Age 49, male, Can anything be done for subcutaneous fat loss, aged skin & neck? (Photos)

Question

I am a 49 year old male with universally aged skin and subcutaneous fat loss to my face as a result of a side effect of a medicaton . I have now lost definition to my neck, with excess skin/fat beginning to gather loosely. I would like to redress the fat loss (around my eyes and to my cheeks), improve my neck and skin quality. What would you suggest? I have some concerns about scarring due to the poor quality of my skin.

Sam Speron, MD, FACS · Answer

Congratulations on your weight loss!  Thank you for your question and pictures! Significant weight loss changes your body a lot. For most, a lot of extra skin is left behind especially on the face, neck and chin. Timing can vary but when at ideal body weight is the easiest although some patients get it done a few times on the way to their goal.

It can be confusing to try to figure out which procedure works best for the aging face and the timing. A mini facelift is a great option for many people, but massive weight loss patients might need full one. The recovery & downtime is very minimal. There are usually no drains, most people can go out the same day, you can shower the next day, there're no scars behind the ears and you can wear your hair up anytime and most patients take no pain medicine. The result is usually the same in selected patients as a full scar facelift, but it really depends on your exam.

Surgery is not for everyone though. In today's day and age, there are many nonsurgical options to consider although surgery usually gets the most improvement specifically of the neck and jowls. Aging lip lines, forehead wrinkles and skin tone can be nicely improved with injectables and laser treatments.

I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of mini facelifts and neck lifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.

I hope this helps and thanks for your question!

Jonathan Kulbersh, MD · Answer

Hello, and thank you for providing images along with your question. Based on your photos, you appear to be a good candidate for tear trough fillers and a neck lift. By injecting small amounts of filler around the tear trough, we can add subtle volume that smooths out the visible groove in the skin. You may also consider fat injections for a more permanent solution. 
To address your jowls and achieve better jawline definition, a neck lift will help rejuvenate your lower face area. It involves making a small incision underneath the chin and then tightening the platysma (the muscles of the throat region) to produce an angled jawline. The surgeon will also tighten the deeper tissue along the jawline and around the lower part of the ear to pull up the sagging tissue. This technique results in a smooth and very defined jawline. 
Many patients will also opt to have excess fat on the neck and jowls removed with liposuction at the same time as the surgical neck lift to produce optimal results. To better determine your eligibility for any procedure, I recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon. Your surgeon can evaluate properly, customize the best treatment plan, and ensure the best possible results.

Mansher Singh, MD, FACS · Answer

Your pictures are not very clear due to blurring but from limited visibility and looking at your profile view, you would benefit from necklift and potentially a facelift.

John M. Rowley, MD · Answer

I would recommend fat grafting or off the shelf fillers i.e. Juvéderm for the loss of volume around your eyes. I would recommend a direct neck lift for your neck. This does involve a vertical incision in the middle of your neck, but in my experience it is usually barley visible after the scar matures. I perform this procedure in the office with local anesthetic and there is minimal recovery time.

John Michael Thomassen, MD · Answer

A face and neck lift would be recommended to remove the excess skin after weight loss.  Some fat grafting around the eyes would correct the lower lid grooves.  Scar quality can be excellent by avoiding excess tension.

Barry M. Weintraub, MD, FACS · Answer

Male facelifting is extremely specific, and quite different from female facelifting. I see in your photos jowls that hang over your jawline, and an obtuse neck that is fatty and possesses skin laxity. This excess skin and fat of the neck you yourself have, in one photo with your hand, demonstrated the effect of resuspension, thereby mimicking an actual neck lift and lower facelift. On the other hand, your upper face seems devoid of subcutaneous fat. There is also apparent circumferential folds onto your cheeks in your smiling picture. This is something I commonly see in patients in my own practice. The solution for your issue is a subcutaneous resuspension of the midface, with fat transfer to reinforce your subcutaneous fat loss of your mid- to upper-face. Male facelifting is particularly challenging since deep SMAS support is mandatory for a long-lasting result, and suture closure must be extremely meticulous so as to be virtually unseen.

Jorge Espinosa, MD · Answer

Thank you for your question. I think you can be a very good candidate for having a rejuvenation surgery. for example a neck surgery and a facelift can help you solve some of the the questions you have about the sagging of your skin. usually The healing of the scars in the face are very good but I think you should go to a consultation in order to evaluate your specific case and decide with the doctor which will be the best procedure for your face in order to fulfill your aspirations.

Age 49, male, Can anything be done for subcutaneous fat loss, aged skin & neck? (Photos)

Answers (7)

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