Am I a good candidate for chin/neck liposuction and fillers for necklace lines? (photos)

Question

I'm 35 years old -- 5' 4" and 130lbs -- unhappy with the appearance of my neck. I have always grappled with a small amount of submental fat and horizontal neck lines, but both have worsened with age. Would chin/neck liposuction help eliminate my stubborn double chin and give me a more defined jaw line? And would filler reduce the appearance of the necklace lines?

Jeffrey Lisiecki, MD · Answer

Yes, both of these things would be helpful. Based on your photos, I would advise submental liposuction with some form of skin tightening like Facetite and Morpheus, as well as Morpheus to the necklace lines. Either before or after this procedure, I would also advise going in and using microdroplet filler and botox to the neck lines. Neck lines can be stubborn, so it's important to know that sometimes you need multiple rounds of the filler/toxin and/or Morpheus. A small amount of neck and jawline filler may also be helpful. Find a plastic surgeon you like and be seen in person to discuss your options and formulate a plan!

David Parizh, DO · Answer

Non surgical modalities exist for rejuvenating a neck. They do require maintenance and often times have a modest result. This can be costly in the long run. They are great for someone nervous about surgery or not looking for a significant improvement. 
Surgical options for a neck have to address the fat below your skin. The muscle laxity. The deep structures under that muscle which include the submandibular glands, the digastric muscle and the fat between them (interdigastric fat). I believe that a board certified plastic surgeon can help guide you in choosing the right procedure for you. I often perform a neck lift which addresses the above anatomy through a small incision below your chin. I’d be happy to see you, perform an exam, listen to your concerns and create a surgical blueprint to achieve your aesthetic goals. Best of luck!

Jason Emer, MD · Answer

"Injecting soft fillers like Belotero in this area can reduce lines, wrinkles and folds as well as improve skin texture with long-term collagen production. Fillers are being used more frequently to contour and lift rather than solely line fill. Of course, fillers are best used in combination with lasers and microneedling with PRP to get the optimal outcome.

I suggest getting a formal evaluation with a cosmetic dermatologist to create an individualized treatment plan that works for you. Best, Dr. Emer"

I suggest getting a formal evaluation with a cosmetic dermatologist to create an individualized treatment plan that works for you. Best, Dr. Emer"

Gianfranco Frojo, MD · Answer

You are a good candidate for submental liposuction. This can be performed in the office under local anesthesia. The necklines would likely be somewhat addressed if the submental liposuction released some of those adhesion points. The lines are natural flexion creases. I would recommend seeing a board certified or board eligible plastic surgeon with aesthetic surgery training/experience who can perform a full exam and provide safe recommendations.

Daniel Barrett, MD · Answer

Dear a.anne,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit form chin liposuction. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi Anne! Great questions. For the submental fat, you could consider liposuction, though there is a risk in thinner patients of creating noticeable lines or imperfections in the skin, especially on neck extension. I don't really use Kybella anymore due to the results being less than impressive for the cost and time involved. For the necklace lines, I would steer away from filler. The results can look quite odd with show-through in areas. Morpheus8 in your age group may be a fantastic option. This is radiofrequency microneedling which helps to tone the skin. The downtime is minimal and the results can be quite nice. Whatever you choose, consider the fact that surgery isn't without risks and may still require upkeep in the future. Hope this helps!

William Portuese, MD · Answer

The limited photographs demonstrate fat deposits in the neck for which liposuction can accomplish improvement in that area. You also have a recessive Chin profile, therefore consider placing a small chin implant to augment the chin forward for better structural support for the soft tissues in the neck. If you're really trying to obtain a high definition jawline, then consider a platysma-plasty in conjunction with liposuction. The horizontal creases in your neck cannot be improved with any type of surgery.

Kevin Tehrani, MD, FACS · Answer

Thank you for your question and posting appropriate pictures. He seem to be a very good candidate for liposuction and skin tightening. Typically this is something that’s performed under local anesthesia with minimal downtime. He may elect to undergo injections in the neck lines with either your own fat or combination of fillers at the same time. Is best to have a virtual or in person consultation for precise recommendations of course.

Darryl J. Blinski, MD · Answer

Great posted facial photos. I recommend sub mental lipo with HA fillers to jaw line (about 4 syringes). Maybe a MyElevate suture technique to obtain sharp jaw line. For horizontal neck lines I use hyper diluted Radeisee with micro dosed Botox. Fees en toto $8,000. Best to virtual consult with...

Mats Hagstrom, MD (license on probation) · Answer

The primary cause for your concerns is an under developed mandible.
Your mandible is small in comparison to your max a lot. This generally causes people to have an overbite dental occlusion, shows the upper lip having significantly more forward projection than lower lip and profile pictures, causes a premature double chin even at a low BMI, causes a lack of jawline definition and the development of premature jowls.Your fat distribution is normal and fat is not the underlying problem in your case.That said reducing fat especially in young people or those who are slightly overweight can give impressive results.
There’s a big difference depending on who does the procedure. The most impressive results come from those who’ve mastered how to do this and to find those individuals you’ll need to have multiple consultations to try to find the right provider.
If you want to address the issue head on and treat the primary problem and you need to talk to an oral surgeon. mandibular advancement is not for everyone but it’s important to understand that if the problem comes from skeletal structure soft tissue manipulation is not going to fix the problem and at best give you a partial improvement.
99% of individuals seeking chin and neck liposuction have an undersized mandible.
Best,
Mats Hagstrom MD

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