Late 30s, 2 children - my double chin never goes away, neck lift? (Photo)

"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"

Thank you for your question. Excess skin under the chin that doesn’t respond to diet and exercise is generally caused by accumulated submental fat in this common problem area. If you are looking for a treatment option that is less invasive than a neck lift, a non-surgical injectable may be right for you. Injectables such as Kybella® can melt this collected fat away to reveal a more defined and youthful jawline. Facial liposuction is another option for removing unwanted submental fat. I recommend that you schedule an in-person consultation with an experienced, board-certified physician who can assess your individual needs and help you decide on the best course of action.

Thanks for your question. The fullness under your chin is indeed likely fat - or at least partly fat. It is NOT just below the skin surface which can make it difficult to treat with liposuction or injections like Kybella. This fat is often below the muscular layer, or platysma muscle, in the neck. It has likely been there since you were very young and doesn't respond as well to weight loss. This can be removed and is best done, in my hands, through a small incision under the chin. The muscles can then be tightened through this incision as well. You have youth on your side which will help for the skin and soft tissues to retract up and tighten. Visit with a board certified facial plastic surgeon to see what is best for you based on an in-person exam.

Based on the 2 posted photos a mini extended neck lift with muscle plication would offer best outcome. Fee $10,000. Best to virtual consult with...

Hello athelon,
Thank you for asking this question and posting your photo and sharing your history. When patients describe your situation - about gaining and losing weight - and not losing the double chin, this is a deeper neck content issue and not superficial fat. Superficial fat comes and goes with weight changes and is addressed with liposuction. Your anatomy shows the following: a loose platysma muscle, and deep neck fat fullness. This is best addressed by a deep neck lift. You have great jaw structure and your skin has great texture and elasticity. A deep neck lift would allow to make the under chin area as tight as possible. I would not recommend non surgical treatments like Kybella or Facetite or Morpheus 8, because they will not address your underlying anatomic issue. I hope this helps clarify.
All the best,
Dr. Sanan, MDAkshay Sanan MD Facial Plastic SurgeryLos Angeles, CA

From the one photograph, it appears that you have fat deposits located above and below the platysma muscle in the neck. A surgical neck lift involves removal of those two fat compartments with surgery and open liposuction and then performing at platysma-plasty to significantly improve the jawline. No skin removal is required when you're your late 30s

The answer depends upon the laxity of the soft tissue when the head is in a more upright position than the photo. Often there is a fat pad under the chin which does not change much with weight.loss. At your age the skin usually has good elasticity so liposculpture can often help.