Would I benefit from a facelift for the lax skin under my chin? (Photo)

Question

Hi! I have slight lax skin under my chin. It's not a platysma band, it's just skin. I am pretty thin naturally although as an adolescent i was heavier. I have very stretchy skin all over my body. I am 41, work out daily and eat healthy. I'm 5'7 127 lbs. i consulted w a facial plastic surgeon who recommended a traditional facelift w platysmaplasty. I just wanted a second opinion.

Steven H. Wiener, MD · Answer

Thank you for question and photos. It appears that you have submental laxity, and no evidence of jowling.  Options include a platysmaplasty, which is a short scar under your chin, or posterior neck lift. Your lower face looks great, and I would avoid a facelift at this time.  Consult with a board-certified plastic surgeon to get another opinion.

Bora Ok, MD · Answer

Hi from Istanbul! You appear to have a slight laxity beneath the skin. A neck lift could be a suitable solution for this. Incisions behind the ears would be used to tighten the muscle tissue in that area for a more tightened and refined appearance to the under-chin area. Hope this helps!

Gianfranco Frojo, MD · Answer

That is loose skin overlaying one of the platysmal muscle bands. I would recommend seeing a REAL plastic surgeon certified by the American Board of Plastic Surgery (ideally with 6 years of integrated plastic surgery residency training and ALSO a 1 year aesthetic fellowship accredited by the Aesthetic Society). I would recommend a necklift only in your particular case; you are one of the few individuals who would be able to have a submental incision only to address this issue.

Michelle Lee, MD · Answer

Happy to provide a second opinion! 
I often see patients with similar concerns–young, healthy and aging well with just a small amount of lax skin under the chin that bothers them. It is becoming more and more common for patients to seek surgery to correct those very first signs of skin laxity/sagging to maintain a youthful appearance throughout their younger years. 
Your photos show that you could benefit from a neck lift or face lift. You are right about the skin laxity being the main issue rather than the platysma bands. However, the platysmaplasty is an important component of any neck or facelift to achieve a sharp jawline and maintain results by tightening the underlying tissues. It is difficult to tell without assessing in person whether or not a facelift is the best option as opposed to a neck lift but judging by your photos, you likely would do well with a neck lift alone.

Andrew Miller, MD · Answer

Based on your photos, a necklift would be the only surgical procedure to undergo at this point. There are non surgical procedures that could help including Ultherapy, J-plasma, and RF microneedling. You may want to try those before undergoing surgery at this point. Be sure to see a facial specialist for consultation.

Timothy M. Rankin, MD, FACS · Answer

In your pictures, you do not appear to have any jowls, though the pictures make it a little challenging to see. For very subtle skin improvement, I would start with a fractional laser that is safe for neck skin like Halo, or an effective RF microneedling like Profound or a slightly more invasive Renuvion. While its not uncommon for patients in their 40's to require a facelift/ necklift, these pictures show that you have a nice jawline. 
The other approach is almost prevention. You may find after a face/ neck lift that you will not age at the same rate as your peers and can help to ensure your privacy if you'd prefer no one knows you had work done. 
I would think that a Face/ neck lift for you may be a little premature but it depends on your goals.

Lucian Ion, FRCS · Answer

Thank you for your question and photographs.

In principle, this is an opportunity to decide what type of reshaping you wish to achieve for the contour under the chin, whether it is related to a smoother appearance or a more defined and smoother appearance.

The photographs shows some laxity under the chin which could also be a platysma band. You can test this by using botulinum toxin to relax the platysma muscle and see if the problem is resolved or attenuated.

There seems to be also some prominence of the left submandibular gland and a bit of prominence of the digastric muscles. If your goal is to achieve a very defined contour of the neck, a deep plane necklift may be more suitable in particular since your jawline contour is already good.

Zoran Potparic, MD · Answer

Although it is difficult to evaluate your condition based on these photos, it does appear that bands in your neck are due to mild platysma laxity. You seem to have minimal fat in the neck, no jowls, and a nice jawline; for that reason, my recommendation would be an anterior neck lift, using an incision placed underneath the chin. This is less than a lower face/neck lift already recommended but I believe that you can achieve good results and delay your facelift for another 7-10 years. Hope this helps.

Alex Neusner, MD · Answer

Hi,The simple answer to your question is yes, a facelift/necklift would tighten and elevate your skin and would help reposition some early descent of your midface/buccal soft tissue to soften your nasolabial folds (folds between your cheek and nose/mouth). HOWEVER, you have relatively minimal skin excess, a beautifully defined jawline, and appear to have excellent skin quality. If you have not already, I would recommend exploring non surgical skin rejuvenation therapies such as Ulthera or Renuvion. While I am not universally impressed by these treatments, I think you are an excellent candidate for these. Regardless of what you pick, I think you will have a beautiful outcome.
Best wishes.Alex Neusner MDLos Angeles, CA

Tanveer Janjua, MD · Answer

The laxity is not much. You are looking great overall and it would be an overkill to do a facelift. You are better off either doing Sofwave treatment for the neck or Thermitight. 
Best
Dr. J

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