41, under neck is loose and ugly & getting worse, can I get muscles tightened? (Photos)

Question

What is this?? I never had this before. Over the last few years I noticed this "sagging" "drooping" I don't know what else to call it! I hate it with a passion. I'm 41, and it just started appearing a couple years go and is getting worse as time passes. I've always been thin and I've never had a "double chin" Can I get my muscles tightened? I'm hesitant to get any lipo as I've read it can cause loose skin. What do I do surgically to remove? I do not want any radio frequency or energy device

Steve Laverson, MD, FACS · Answer

If that bothers you at age 41, it's likely worth investing in the procedure that will produce for you the best result forever, a neck lift.  Non-surgical measures (Kybella, FaceTite, Morpheus, etc.), and even non-invasive procedures like liposuction will not resolve fullness in that area from sub-platysmal fat, anterior belly of your digastic muscles, platysmal diastasis, your submandibular glands, etc.  Find a surgeon who does an excellent neck lift for a slim neck, well defined jaw-line, and no localized sagging or bulges.

Gianfranco Frojo, MD · Answer

I would recommend a necklift.  I would recommend seeing a 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).

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photographs.

The area that concerns you seem to be related to the volume of the digastric muscles. They will not be adequately treated by liposuction.

Deep plane neck lift procedures tend to address the volume situated deep to platysma muscles for the appearance of the area under the chin both in neutral position and in neck flexion.

Depending on the elasticity of the skin, it is possible sometimes to do just the volume reduction through a 3 cm incision under the chin. Individual characteristics of the skin or patient preference may require skin tightening also.

The photograph suggest that if the skin has slight laxity, so an isolated necklift which associates a small amount of skin tightening in the back of the ear and in front of the earlobe may be sufficient.

Depending on the characteristics of the change that you wish to achieve, this type of surgery can be complemented by a facelift intervention. The purpose of the facelift would be to address the slight laxity next to the corners of the mouth which is visible mostly when leaning forward. The facelift also creates a more V shaped contour of the lower face.

In essence, you can decide whether management of the neck alone or facelift and neck contouring are your preferred course of action. I suggest that you examine your face lying down completely flat without a pillow and then sitting up. The appearance of the face when lying down is relatively close to the impact of a dee plane facelift intervention.

If you feel that this is the direction that you want to take the combination of procedures is preferable. If you feel that it brings relatively little benefit for your facial features, you could just focus on the neck and that should be your answer.

Jacob Tower, MD · Answer

Hello, hope you are well. Thank you for submitting your photos and questions. It appears that you have submental fullness which is clearly visible on the A-P and profile views. The most straightforward and reliable way to treat this is with a neck lift via a small incision under the chin. This allows access to deep fat deposits and muscle that can be contoured, and tightening of the superficial muscle layer if needed.
Best,Dr. Tower

Zoran Potparic, MD · Answer

Based on these, less than perfect photos, it seems that correction of the anterior neck fullness and laxity  by means of neck lift would the way to improve your current situation. However, only on the basis of in-person consultation or, at least, teleconference,  an experienced face/neck lift surgeon could decide whether lower face lift should be considered as well. Hope this helps.

Samuel Lin, MD, FACS · Answer

Thank you for your question. In this area typically immediately behind the chin there is skin and fatty tissue. There are muscles in the area as well and a range of treatments available from more noninvasive methods such as injectables and energy based devices (Facetite) to more procedure based approaches (liposuction, direct removal of fat, muscle tightening). It will be key to see your plastic surgeon who has experience treating this area to examine the area to determine with the patient a  plan--

Connie Hiers, MD, FACS · Answer

Welcome to middle age! Yes, you can get some really effective noninvasive treatments like Secret with radiofrequency and micro-needling to help tighten and tone your skin.

William Portuese, MD · Answer

At 41 years of age, your skin tone in the neck should be acceptable. A neck lift procedure can accomplish removal of the fat compartments above and below the platysma muscle in addition to a corset platysma plasty to significantly improve your jawline. No skin removaI is needed. A Full and better set of facial and neck photographs would be required to make a determination

41, under neck is loose and ugly & getting worse, can I get muscles tightened? (Photos)

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