What to do about fat pouch under my chin? (photos)

There are a few treatment options to try and improve the fat pouch under your chin.  As you mentioned, one option would be more liposuction.  Other options would be Kybella and CoolSculpting.  Kybella is a medication that is injected to dissolve the fat and CoolSculpting is a non-invasive procedure that kills the fat by freezing it.  

I would recommend Kybella, an injectable fat dissolver
that can minimize the appearance of a double chin. Approximately 3 treatments
are necessary for maximum result, spaced 4 – 6 weeks apart. If you are
looking for more of an immediate result, micro-liposuction to this area can be
another reasonable minimally invasive surgical option.Hope this helps and best of luck. 

Kybella is a fat dissolving agent marketed by Allergan, and approved by the FDA to dissolve under the chin fat.

 A full set of photographs and an in-person examination are required to determine what is causing the bulge in the lower neck. Most patients have accumulation of fatty deposits above AND below the platysma muscle which requires surgery to remove. A platysma plasty is also required to accentuate the jawline. For more information and many examples, please see the link and the video below

Hi, a non smiling true profile view would be helpful in the evaluation as I suspect, from these photos, that your chin is weak. I have performed many Chin Augmentations using chin implants for over 30 years. From the photos, your chin is weak. A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin. Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty. I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone. In my opinion, you are a good candidate for chin implant surgery. Excess fat and/or skin can be removed from under the chin at the same time using the same incision. Hope this helps.