few weeks. I swapped between two compression garments: a tighter one for daytime, and a softer more comfortable one for sleeping. There were instances when I needed to take meetings or pop into a neighbor's birthday celebration, so I was able to be a flexible with it. Dr. Shafer's advice was spot on; seeing the swelling was a little bit stressful in those initial few weeks, but after around the six week mark, the results were undeniable.
Around eight weeks after my procedure, Dr. Shafer texted me that he needed a model for Juvéderm Volux, which is a filler the FDA approved last January that's specifically designated for the jawline area, used to help define that area even more. I was already happy with my results from the liposuction, but am all about maximizing results, so, naturally, I was game to try it out. The immediate before-and-after photos were so impressive — far more impactful than previous jawline injections I'd gotten.
While my new jawline isn't giving Brad or Dean a run for their money, I really couldn't be happier with how everything has turned out for me. I look back to just a few short months ago, and it seems so foreign to recall the extent to which I was always so on edge about my appearance. No matter where I was or what situation I was in, I'd always be thinking about how I was positioning my body to minimize the double chin. In photos, the double chin was the first thing I looked for. Now, it's like I'm finally able to relax.
Discussing plastic surgery is tricky. Societally, there isn't a lot of nuance on the topic; we seem to only hear about the "Botched" kinds of extremes, horror stories and stigmas. While I couldn't be happier with my own experience and ultimate outcome, I'm also acutely aware of how it can be a slippery slope. Shortly after my chin liposuction, I started to think about whether I might want to get my buccal fat removed, too; but then I reminded myself that just because I was happy with one result, doesn't mean I need to chase another.
If you are considering plastic surgery of any kind, it's as important to invest time not only into researching your doctor, but also into understanding what your goal is.
It's also not lost on me that undergoing so many treatments over the course of several years may make me sound like a bit of an aesthetics extremist, but I don't regret a thing. My jawline journey has been an education not only in the world of cosmetic procedures, but also in my own relationship with my physical appearance and how I perceive myself. I'm thankful for the privileges and access I've had to be able to safely take these matters into my own hands (or at least, those of a trusted doctor) — being able to have autonomy over the appearance of my face has profoundly impacted my confidence, and that's not something I take for granted.
Editor's Note: Because he appeared as a social media model, the writer received all treatments and procedures mentioned throughout this essay gratis.
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