Double Chin Lipo for 30 Year Old Male

My family has a hereditary double chin that is...

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.

Seattle Plastic Surgeon

Dr. is extremely talented and has a great track record working on the neck for liposuction, neck lifts, and full facelifts. His surgical team is great, and they walk you through every step so you know in advance when new sounds or sensations are going to occur. His assistant will even hold your hand, which is surprisingly reassuring even if you've had minor surgery under local anesthetic.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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Thank you for your review. I'm considering SlimLipo. I have a question. You mentioned getting the muscle tightened. I'm curious. Can you have lipo and the muscle tightened without having the scars around the ears? Liposuction has a smaller scar under the chin and two small punch hole scars where the ear meets the jawline. With neck lifts the scar under the chin is much longer and the scar along the ear is more noticeable because it is a line along the ear. Can you clarify whether you can have liposuction and the muscle tightening without the scars associated with the neck lift procedure?
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I don't have scars around the ears -- those are only used when skin is removed. You can have a platysmaplasty with only a scar under the chin. The scar will be longer than the tiny lipo scar, but the results fron the playsmaplasty will be long lasting while with lipo the neck bands will become visible. Skip the lipo and either get a platysmaplasty or accept your neck as it is; neck lipo isn't worth it compared to a platysmaplasty.
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Thank you for your answer. :) I'm getting kinda overwhelmed reading all the reviews online. I'm reading different doctors perspectives. Why do you recommend platysmaplasty without liposuction? I don't have any neck bands, but I have heard liposuction can make neck bands visible. I have read platysmaplasty is possible without liposuction, but most doctors almost always conservative liposuction.
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Fat is removed during a platysmaplasty by direct scraping as that provides the surgeon with great visibility and accuracy. Since the fat can be scraped off the skin and muscle there is no need for external suction. So you definitely want fat removal during a platysmaplasty, surgeons typically don't use suction for that.
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Great answer. :) Thanks for explaining that. You have been so helpful. :) So, I can ask for platysmaplasty. Fat will be removed via. scraping and muscle will be tightened. Therefore, double chin will be gone. :) And by avoiding external liposuction, I will avoid lumps and possible bands that come from liposuction side-effects. Is that the reasoning? And basically, this is just a better and easier way for long-term improvement. I have heard doctors say on this site that sometimes liposuction patients come back years later because of liposuction causing bands and also I've heard the muscle starts to move up and down beneath the skin and can be seen because platysmaplasty wasn't done.
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Without a platysmaplasty, there is nothing to support the skin and other tissue directly under the front of the chin or to prevent platysmal bands from showing. By sewing the two sides of the platysma muscle together like a corset, a platysmaplasty provides a long term fix to the sagging that would otherwise occur under the chin.
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Thanks for all your info Eric. I wish that i had had a neck lift. In fact I had a laser tightening afterwards and it still made little difference after the lipo. I think alot of people waste their money on lipo when they really need major surgery as jaw realighnment or neck lift. The company wanted to use me in their adds but the laser did very little so i never heard from them. What really hurt my feeling was some of my co-workers who said i was a fool and wasted my hard earned money. That was about 5 years ago and I am still living with this freakin chin.I wish I would of done more research. I have tried chin exercises and even lost 20 pounds but it does nothing. I am going on vacation and I will grow a thick beard to hide my double chin. I am done trying to correct a problem. The surgeon wasnt very confident about a neck lift because my chin has very little definition and probaqbly cant be helped, so people just dont have chins even though they are in good shape. Women like bearded guys better anyways, I hope!!
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5 years Post and Chin Lipo Didnt Work? I had chin lipo done around 5 years ago.. I am not over weight and in good shape but all my family has double chins. I was fed up with chin exercises etc. I went to a very famous plastic surgeon in Irvine CA. I saved up for over a year and it was around 4,000. He did the lipo and was going to put in a chin transplant but stopped once he did the lipo because he said I did not need one. I went back a couple months later and I hardly noticed any difference. Do i need a neck lift?
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John, it depends on your priorities and facial/neck structure. In my case, I never had a strong jaw line even when I was a rail thin teenager. The neck lift definitely helped more than the lipo, yet the improvement wasn't as significant as for Robert T's neck lift. Still, I'm happy because I know that sewing the platsymal muscles together will prevent the neck bands that my dad has and by minimizing the sagging under the chin, will allow me to avoid a facelift later in life. The neck lift scar is definitely more noticeable -- it's about 1.5" under my chin and there are two 0.3" ovals on either sides of my jaw from the skin hooks where the beard hasn't grown back after a year. I already had a horizontal scar on the edge of my chin from a fall as a kid so another one wasn't a big deal. To make the scar and the ovals less noticeable, I might choose to have laser hair removal on the hair under my chin since it's harder to shave their anyway. If you do choose to go for a neck lift consultation, make certain it is a doctor who does specializes in male neck and facelifts. Female facelifts are a bit different because there's no concern about killing off the beard hair like there are for men. Avoid any doctor who uses iGlide or another thread-based neck lift as thread-based lifts won't provide a lasting benefit but do create a permanent foreign body problem.
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Michelle, it is a good idea to do the neck lift separately because you want the surgeon to focus ONLY on doing a great job on the neck lift without having to rush to complete it or the other surgeries. Plus, the recovery will be easier if the rest of your body isn't also healing. It's really important that you sleep on your back for the first few days of recovery (so there isn't extra tension on one side of the sutures), and if you a side-sleeper like me that is hard enough on a regular night!
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I couldn't agree more. I really do want to focus solely on this operation and the recovery. And yes, I am a side sleeper and sleeping on my back is and will be an issue for me. I think what is scaring me the most about this surgery is possible nerve damage-You mentioned something previously about getting the lipo first because of something your mom went through with damage to the nerve. My Dr. did explain to me that there is a nerve that runs along the neck and that damage or bruising can cause a problem with my face..... I can't even put into words how much that scares me.
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You are completely right about age... but my neckline was inherited from my mom. I've always had it, but it was somewhat tolerable. Age + weight gain in an area that already inheritedly looked bad... well let's just say- I need to do something. Both you and Eric K are still young- this area that would benefit from LESS attention only gets worse with age:) Much like yourself Robert, I've spent a lot of time working on myself from the inside and now it's time for me to make some changes for the outside (that diet and exercise won't help).
Thank you again. Like I mentioned earlier, I am having a couple of procedures done in the next few months. But after reviewing what both you and Robert T. are advising, I am going to search for a surgeon in my area that has more experiece with necklifts. I love my Dr./surgeon that I am going to for my other procedures but the necklift is the scariest for me due to possible nerve damage. I need to know that I have the best surgeon doing this procedure.
I thank you both for the information, it really does help! I would love to post pictures to give you an example of the area we're discussing but I am still very new to this site and have concerns about posting pictures.
Thank you again
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Robert T makes a great point -- you want a "platysmaplasty" where the neck lift muscle is cut and retied, not an iGuide necklift or a neck lift where the only scars are around the ears. Surgeons who are experts at facelifts are the best because the platysmaplasty is a key part of a facelift.
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Age sometimes doesn't matter for people.  Eric and I both inherited a bad neckline.  It can be genetic.


A LOT of doctors do necklifts in different ways.  THEY MUST CUT and RETIE the muscle for the most dramatic effect.  It's considered simple by trained surgeons  but quite a few haven't been trained in this. 


See my necklift review for more info.
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To answer your question... yes I am considering a neck lift. I was never opposed to going a more invasive route for my chin but every Doctor I spoke to thought I should try lipo first, saying "you're so young to be considering this procedure". My point was why do the lipo without predictable results. The lift would give me predictable results and most likely more desirable results. I was scheduled Thursday (this past Th. the 19th) for Smart Lipo on my chin. When I went in for the pre-op, the doctor pretty much confirmed everything I said but still thought we should give lipo a shot. When I got home I started to do more research and after reading your posts and a few more, I decided that a neck/chin lift is the best choice. I have always been self-conscious of my chin. I would look at pictures of me in the past and throw/delete the ones where you could see my chin. Now that I'm older and weigh a little more, you can see my chin in every pic. Let me add that by no means am I overweight, I was actually underweight in the past. My chin made me look like I had a fat face!!! I hope that makes sense. So thanks again for all your info. I'm actually scheduled to have a few other procedures done also, so I'm putting the neck lift last on the list (probably Jan,/Feb.) But I will post pics. when I do. Thanks again~ You really helped me make a tough decision.
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I need to thank you for giving so much information and with such detail. I just got off the phone with my surgeon's office and canceled my chin lipo appt. for tomorrow. At my pre-op appt yesterday he (the Dr.) expressed that ultimately I may not be happy with my lipo results and would probably be happier with a chin lift. He did advise me that going a "less invasive" way first could get the job done but that there was no way to know for sure. He also said that I wasn't your "typical" chin lipo canidate, and that there isn't much fat in my chin/neck. I too have the hereditary issue. Even at my thinnest I always had a double chin. Now that I'm 15lbs heavier (and 15 years older), I can't bear to see pictures of myself and actually run when someone takes a camera out.
So thank you in helping me make this decision.
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Are you considering a neck lift? I'm very happy with my results and the recovery is similar to chin lipo. (In fact, because there was a drain with the neck lift the bruising, swelling and hard lumps that I had with lipo were avoided by directing any fluid out of the drain.) If you've always been self-conscious about your double chin, as I was, then a neck lift is the best way to remove the extra chin and prevent the neck bands from forming in the future. Neck bands are the edges of the platsyma muscle, and that muscle is sewn together in a platsymaplasty (aka Neck lift).
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I recently had my chin/neck/jowls done. I had the procedure done on April 22. I have worn the garment for about 99.5% of the time, with varying degrees of tightness, because I keep 2nd guessing how it should be worn.

Under my chin is still swollen and numb. The doctor told me before the operation that my results will not be exactly what I will be hoping for, since my chin and neck muscle structure forms a triangle and not a 90 degree angle. She said that i should definitely see results though. During the procedure, they said the sucked out 5 (measures?) of fat, which was normal.

I have been hiding in my apartment since the procedure and I have class tomorrow. I am scared to take the garment off at all.
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Yeah, for people like me who never had a 90 degree chin angle, lipo alone was never going to do much.  That's why I followed it up with a neck lift which had better results that should last much longer (because the thin platsyma muscle is sown together under the chin as a sling).  The downside is that the scars (both a 1.25" scar under the front of my chin and two small circles on the left and right) are more obvious than I expected even after 5 months.  I already had a childhood scar on the bottom of my chin, so another scar doesn't worry me, but it is a trade-off for a stronger chin angle.


Most people won't notice any bruising if you use some cover up for the first week or so.  The recovery process is always harder than everyone expects, so don't worry that it wasn't easy and you're self-concious about your results.  That's normal.

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I will go back to work on Thursday. I hope the swelling will go down. I am on day 6 and my face is fatter than before? I found a lot of comfort on this site. Thanks everybody.
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So are you going to review your latest procedure? We would love to see photos! 

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It was only 2 weeks ago -- I'm waiting until the 5 week follow up when the 'after' photos will be taken since I know that swelling takes a while to resolve.  So far, it really does look like Robert T's result from the side profile. 

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I just had my done last Thursday (face, neck, jowl) and the bruising didn't kid in until yesterday 03/05/12. Mine is mostly yellow from mid- neck down. Is that my normal? There was no black and purple just yellow. My face is really swollen and I'm worried. I know it will disappear in time but still very nervous. Though the fat under my chin is completely gone.
My neck and jaw are still very numb, tender, and stiff. I haven't touch my neck as it still very tender. The right side of my lower lip is numb and still couldnt move so my smile is kind of crook. My doctor said it will go away but I still very worried.

In regard to compression garment, I have it on 24/7 unless I needed to remove when I took a shower? Do I
need to wrap it tight?
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Yellow bruising is normal -- that's what I had after my neck lift, and yes the bruising tends to move with gravity downward.  It will go away in another week.

Keep the compression garment on 24/7 (especially important at night) except when you shower.  If you have Dandruff (like I do), it will probably get worse with the garment on your head and you may need to use Nizoral shampoo to clear it up. 

Numbness does go away but it takes months.  Try to be patient and distract yourself with books or movies when you're not otherwise busy.


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Toonervous - from everything I've read/heard about lipo on any part of the body, significant swelling is very normal in the first few weeks. Dr. Steven Wallach told a RealSelf member that "4 weeks out from surgery is too early to be overly concerned about the swelling under your chin."

Another opinion that directly applies to your concern: "Even though you have no swelling at 48 hours after Chin or Neck liposuction, maximal swelling after Liposuction can continue and occur even after 4-5 days, so I recommend that my patients not remove the garment until at least 7 days and continue to wear it at night for an additional 4-6 weeks." - Dr. Brooke Seckel

If you've never seen a video of someone getting liposuction, I recommend checking it out just to gain an appreciation for how much trauma your tissues endure during the procedure. It's shocking, but definitely puts the swelling into perspective!

Here are some doctor Q&As you may find helpful:

Good luck in the rest of your recovery.

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