Submental/Neck lipectomy vs liposuction?

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation. I prefer a combination of direct lipectomy and liposuction of the neck.  A chin implant can be performed at the same time for
improved jaw line contour.  I always use a medpor implant with screw
fixation, which stays in place over time.  A silicone chin implant has a
high rate of malrotation over time.  Make
sure you specifically look at before and after pictures of real patients
who have had this surgery performed by your surgeon and not just a computer
animation system. The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

In some cases, skin flaps are fully elevated and the majority of fat is removed with a liposuction cannula. The entire layer is defatted in this open technique. Some areas under the muscle can be defatted as well and a cannula might be used as well. Areas of residual fatty deformity can also be sharply excised with a scissor or knife. In a closed technique, the flap is not raised and fat is taken out via non contiguous tunnels on top of the muscle. It has a quicker recovery and less risk of hematoma with the closed technique, but in the open technique, you can see everything you take out.

Great question. With advanced liposuction techniques, you have far better control and predictability managing the neck fat with liposuction, particularly SAFElipo, compared with direct excision. This is why patients wanting removal of fat from their hips use liposuction and not direct excision. Direct excision also requires direct visualization and therefore much larger incisions and recovery and risk. If the problem is simply fat excess from the neck, I perform neck SAFElipo 10 times out of 10. If the patient also has a skin or muscle problem, then that is a different scenario. But, for  an isolated fat problem, some surgeons are not trained in advanced liposuction and in their hands, they may get better results with direct excision. I would seek another opinion and consultation. Hope this helps. 

 It's important to know that there are two compartments of fat in the neck, and they're located both  above and below  the platysma muscle in the neck. Some patients have more fat located above the muscle, while other patients have more fat located below the muscle. A surgical lipectomy is required to remove fatty deposits underneath the platysma muscle, while liposuction is performed to remove the fatty deposits above the platysma muscle. A platysma-plasty is performed after fat is removed from below the platysma muscle. In our practice, this is considered a necklift. A lower face and neck lift is required if there is loose and inelastic skin in the neck.  For many Neck lift examples, please see the link and the video below