Neck lift or other procedure to define my chin/neck? (Photo)

Question

I am 49, and cosidering a procedure to define my chin/neck. When I was a child/in my early 20s, I was quite skinny and very active - but always had a 'loose' chin area, lacking a defined angle. With age I gained weight, but am still active, and my chin is very 'full', a double chin is prevalent when I look down. I tried liposuction some years ago, which did nothing too change the shape. Which procedure could help?

Richard G. Schwartz, MD · Answer

Since liposuction didn't help define your neck, I would recommend one of two options, with the choice depending on your scar preference.  A standard necklift, which leaves a scar around and behind the lower ear, traveling into your hair behind the ear as well as a short horizontal scar in a natural chin crease, would allow the surgeon to surgical trim away fat from your neck both in the subcutaneous plane and from under the muscles in the front of the neck, tighten/lift your neck muscles in the front, and remove excess skin and tighten neck skin from behind the ears.  If you didn't mind having a visible zig-zag scar running vertically in the front of your neck, then the same improvement in skin, fat, and muscles can be achieved by a less extensive anterior necklift in the front, but it does leave a visible scar.  Both approaches should create better jawline and neck definition.

Jason Emer, MD · Answer

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime.​  Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Jonathan Kulbersh, MD · Answer

Thank you for your question. Being that you didn’t receive your desired results from facial liposuction, you may be a good candidate for a lower rhytidectomy, or neck lift. This dual surgical procedure can tighten and reduce loose skin through cervicoplasty, while also tightening the deeper neck muscles through platysmaplasty to help produce a long-term result. I recommend that you schedule an in-person consultation with an experienced, board-certified facial plastic surgeon who can help assess which procedure would be the best option for your specific needs.

Zoran Potparic, MD · Answer

Based on these photos, major correction is required in the neck. Extensive shaping of superficial and deep fat in the anterior neck, platysmoplasty with transection of platysma muscle and, very likely, conservative skin excision in front and behind the ear, will be needed to achieve good result. In person consultation with a board certified plastic surgeon, expert in face/neck lift, possibly 3D simulation, is recommended. Good luck.

Akshay Sanan, MD, FACS · Answer

Dear Generous665366
Thank you for uploading your photos. You are a good candidate for a deep neck lift based on your history and photos. You said you have always had a loose chin area and lack a defined angle. This is why liposuction did not help your problem. You have deep neck fat (genetic) and an obliquely shaped platysma muscle (genetic). These layers are addressed with a deep neck lift. You also likely have large submandibular glands that would be reduced in surgery. If you had presented in your 20s you would have been a good candidate for an isolated deep neck lift. Since you are 49, your skin has lost elasticity and needs to be lifted as well, which is addressed with a lower face/neck lift, to pull back, tighten and remove any extra skin. The procedure of a lower face lift and deep neck lift will help you achieve your goals and give you the best version of your face/neck for your anatomy. 
All the best,Dr. Sanan, MDFacial Plastic SurgeryLos Angeles, CA

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