Facial aesthetics is primarily determined by bone structure. It is bone structure, the differentiates, the appearance of men from women and those who are perceived as being more or less attractive. Issues related to premature double chins, lack of jawline, definition and premature jaws tend to coincide with individuals who have an underdeveloped mandible in relationship to their maxilla. This causes the underlying plates from muscle to drain the neck in a more oblique fashion. You don’t have an abnormal fat distribution. Your concerns come from the way your facial bone structure is. Recognize that soft tissue solutions to skeletal problems are inherently only going to give partial improvements. Liposuction can be helpful, but again it isn’t addressing the primary problem. Liposuction results are highly dependent upon who does the procedure. I cannot emphasize enough how much variation there is among plastic surgeons when it comes to Liposuction skill and experience. The fact that someone has 20 years of experience and his poor certified and plastic surgery does not mean that they have any real skill or talent with this procedure. Delivering consistent quality the most suction results is far more difficult than most people realize. The number of surgeons of truly mastered this procedure are in a small minority. For anyone, considering Liposuction I highly recommend being stringent about provider selection, and only choosing providers after having multiple in person consultations. There are many different tissue layers that have an impact on the lower 1/3 of the face and neck. Skin laxity can contribute last can how the plum muscle drapes the neck. Necklace and face lift is basically the same procedure. The operation is generally better for older individuals because with age patients become lesser candidates for Liposuction. The primary reason for this is with age we loose skin, elasticity, and skin laxity is one of the primary reasons patients failed to get quality, liposuction results. at age 50 people generally graduate out of being good Liposuction candidates and become far better candidates for a neck lift. The neck lift has the advantage of treating skin, fat and the plasma muscle, so it is going to have a greater impact because it treats three tissue layers But it’s still doesn’t address bone structure. This area is complex and there are no easy yes or no answers or definitive procedures. Jaw lengthening is usually out of the question for most people even though it is the definitive that treats, the primary problem. For these reasons different providers to have different opinions. That is often the case when there is no one definitive, correct procedure or there is complexity with multiple tissue layers involved. In a nutshell, Liposuction can give you partial improvements, but it is so provided dependent that you can’t really give a definitive answer in regards to it being a good or bad procedure. In the hands of the right provider, you will definitely have nice improvements from Liposuction but the reality of finding that one surgeon who mastered this procedure is fairly uncommon. There is such a discrepancy in Liposuction skill that I’m sometimes reluctant to encourage people to have the procedure despite the fact that those who mastered the operation can deliver, consistent quality, stunning results on a regular basis, and have the ability to differentiate those who are good candidates from those who were not. In other words , with skill and experience coast, ability to make an accurate assessment which delivers predictable outcomes. This is probably the greatest difference between those who have experience in those who have not. To find the right provider I suggest patients have multiple in person consultations with providers in their community. Avoid virtual consultations whenever possible. During each consultation, ask each provider to open up their portfolio and show you their entire collection up before, and after pictures of previous patients, who had similar facial characteristics to your own. And Experian provider should have no difficulty showing you the before, and after pictures of at least 50 previous patients. Being shown a handful of pre-selected images, only representing the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider, what your results are likely to look like or how many of these procedures they’ve actually done. In reality Someone who mastered the procedure will have hundreds or preferably thousands of before and after pictures to choose from. There’s no correct number of consultations needed to find the right provider. The more consultations you have the more likely you are to find the best provider. Considering how much variation there is among reputable plastic surgeons, when it comes to liposuction, I recommend patients consider having at least five consultations before having a permanent reversible facial operation that can potentially leave people disfigured. Best, Mats Hagstrom, MD