Best option to reduce or remove loose skin under chin? (Photo)

Question

Hello, I am 5ft 9 174 lbs. I have had this double chin problem for a very long time . Recently I tried cool sculpting. At first it appeared to reduce my double chin but as time went on it came back. The specialist informed me I have loose skin . Is getting a neck lift the only option for this? What kind of cost should I be expecting for this surgery? If not surgery route, should I try kybella. Would losing weight to 160lbs help reduce this problem at all? Appreciate your honest feedback.

Stephen Prendiville, MD · Answer

Your question would best be answered by a consultation.  Depending on a number of variables including your age (not mentioned), presence or absence of a strong chin (not seen in profile), a surgical approach and potentially a chin implant may be the best solution.

Jason Emer, MD · Answer

"For a double chin, InMode FaceTite with VASERlipo would give you the best result.

With significant neck sagging you would need a facelift / neck lift with muscle tightening (platysmaplasty). At the same time, I would recommend lasers (Fraxel, CO2, Halo, or Erbium) and microneedling RF (Fractora, Morpheus8, PiXel8, Intensif) to improve the crepey skin and wrinkles. Overall, the neck can be treated with a combination approach:

1. Microneedling and laser treatments for texture
2. Botox, Dysport, Xeomin or Jeuveau to help platysmal bands
3. Intensif, Fractora, PiXel8, or Morpheus8 microneedling RF for crepey skin and lifting
4. Injectable fillers like Belotero, Restylane Silk, Versa, and Juvederm Volbella to improve lines and folds
5. Face/neck lifting if sagging is prominent or premature, with or without platysmaplasty (muscle tightening)
6. Renuvion (J-Plasma), ThermiRF, and InMode FaceTite/AccuTite for internal tightening
7. Ultherapy and Thermage for external tightening
8. Regular Venus Legacy, Exilis Ultra, or InMode Forma treatments with facials to maintain tightness
9. PDO NovaThreads or Silhouette InstaLift cone threads for lifting and long-term collagen production

See an expert for a formal evaluation and to develop a personalized treatment plan based on your individual situation and goals. Best, Dr. Emer"

Bradley Bengtson, MD, FACS · Answer

Coolsculpting
and Kybella are two excellent treatment options for fat reduction as they
specifically treat and damage/destroy the fat cells contributing to submental
fullness.  These treatments are indicated for fat reduction but are not
indicated for skin tightening.  Achieving a sustainable goal weight is
preferred when preparing for a treatment as this helps your provider best
assess and examine you at a baseline.  That being said, it is possible
that weight loss can contribute to skin laxity as fat distribution changes with
volume loss.  Ultherapy and ThermiTight are two non surgical options for
skin tightening.  Surgery is a predicable way to remove excess skin that
contributes to laxity that is outside the treatment parameters for non surgical
options.  Once you reach your goal weight I would recommend a consultation
with a board certified plastic surgeon where your concerns can be reviewed and
you can be examined to determine the best treatment plan for you!

Melissa Chiang, MD, FAAD · Answer

The physical examination and critical assessment is one of the most important aspects of the consultation.

Based on your picture, it appears that you have excess volume.  I cannot tell from the photo that you have loose skin.  I suspect that you would need multiple coolsculpting treatments followed by several kybella treatments for fine-tuning.  If you were open to surgery, you would achieve a better, faster result with surgery.

Daniel Barrett, MD · Answer

Dear ab102,Kybella typically takes 3 to 5 treatments to work. This is why I've stopped carrying Kybella in my office.  I recommend neck liposuction more often then any injectable procedure for the neck now. It provides superior results gives me more control over the area than any injectable.  It also costs about the same as what you paid for your first kybella session. The liposuction can be done under local while awake in the office and recovery is about the same as kybella.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery 
Member, Am. Society of Plastic Surgery

Kenneth D. Steinsapir, MD · Answer

I recommend that you look into a neck liposuction.  It is far less radical than a neck lift. You can have a neck liposuction and return to your schedule within a few days. If your surgeon does not want to offer just a neck liposuction, seek other opinions.

Sean R. Weiss, MD, FACS · Answer

you appear to have both excess fat and skin under the chin. This can be due to being overweight, and it can also be hereditary. If WeightLoss does not help in this area, it can be treated in a number of ways. Often times this is addressed with nonsurgical options such as Kybella injection and cool sculpting.  Alternatively, this area may best be treated with laser liposuction, or liposuction followed by skin tightening with Thermi RF.  Be sure to find a specialist with experience using all of these approaches including surgery to ensure optimal results. Best regards, Dr. Weiss

Ray Bayati, MD · Answer

Hello
Your loose skin seems related to excess fat tissues.
Your double chin seems extending beyond chin (submental) area so Kybella may not help to treat all area.
You didn't have good results with coolsculpting as you explained.
My recommendation is to go for liposuction. It would be done under local and costs could surprisingly be lower than other methods. 
Good Luck

Kouros Azar, MD · Answer

This is really something that absolutely requires an in person exam. Non-surgical options such as CoolSculpting or Kybella can get rid of the excess fat but they don't do anything for the loose skin. There are non-surgical skin tightening procedures but they are never going to be as effective as surgery so.... It's going to depend on your goals and the degree of your laxity.

Richard E. Moore, MD · Answer

Thank you for your question and submitting your photo. It is difficult to give you an exact answer without examining you and taking into account your age. Assuming skin laxity is present, two minimally invasive treatments should give you a very nice result - FaceTite/NeckTite and ThermiTight. Both of these devices use radio-frequency energy injected beneath the skin to destroy fat cells while achieving significant tightening of the skin. This is a one time treatment that tends to be more effective than Kybella. Kybella would likely require 3 to 4 treatments spaced 2 months apart with the potential for significant down time with each treatment. The cost for the NeckTite or ThermiTight procedure is typically around $3000-$3500. I hope this was helpful - Dr. Moore.

Best option to reduce or remove loose skin under chin? (Photo)

Answers (13)

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