Nefertiti necklift w/ Botox after chin lipo (photo)

Question

I’m 52 and six weeks post-op from traditional chin liposuction. After reviewing my before-and-after photos, I still notice jowling and less definition along the jawline and marionette areas. My surgeon has recommended a Nefertiti neck-lift with Botox—will that on its own create a crisper jawline, or should I also consider fillers or other treatments?

Oliver Chang, MD · Answer

Based off your limited photos (and very small resolution photos) - jowling is present lifting needs to take place above that facelift (not neck lift). You could benefit more from a neck lift to give a more distinct submental angle. But consider discussing a facelift (+/- browlift, bleph) with your surgeon or second opinions to really address the correct things you want to address on your neck and face for a more rejuvenated look.

Kyle Kimura, MD · Answer

Great question and thank you for providing photos!
While submental liposuction is a great procedure, it does have its inherent limitations. Notably, fat is removed which can decrease some fullness in the area, but this does nothing to lift the jawline or address excess skin. I do not think botox is going to create a significant change, though it is an easy procedure to perform and you don't necessarily lose anything at least trying it. 
The option that is most likely to get you the results you want (improved jawline, decreased jowls) is going to be some version of a face and neck lift. This is the only procedure that truly lifts the tissues that have descended over time which contribute to jowls and fullness in the neck. 
Hope this helps and best of luck! Kyle Kimura, MD

Christian L. Stallworth, MD · Answer

Hello nadeto-
1.  You will still continue to get some noticeable improvements through tissue tightening for another 6-8 weeks.  You aren't done healing.
2.  You had a minimally invasive procedure that only targets a focused area and focused tissue layer.  You will never remove the jowl, elevated the face, tightened and redistribute muscle and fascia, address deeper structures like buccal fat, salivary glads, etc with superficial liposuction under the skin.  "Mini" procedures yield "mini" results and what you have achieved with this procedure looks nice and expected.
3.  To truly obtain a lasting improvement in the jawline, the face and neck must be surgically lifted.  You certainly don't have to have surgery, but I would not expect a surgical result from a mini-procedure.
4.  Which then also brings up the fact that your "surgeon" is offering non-surgical botox injection to shape and create the look you want.  Fillers and Botox will not achieve the result you likely want.  By themselves, they are cheaper and less invasive than surgery, but if you continue to add the cost overtime you will likely find less satisfaction, a suboptimal result and MORE expense over the next decade going the minimally invasive route. 
5.  If you were my patient, and depending on your goals and exam, I would recommend a deep plane face and neck lift, recover, and then enjoy the results for years and years to come.

Michele A. Shermak, MD · Answer

This Botox treatment is subtle and will only last 3-4 months. I think filler would make more sense. Volux is a great one to enhance the jawline. And it should last for over a year. You may want to consider other options. I would recommend you see a board certified plastic surgeon. You can find one at plasticsurgery.org. Best of luck to you!

Zoran Potparic, MD · Answer

One could say that there is some improvement but nothing significant, unfortunately. A neck lift or lower face/neck lift is appropriate procedure which will create desired look. In person consultation with a board certified plastic surgeon with good reputation in facial rejuvenation (face/neck lifts) is recommended. Good luck.

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