Can anything help a too-prominent, lopsided chin that's especially evident when I smile? I have a double chin, too. (photos)

It appears that major problem is small chin; augmentation with implant will significantly correct the problem. Whether additional neck surgery by means of neck lift or liposuction is needed can be assest only on the basis of in person evaluation. Good luck.

There are two fundamentally different approaches to your chin issues. Ideally a sliding genioplasty wold be beneficial as it would bring the chin out, improve the length of the jawline and stretch out he neck tissues. (it may be combined with some neck liposuction as well for the maximum benefit) This may or may not improve the soft tissue asymmetry as the advanced bone stretched out the overlying soft tissue pad of the chin. The second approach is to do s submental chin tuck with neck liposuction. This will help smooth out the double chin and may help the asymmetry when smiling....but still leaves the chin short with no help for the jawline.

The fatty deposits in the neck are best treated with liposuction, while a chin implant is required to augment the chin forward which is weak and recessive.  Both procedures are accomplished through an incision underneath the chin under local or general anesthesia.  The improvements are made at rest, not upon smiling and animation.  You will still be asymmetric when smiling.  For many examples and more information, please see link and the video below