What are my surgical options to get rid of a double chin and loose skin? (Photos)

If your goal is a well contoured neck and jawline, then a platysmalplasty and chin implant will improve the contours and definition. Another option is a lower face and necklift and chin implant. Lack of chin definition and projection is exacerbating the condition.

The photographs demonstrate significant fat deposits below the platysma muscle, and that's why the liposuction was ineffective. A surgical necklift is required to remove the fat deposits below the platysma muscle which also includes a platysma-plasty to significantly improve the jawline. No skin removal is required. The photographs also demonstrate the recessive chin profile. Also consider placement of a chin implant to augment the recessive chin forward for better structural support for the soft tissues in the neck.

When doing a facial aesthetics it’s important to make an accurate assessment. In other words the surgeon needs to have the correct diagnosis in order for the outcome to be of quality and predictable.
In your case the primary problem is that your mandible is small in comparison to your maxilla.
Having an undersized mandible typically creates a premature double chin, lack of jawline definition, an overbite dental occlusion, an upper lip that has more forward projection than the lower lip on profile pictures and premature formation of jowls.
When the Mandible lacks sufficient projection the underlying platysma muscle tends to drape the neck in the more oblique fashion.
Augmenting the tip of the mandible or the chin alone does not change the position of the platysma muscle while a jaw advancement procedure does.
During facelift surgery there are two tissue layers that are manipulated. The first is the deep layer under the skin often called the SMAS or Superficial Muscular Aponeurotic System. It is the continuation of the platysma muscle that drips the neck into a membranous structure that goes up over the cheek.
This structure is created to be like a hammock and typically lifted straight up. when plastic surgeons talk about directions of pool we usually call it vectors. The vector of the platysma Paul it’s usually in an up direction the way you described what you’re trying to achieve. lifting up the platesism muscle allows the skin to follow and get rid of the double chin.
It’s true that the vector of the skin pull is more posterior or posterior superior and that is both for technical and aesthetic reasons.
Instead of trying to figure out how facelift work I suggest you focus instead I’m looking at what they deliver.
Male facelift surgery is tricky and more difficult than it is on women’s faces for a few reasons.The primary one is that men have bearded skin on their face and this gets moved during the procedure.
There’s a handful of plastic surgeons around the country specialize in male facelift surgery. there’s more variation and the outcomes the mail facelift surgery than female facelift surgery.
If you’re interested in that procedure I would encourage you to spend a significant effort in finding those few individuals who really have a name for themselves doing male aesthetic surgery.
Tim Marten MDin San Francisco or any other plastic surgeon trained by Dr. Bruce Connell would be an example. Individual plastic surgeons who did fellowships under the late Bruce Connell and members of an informal society called the Connell Society.
Any of those plastic surgeons would be good ones though there is no website so finding them can be difficult.
Your post says you live in Emeryville so at least Timothy Marten MD is at your disposal if interested.
Best,
Mats Hagstrom MD

You have a common issue. Male patients tend to have 'heavier skin' with laxity. As well, the actual jawline/bone support is weak so there is less definition along the jawline when the head is in a neutral position. Xrays and clinical Exam determines how the bone influences the result. Otherwise, the necklift approach does work to 'lift/retract' the skin towards the back of the ear with an occasional incision needed to flatten the area under the chin. The surgeon will guide you