Would I benefit from liposuction on my neck, jaw, face? (Photo)

Question

Hi, I need help trying to find the right procedure for my neck and jawline. I'm a 38 year old male. I'm not sure if it is sagging skin or fat on my neck/. The skin seems tight where I can't pinch it like my skin on my hand, but i can pinch large areas of it but there doesn't feel like there's anything there like fat , so not sure if I need a facelift or lipsuction. I can provide photos. Any help would be appreciated. Thank you

Franklin D. Richards, MD · Answer

From your photos, the short answer is absolutely, yes. At 38 years old you should still have great skin elasticity. Liposuction of the neck not only removes the excess fat, but it gets the remaining tissue to fibrose (or scar up) to the foundational base of the underchin and neck. In young individuals this works very well and avoids the need for a necklift or facelift. Older individuals that have lost skin elasticity and tone will not have such a good result.

Bora Ok, MD · Answer

Hi from Istanbul, thanks for your question. A combination of liposuction and a chin implant might be the solution for your concerns. These procedures together could address the issues you're experiencing with your neck and jawline. More extensive treatments, such as a neck lift, seem premature and possibly unnecessary at this stage. Best of luck on your journey!

Matthew Schulman, MD · Answer

Based on the photos, it does appear that you could benefit from some targeted liposuction of your chin area. You do not have a lot of fat, but it only takes a small amount of extra fat to give a fuller appearance to that area,  It is hard to see from the photos, but it does appear that you have a small lower jaw and often we combine liposuction and a small chin implant to give a more contoured appearance. Seek a consultation with an experienced plastic surgeon and see what they say.

Lucian Ion, FRCS · Answer

Thank you for your enquiry and sharing your photographs.
The volume under the chin and it is of concern to you consists of some fatty tissue situated under the skin, some Tissue situated deep to the platysma muscles, the volume of the digastric muscles and the volume of the lower part of the submandibular glands.
Contouring the area to the characteristics that you are depicting in the fourth photograph involves reduction of all these contributions to the volume excess and can be carried out through a 3 cm access incision under the chin. There is no skin excess to address and therefore the facelift would not be of any benefit in your situation.  There are no scars around the ears with this intervention

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jacob Tower, MD · Answer

Hello, hope you are well. Based on your age and appearance, skin laxity is unlikely to be the primary issue that needs to be addressed. Loss of neck and jawline contour is much more likely to be from subcutaneous and subplatysmal fat depots. Your best result would be with a neck lift to remove subplatysmal fat, along with subcutaneous liposuction and bipolar RF (i.e. NeckTite) to tighten the soft tissue envelope under the jawline. Good luck!
Best,Dr. Tower

Michael P. Morrissette, DDS, FACS · Answer

The facial covers up some of the important anatomy, but you likely need some additional horizontal projection of your chin with either a genioplasty or chin implant. I usually recommend simultaneous chin and jawline liposuction.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Shah Facial Plastics. This is a great question. I highly recommend scheduling an in-person consultation in order to better assess your areas of concern and discuss an appropriate treatment plan to help achieve your aesthetic goals. Our office phone number is: (312) 944-0117. I hope this helps and best of luck!

William Portuese, MD · Answer

At age 38, your skin tone should be acceptable, however, you do have significant fat deposits, located both above and below the platysma muscle in your neck. A  neck lift would be required to remove the fat deposits above the muscle with liposuction, and surgical extraction of the fat deposits below the muscle, which also includes a platysma plasty to significantly improve the jawline. No skin removal is required. This is usually performed through a 1 inch access incision underneath your chin, and is performed under brief general anesthesia.

Mats Hagstrom, MD (license on probation) · Answer

Facial aesthetics are primarily determined by facial bone structure. Soft tissue coverage tends to be fairly consistent from personal person and what gives each individual person their own facial characteristics, whether desirable or not is more based on bone structure. Individuals perform a premature double chin with loss of jawline, definition, and premature jowls. tend to have a facial imbalance with mandible that is small or lacking in projection in comparison to their maxilla.
Decent individuals will typically have an overbite dental occlusion. On profile pictures often the upper lip will have more forward projection than the lower lip, even though the lower lip tends to be larger than the upper lip.
 When the mandible doesn’t have sufficient projection, the underlying plate muscle will drape the neck in a more oblique fashion, causing the above stated aesthetic issues. Implant or sliding genioplasty will help individuals hack projection of their chin, but will not move the body of the mandible forward.
Treating the primary underlying problem is often seen as to invasive and undesirable so both patients and providers look for easier softer alternatives.
Recognize that soft tissue manipulation is at the best. Going to give you partial improvements when it isn’t addressing the primary problem.
You are correct in your assessment regarding lack of fat.
That should tell you that Liposuction isn’t going to have much of an impact.
 Well done necklace may or may not be appropriate.
I have seen surgeons who can suspend the neck using a permanent suture with good results (until the suture breaks)
You’ll probably find that both assessments and treatment options are going to bury from provider to provider.
This is often the case when there is no simple, definitive issue or treatment.
If you really want to move forward with surgery, then I suggest scheduling multiple in person consultations with providers who seem to have substantial experience doing male Aesthetic surgery. A male neck lift is inherently different than female surgery.
During each consultation ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar characteristics to your own.
 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 for your needs.
I don’t think it’s possible to select providers without in person consultations.
When in doubt, slow down and schedule more consultations.
 no one has to have cosmetic surgery. 
We can’t really give you a good assessment based unlimited pictures.
The lower 1/3 of the face is always judged in context to the rest of the face.
Best,
Mats Hagstrom, MD

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