If your Mohs reconstruction was performed over a year ago, giving time for the scar to mature, scar revision could be considered.  Other options for visible scars include dermabrasion, laser treatments and sometimes an injectable filler for depressed scars.  A thorough evaluation would be required to make that determination.

If you have extra fat under your chin and have good skin elasticity, submental liposuction may be all that you need.  If you have a lot of skin laxity and jowl formation along your jawline, you may require a neck lift or a lower face lift.

As one ages, the soft tissue of the face starts to sag and also lose its thickness of the layer of fat under the skin.  With the lower eyelid and cheek, there can develop a separation between the cheek fat due to sagging, and prominence of the lower eyelid fat, leaving a groove between the eyelid and cheek.  A non-surgical way of addressing this is with an injectable filler that can fill in the gap between your lower lid and cheek.  This can work very well in experienced hands.  A more definitive way is with lower eyelid surgery and/or a mid-face lift.

Chin implants can be done under general anesthesia or IV sedation.  The pain at the implant site can be moderate in the first 24 hours but usually quickly subsides after the first day.  Many patients do not require much pain medication after that.  Sutures are removed from the incision after one week, and most of the swelling will subside in approximately 3 weeks.

Laser resurfacing is my treatment of choice for acne scarring.  I use a CO2 laser to accomplish this.  You would be a good candidate as long as your acne is no longer active.  Dermabrasion is another option for skin resurfacing, but I prefer the CO2 laser.  The most important factor in deciding to have this procedure is the healing period.  It takes several weeks for your skin to heal, and you will need to avoid direct sun exposure.  I tell my patients to plan at least 3-4 weeks "down time".

Many people have that "family trait" which gives them the fullness under the chin, despite working hard at losing it with exercise.  Since you are at a young age, your skin should respond very well to submental liposuction and retract upward to better shape your neck after that procedure.  I would consider you a good candidate if it is a distinct concern for you.

In my experience, patients have received either a chin implant or cheek implants at the time of surgery, but not both. They could be done at the same time if indicated.

Posted by William E. O'Mara Jr., M.D.

As a professional boxer, I would council you to avoid facial cosmetic procedures until you have retired from boxing! Nevertheless, the chin implant I use is a soft silastic material that is placed into a pocket directly overlying the mandible. A hard punch could possibly split the implant, resulting in a palpable crease, but I have not seen this in my practice.

Posted by William E. O'Mara Jr., M.D.

Preformed cheek implants fitted correctly to the patient should continue to look natural as the patient ages. However, in my opinion, cheek implants placed too high can sometimes be more masculine in an older individual. If loss of fat is an issue, fat injection or injection of a synthetic filler can work well in the cheek.

Posted by William E. O'Mara Jr., M.D.

In general, patients receiving cheek implants have weak malar eminences, or cheekbones, resulting in mid-face flattening from an oblique view of the face. If your cheeks are very rounded, a cheek implant may not be recommended. Cheek implants are positioned over the majority of the surface area of the natural cheekbone resulting in a fuller more prominent mid-face.

Posted by William E. O'Mara Jr., M.D.