My family has a hereditary double chin that is truly the last place where diet and exercise will get rid of the fat. I've had the double chin since when I was a baby, and it was only minimized when I was rowing obsessively as a teenager. Even then, at 4% body fat and with six pack abs, I didn't have the neck definition that some men have at 14% body fat. There just isn't much space between my neck and my chin, so it doesn't take much fat to get an extra chin.
10 years ago, after realizing that exercise alone wasn't going to fix it, I decided that I was going to get lipo. The 2001-2003 recession made it harder to find the kind of Internet job I was looking for, and picking a surgeon and understanding how much to pay was so confusing back in 2000-2004 that I kept putting it off.
The goal of getting rid of my double chin was a major reason I started working on RealSelf in 2007 -- it was a great way to learn enough to make a good decision and also to help people like me choose wisely.
At RealSelf, I learned that the liposuction device doesn't matter as much as the experience and skills of the surgeon. The procedure itself only took 30 minutes yet didn't feel rushed. The only pain was the application of local anesthetic and that was minor. After that my upper neck was numb and the surgeon used a thin straw to break up the fat and suction it out. The sensation was a bit like pushing on the inside of your mouth with a toothbrush, with occasional vacuuming sounds. My doctor did caution me that the results wouldn't yield as strong a neck angle as with a Neck Lift, so it will be interesting to see what the results look like after the swelling goes away.
Updated on Feb 16, 2012
Liposuction did eliminate the double chin, but sure enough my neck muscle (platysma) is just genetically not positioned for an angular profile. You can see this in the photo of me from when I starved myself in 2000 -- it wasn't fat under my chin that caused the weak chin angle, it was the platysma muscle. So I decided to go for a full neck lift (Corset Platysmaplasty) to achieve a result like Robert T's neck lift and the difference was immediately obvious. Even better, the concerns about nerve damage that kept me from doing the neck lift originally (because my mom had nerve damage from non-cosmetic jaw surgery) were unfounded and the recovery was even easier than the liposuction. (The drain that prevented fluid from accumulating, and the fact that the Dr cauterized the little blood vessels, meant that I didn't have the hard lumps like I did after liposuction.)
Reading other people's stories here, especially Robert's, were what helped me make the choice to go through with the Platysmaplasty, and I'm glad I did. If you're 30+ and thinking about liposuction, make certain you do your research about a Platysmaplasty too. (The term "Neck Lift" is used by some surgeons to mean that there are incisions around the ears and skin is sometimes removed. Since I didn't want either of those things, I'm using the term "Platysmaplasty" for clarity.) While liposuction is slightly less invasive, the recovery isn't any easier and the results won't compare to a Platysmaplasty. Trust me, you don't want the time and expense of going through two recoveries when you can accomplish everything with a Platysmaplasty.
There have been long term studies that show that a Platysmaplasty provides long lasting neck results because the platysma muscle is sown together into a sling that supports the tissues under the chin that otherwise sag with age. So it prevents the turkey neck and banding that otherwise occur. Sure, you could just wait until you need a full face lift, but in men that means needing to shave behind the ear because the beard skin is pulled to that point. I would much rather have a scar under my chin (where I already have a childhood scar) than wait too long and have to deal with scars around my ears.
This underscores why it is important to go to a Board Certified Plastic Surgeon (not someone who calls themselves a "Cosmetic" surgeon) since they have the experience required to do either Platysmaplasty or Liposuction, so you will get a realistic idea of what either of those two procedures can do for you. A doctor that only does liposuction will think it's the best answer even if you'll eventually need another procedure to tighten the platysma muscle.