Suggestions for fat pouch under chin and crepey neck skin?

Question

I'm 47 and looking want to remove the fat pouch and crepey sagging skin on my neck. I've tried some laser procedures which were a waste of money. I'm wondering about a neck list with lipo, but don't need a facelift. What is my best neck-improving option and who is the best doctor to solve this problem in the Atlanta area?

Lucian Ion, FRCS · Answer

You photo shows a combination of soft neck skin, relatively small amount of fat under the skin and more volume under the platysma muscles. It is possible to evaluate for yourself how much fat you have under the skin of the neck by contracting the platysma ( like when you show your lower teeth) and pinching the skin over the contracted muscles. If there is relatively little in the pinch, liposuction is not a great option. The fat under the skin allows your neck skin to look smooth.The alternative is to combine a reduction of the volume in the deeper layer of the neck, below the platysma muscles with contouring of the platysma and skin tightening.  This can change the shape of the neck but maintain smooth contours.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Kenneth Hughes, MD · Answer

Hello, thank you for your question. You may benefit from a lower face and neck lift  and can be performed with a short scar that is just around the ear and does not extend to the sideburn or neck. I recommend you to schedule an email, Skype or in-person consultation with a board certified plastic surgeon.

Alejandro J. Quiroz, MD · Answer

Thank you for your question. As you had experience the noninvasive procedures have limitations and they have to be explain carefully to have expectation clear before you spend money. For your pictures you need to remove fat form the under chin but if you don’t have a good skin tone the open technique to remove fat and also tighten the muscles and removed skin.

Alan B. Brackup, MD, FACS · Answer

Thank you for your question and your photo. Based on the amount of laxity and your skin texture/tone I would recommend a necklift. There are some non-surgical devices that could give you improvement, but nothing will compare to a surgical procedure. If you meet with a board certified cosmetic surgeon they will be able to talk to you about your expectations and decide which is best. Hope this helps.

Zoran Potparic, MD · Answer

Based on this photo, neck lift would be a good procedure for you. This is done through a small incision underneath the chin. In person consultation with a board certified plastic surgeon with good reputation in face and neck lifts is recommended. Good luck.

David Hansen, MD · Answer

Getting the jawline and neck liposuctioned under local and then getting the platysmaplasty (neck tuck) at the same time would give such a beautiful neck/jawline. It is so easy to undergo with dramatic results.

Francis Johns, MD · Answer

Thank you for your question.I would like to see a photo of the whole face to really determine if anything needs done higher on the face. Based on this photo, I do think you would benefit from a neck lift. That would removed the fat from the neck and tighten the skin at the same time.

Thomas Trevisani, MD · Answer

In person exam is essential. Also,without  a full set of standard photos with all views- it's difficult to give the best answer. You may benefit from a neck lift . I suggest that you seek an experienced Board Certified PS for in person exam

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from a mini facelift with a neck lift. If good technique is used, this can be done with minimal scarring and can result in a natural look, not over-done look, with rejuvenation of your face. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results. Best wishes and good luck.

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon

Suggestions for fat pouch under chin and crepey neck skin?

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