Self-Conscious On Video Chat? There's a Surgery for That

MakenzieR on 1 Mar 2012 at 10:00am

Do you ever look at yourself on a video chat and think “That’s what I look like?” Apparently this issue causes enough concern among mobile phone video-chatterers for one plastic surgeon to dub his neck lift technique the “FaceTime Facelift.”

Plastic surgeon Dr. Robert Sigal says his “FaceTime Facelift” differs from a traditional neck lift because of the incision placement. He told RealSelf that “Most lifting procedures involve a cut under the chin. Generally the expression is that doesn’t really matter, because no one but your lover or your dog will see it, and neither will care. That’s not true with FaceTime, because it does show that [area].” (For the non-iPhone users out there, FaceTime is Apple’s video chat app.)

Taking this into consideration, Dr. Sigal says he “figured out a way to do the area under the chin without that cut. I can do everything with a lateral sling, which is a stitch from behind the ear which elevates the tissues.”

Now, we’re all for less noticeable incisions. But we also know that the average price of a neck lift is around $7600. So should you be looking at your video screen self and thinking "where did extra chin/flabby skin come from?" here’s another option to consider that’s wallet-friendly and requires zero downtime.

Hold the camera at a different angle. 

As most young women on Facebook would tell you, the key to looking great when capturing an image of yourself is to hold the camera slightly above you. I willingly submit my own face as proof of how quickly this trick will solve your FaceTime dilemma:

FaceTime Facelift  FaceTime Facelift  FaceTime Facelift

Notice in the straight on I’m double-chinless. Then from below - POOF - flashback to 5th grade me. Above? Me when I danced twice a week in college.

What’s the moral here? We know scar visibility is a huge part of surgery consideration. So if you are thinking about this path, then Dr. Sigal’s cleverly named neck lift may be worth looking into. But, if you only feel self-conscious when you are looking down at an unnatural angle, and you don’t have $7k to drop on surgery, it’s probably not worth it to get a FaceTime Facelift or any other invasive procedure.

Do you feel self-conscious when you use video chat?

Learn more about the FaceTime Facelift from Dr. Sigal’s own video:

Comments (8)

nice info, thanx!) but as for me, i usually use this tool for FaceTime calls recording, it's simple and nice!)
Interesting post. Even though I am a facial plastic surgeon, I think the positioning of the iPhone/iPad is the way to go. To place the iPad on your lap and tilt your head down 45 degrees to do Facetime is not only unflattering, but also hard on your neck. Of course, when we look down the weight of our facial skin, fat and other tissues is literally hanging off of our faces, as opposed to draped over our normal bone structure with some gravity involved.. If we look upwards or are lying on your back, the facial tissues are draped over our bone structure without any gravity pulling the facial tissues downwards (many of my patients who come in for facelift and necklifts will tell me that they want to look the way they do when they are laying flat on their backs, and not stretched and pulled.) The downward pull of gravity can create more shadows on the face by deepening folds and wrinkles.

If you are looking downwards, the folds become deeper, and because the chin is pointed downwards the tissues along the jawline and under the chin which normally cover 3-4 inches from the front of the neck to the front of the chin is then compressed into a 2 inch space. Of course this will create a double chin and make a person look worse. Throw on top of that, ambient lighting is usually on the ceiling or at least 4-5 feet from the floor, then the overhead lighting will create even more "bad lighting" or "unflattering lighting."

One last "pet peeve" with FaceTime is the "Fish Eye effect" of a tiny camera lense which is only a couple to a few feet from your Face, this will cause the middle part of the picture to look bigger than the perimeter. It can make your nose look bigger than it actually is. I have patients who have come in thinking that their noses have gotten bigger, and bring a candid photo of themselves where it does look bigger, but when I take standardized photos, they think my camera is flattering as opposed to the ones that they take from arm's length. It is actually the opposite. A good telephoto lens on a Digital SLR (the big fancy cameras with a separate lens, not the point and shoot) take photos which are more "real" and the small lens cameras which are "unflattering."

To get plastic surgery, to look better on FaceTIme is a bit ridiculous. I have been FaceTiming with my parents (late 60's,70's), so that they can see their grandchildren, and I do see what the article is talking about. My parents always have the iPad on their lap, and they are looking down at the iPad (not flattering.) I have my iPad on the dining table with the clever "folding magnetic iPad cover" which my parent's can't seem to fold correctly so that it doesn't fall (fold it into a triangle so that the gray part is on the outside and the color part is on the inside). I also have the iPad further away (2-3 feet away on a table) so that my 3 children can all fit in the picture, instead of having one face fill the whole screen. The Facetime video is not in HD, so if you are too close it can look fuzzy, so being further away actually looks sharper.

Anyway, finally this past weekend, my parents asked me why my picture is steady and clear and I'm not even holding my iPad, so I explained my set up, and they finally did it (in addition to better lighting.) They look much better. No plastic surgery, didn't spend a dime.

Last rule of photography and video, is the concept of "Lights, Camera, Action." You are the "Action", the iPad is the "Camera", so the "Lighting" should always be in front of you behind the iPad so that your friends and love ones are not looking at a "sillouette" of your face. If you are taking a photo of a person with the Lights behind them (Lights, Action, Camera (thats you with the camera) then turn on the flash so you can actually see them in the photo. That's another one of my pet peeves.

If you can remember Lights, Camera, Action, it will make your FaceTime, photography, and regular video taking much better.


Dr. Yang

Thank you for such a thorough response, Dr. Yang!


Two scars around the ears sounds worse than one scar under the chin if you don't have long hair.  But that's because I'm a guy and chin scars heal better in men (because of the extra blood flow for the beard hairs) than in women apparently.  I already had a scar on the lower right party of my chin from a childhood injury.  The average neck lift price includes people who paid for a what is essentially a lower face lift with scars around the ears.  The neck lift that just involves a chin scar is less expensive.

Hi Eric,

I agree, but depending on the surgeon, some surgeons I've seen their unhappy patients have under chin incisions which border on 1.5 to 2 inches under the chin. If that is the type of incision under the chin (submental incision) then I agree with Dr. Sigal, that placing the incisions behind the ear "only" not in front, is not a bad alternative. The decision to go behind the ears versus under the chin has other factors to consider other than simply avoiding a 1.5-2 inch incision.

Submentoplasty with a Shorter under chin incision.
Necklifts through a single incision under the chin are called Submentoplasty. Sub- meaning "under" and -mento- meaning chin, and -plasty meaning plastic surgery. My incision for a submentoplasty is between 1/2" to 3/4". If I perform liposuction only, that incision is 1/4". Compare that to the incision which would be behind a person's ear which may be 2-4 inches long.

In general, submentoplasties work best in younger people with good skin elasticity. The general cut off age is around 45 years old, although some younger patients who have loss significant weight, or lack skin elasticity, may be better off with a necklift, while some people over 45 still have good skin elasticity and may not have much skin hanging, so they may be an exception to the 45 year rule. The incision itself is about 1/2-3/4" and depending on the person, they may already have a wrinkle there from where their double chin skin tends to fold over there. The area that is lifted up is about the size of a coaster.

To be a "true" submentoplasty, a muscle tightening called a platysmaplasty (you can google that) can create a corset under the chin to tighten the area.

Liposuction alone.
If no midline (or corset) platysmaplasty is performed and only liposuction under the chin is performed, then it would simply be liposuction under the chin, or Submental liposuction (Sub- under/ -mental chin). Depending on the patient, liposuction under the chin, may or may not be performed at the same time. Why tighten behind the ears if a 1/4" incision for liposuction under the chin will do?

Necklift with submentoplasty
Not all patients will want an incision on the front of the ear. If that is the case, some patients may be a candidate for a regular necklift with the same incision in the wrinkle under their chin, along with an incision behind the ear and around the base of the earlobe. This is a regular necklift. I tend to recommend this for my male patients so that they can avoid any incisions in front of the ear, and prevent their beard/whisker hairline from going towards their ear. For some surgeons, they may pull the bearded skin onto the ear itself, and the person has to shave their ear.

Some people actually would benefit from a facelift.
If the incisions extend in front of the ear, then that would be a facelift incision. A facelift incision helps to lift the jowls which can make a person's face look square in a front view. This is done in a lower facelift or mini-facelift.

Lateral Necklift
As far as the necklift method using the incisions behind the ear only, this is called a lateral necklift. After making the incisions behind the ear and lifting up some skin towards the neck, the platysma muscle can be pulled backwards behind the ear. By doing this the extra skin can be trimmed off using the incision behind the ear. If the patient has muscle bands under their neck, pulling the skin behind the ears will reduce the overall amount of skin on the neck, but will unlikely make any significant improvement on the muscle bands on the front of the neck. If no liposuction is performed either, just pulling the skin behind the ears does not make the fat under the chin disappear either. If the surgeon pulls too hard to try to "flatten" the fat, but without suctioning it out, the fat may "re-expand" and pull the skin behind the ear and the earlobes themselves towards the front of the neck and potentially cause a "pixie ear." This is why I have abandoned the lateral platysma tightening and mainly tighten the platysma muscle under the chin. I still remove skin behind the ears when there is excess, with loss of skin elasticity in patients over 45 (general rule.) But, I am afraid to tighten the platysma behind the ear based on my past experiences of tightening the platysma behind the ear from 2006. I haven't looked back since.


Dr. Yang

My arm literally gets tired and loses blood from holding it so high to FT with my mom in CA.


I look so bad in videos!  


It's all about the above angle. That's all my boyfriend sees when we FaceTime. (shhhh)