Thank you for your question. You submitted 3 photos asking about the best way to get a tight neck and jawline, and how to improve the appearance in this area. With the photos you submitted, I can see enough to give you some guidance like how I discuss this with my patients in my practice.
To give you a little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years and facial rejuvenation is a big part of my practice, and people wanting to see better definition of facial features, whether it’s cheekbones, jawline, and neck are very common issues.
In the context of the limited views of your photos, I’ll give you first some global understanding of how I have a discussion with patients, then I’ll give you some ideas of what I’ve done for people in specific, unique scenarios , as well as more common scenarios.
Let’s begin with your baseline appearance. Has this always been an issue for you? How well-defined has your neck been? Is this a family trait? Often, people will say that in their family, everyone has this volume under their chin, or all have short necks, or that type of scenario. Another circumstance that affects the definition is physical weight -some people tend to gain volume in their cheek and neck areas. There are also people who can be fit otherwise, but still not have good definition around this area, so I want to help you distinguish a bit the difference between tight and defined.
In your situation, I think what you want is better structural definition. I think it’s a little too early for you to have a lifting procedure as you are relatively young. The procedure that can define this area is perhaps liposuction, with the skin having a tendency to retract when fat is reduced in some critical areas, then you get that definition. I always explain to patients that a young face is not a tight face, and an attractive face is not a tight face - it is really about definition. I think it is very straightforward that a liposculpting procedure is beneficial.
One thing I really want you to understand is fat isn’t completely the enemy. Fat in the wrong places can be sculpted, and fat is very important for youthful skin to have a certain amount just below the skin to create a nice, soft, youthful look. One of the unfortunate realities of surgery done very aggressively is it can result in wrinkling and aged appearance of the skin. When you look at a young person, a teenager, a child, or someone in their 20s, they have this nice look of smoothness and softness reflective of several factors, but one major factor is often referred to as baby fat, which is the fat layer under the skin.
I would say in situation like yours, if you have any plans to lose weight, I would say reevaluate after the weight loss. The reason is often when people lose weight, they tend to lose weight in their face, which is like self-lipo, so by just reducing fat globally, they get better definition. If someone is pretty close to their ideal weight, or they don’t expect to lose weight any time soon, then strategic liposuction can be an option. We had a patient who was planning to get married in a few months, and she was at a certain weight that wasn’t going to change much in that timeframe, so for her this procedure turned out to be perfect. Liposuction really defined her face and neck in a way that would really work favorably for her.
I think the take home message here is first, is there a more global issue with the distribution of fat, and if so, is there something you can address holistically with weight loss? Two, if that isn’t the situation and you are likely to stay at a certain weight for the long-term, or for the next few years, then liposuction at this point is likely to be of value to you.
Meet with qualified, experienced cosmetic surgeons and decide who you are comfortable with and how you want this done. We generally do this procedure under local anesthesia with very light sedation - it is a very straightforward procedure that doesn’t take long to do. It is an art, with the talent to take some fat out, and leave some behind just to get the best sculpting and contour. I hope that was helpful, I wish you the best of luck, and thank you for your question.
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