How to determine jawline/neck/double chin skin laxity during a consultation? (Photos)

Question

How do you determine skin laxity during a consultation? Would this be an example of poor skin laxity, submental fat, or both? If both, is one more of an issue than the other? (An example, assume no history of smoking, tanning, on younger side).

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Sabrina Fabi, MD · Answer

In most cases, skin laxity can be determined through an in-person exam. Based on your photos, it does appear you have some submental fat that can be treated to refine your jawline. One option is CoolMini, which works by freezing and destroying the fat cells in the treatment area so they can be eliminated naturally by the body. Another option is Kybella, which destroys the fat cells via injection. The treated cells are eliminated in a similar fashion to CoolMini. The final option is liposuction, which removes the cells via micro-cannulas and gentle suction. 
If skin laxity is also a concern, you can combine liposuction with a nonsurgical skin-tightening treatment like ThermiTight to produce the best possible result. No matter which treatment you select, make sure the doctor performing your procedure is board certified with extensive experience in your procedure of choice to ensure the best possible result.

Douglas Wu, MD · Answer

While I would need to see you in person to determine whether skin laxity is a concern, it does appear that you have some submental fat under the chin that could be removed. The CoolMini device might be an option depending on the amount of fat you need to remove. Liposuction is usually preferred when there is a substantial amount of fat. This procedure uses micro-cannulas to gently suction the fat out of the area, leaving a more defined jawline. The procedure is performed with local anesthesia and recovery is typically just a few days. If skin laxity is also a problem, we could add a nonsurgical skin-tightening treatment like ThermiTight to ensure the skin conforms smoothly over the new contour. I recommend scheduling a consultation with an experienced, board-certified dermatologist who can examine you in person and create a customized treatment plan based on your precise needs and goals.

Daniel Barrett, MD · Answer

Dear Anna617,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would be a good candidate for a liposuction. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Leo McCafferty, MD · Answer

The best way to determine laxity during a consultation is by a physical exam and placing a gentle hand on the patient.  It appears from your pictures that you have fairly good skin tone and that you are fairly young.  Although I can't tell precisely form your photograph, I do believe you would be a good candidate for liposuction of the neck and jawline or possibly one of the non-invasive options such as Coolsculpting or Kybella.  Good luck!

How to determine jawline/neck/double chin skin laxity during a consultation? (Photos)

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