What to do with an uneven face shape and loose skin under my chin? (Photos)

Question

I'm 34 and I've lots and gained weight multiple times so I feel like the skin on my face / neck isn't as firm as it can be. what procedures do you think would be helpful to resolve my issues. 1. Skin under my chin 2. Uneven cheek area??

Raffy Karamanoukian, MD, FACS · Answer

Unlike other tightening treatments, Ultherapy only requires a single treatment every one to two years and has long-term effects in skin stimulation and collagen production. Ultherapy is ideal for men and women who are experiencing mild to moderate skin laxity and desire a noticeable and long-term skin tightening treatment without the complications and risks of more invasive surgical procedures. Ultherapy can be combined with dermal fillers, Botox treatments, chemical peels, skin tightening lasers, and skin facials. Our plastic surgery and cosmetic center in Santa Monica offers Ultherapy as a complement to other skin treatments and cosmetic rejuvenation procedures.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your photos and explaining your concerns. It’s very common to see some unevenness in the cheeks and mild skin laxity under the chin, especially after weight fluctuations.

For the skin under your chin, treatments like radiofrequency microneedling (Morpheus8 or Thermage) or ultrasound skin tightening (Ultherapy) can help firm and lift the area by stimulating collagen. If there’s a small pocket of fullness, Kybella injections can also be helpful to contour the jawline.

For the uneven cheek area, hyaluronic acid fillers can subtly restore balance and symmetry, while also enhancing natural facial contours. If there’s minimal volume loss, tightening treatments alone may be enough.

In most cases, a combination approach—using gentle tightening with selective filler placement—achieves the most natural and harmonious results. Over time, this helps redefine the lower face, improve firmness, and create a smoother, more balanced appearance.

Nelson Lee Novick, MD · Answer

Microdroplets of Botox placed along specific points spaced along the jawline, spaced along the uppermost portion of the neck and in a row spaced along the upper neck can lead to overall tightening of the jawline and upper neck. This would be a reasonable and relatively simple method for addressing your current concerns. You would be wise to consult with an experienced, board certified cosmetic dermatologist injection expert and best of luck.

Camille Cash, MD · Answer

You will likely have the best results from a combination of treatments.  Dermal fillers are a great tool to contour the face and help improve asymmetry.  For tightening you can explore Morpheus8.  This treatment combines RF technology with microneedling to improve overall skin tone and texture.  Three sessions spaced a month apart are generally advised for optimal results.  I've included a video I hope you find helpful.

What to do with an uneven face shape and loose skin under my chin? (Photos)

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