I’m 35, fit, average diet, 25% body fat, but I have a double chin. Advice? (photos)

Question

I’m 35, fit, average diet, 25% body fat BUT I have a double chin And it’s making me so miserable I don’t know what to do anymore. My face is quite flabby, and it just feels heavy, my mouth pulls down at the sides and I have no jawline. I’m not sure whether Vaser Lipo is the way to go or whether I need a face and/or neck lift Any advice would be appreciated

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. Based on the images, I might recommend a surgical neck lift, which could remove the submental fat as well as a portion of the submandibular glands and digastric muscles. This procedure would require a couple of weeks of recovery time, but would produce dramatic, long-lasting improvement for you. If you didn't want to commit to surgery at this time, you could consider liposuction to remove the submental fat. I encourage you to schedule a consultation with an experienced, board-certified facial plastic surgeon for further assessment and a customized treatment plan based on your precise needs and goals.

Jason Emer, MD · Answer

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 morpheus 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.

Charles H. Thorne, MD · Answer

The only procedure that I think will help you enough to make you happy is a necklift with removal of the subplatysmal fat and partial removal of the submandibular glands and digastric muscles. It sounds like a big procedure and I guess it is for someone your age, but I honestly think it is the only thing that is really worth your time, money, recovery etc.. It would give you a clean jawline and neck contour which I just don't think you can get any other way.

Val Lambros, MD, FACS (retired) · Answer

If you have a lot of money and time the perfect solution would be top get a necklift with removal of the submandibular glands and digastric muscles. A pleasing, but not so perfect result would be to do a little liposuction in the submental area. This is an office procedure under  local anesthetic, the skin will be fine and not wrinkle or sag

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