How can I fix sagging skin under my chin after liposuction? (photos)

Question

I underwent liposuction on my jawline and double chin when I was 33. Two years later, my jawline is more defined but I've been left with sagging underneath my chin. I am pretty sure that the problem is excess skin rather than muscle laxity. Can anything be done to remove skin without having a full neck/facelift? I've looked into other options ( Facetite and Renuvion) but I've been told it can only make 30-70% improvement. Is this the best option for me?

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

Jason Emer, MD · Answer

internal heating witht renuvion j plasma or facetite would help but you have muscle banding that needs a platysmaplasty.  most my younger clients will do facetite with or without platysmaplasty, and then start morpheus treatmentts every 2-3 months, botox every 2-3 months and threads.  an early neck lift can be done as well.
With significant neck sagging you would need a neck/face lift with muscle tightening (platysmaplasty). at the same time lasers (fraxel,  co2 or erbium( or microneedling RF (fractora, intensif) can be . performed to improve the crepe skin or wrinkles.  You need a formal consultation, as the neck can be treated with a combination approach:
1. micro needling and lasers for texture
2. botox, disport or xeomin to help platysmal bands
3. intensif or fractora RF microneedling for crepe skin and lifting
4. fillers like belotero, restylane silk, juvederm volbella to improve lines and folds
5. neck/face lifting if sagging is prominent or early starting +/- platysmaplasty (muscle tightening)
6. J plasma/Renuvion, thermiRF, inmode facetite 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 full evaluation and treatment plan based on your individual situation and goals.
Best, Dr. Emer.

Kenneth Hughes, MD · Answer

Hello.
Great question. Thank you for your pictures. Based on your images, it appears you may benefit from skin tightening (FaceTite). Please visit a board certified plastic surgeon for a detailed surgical plan to achieve your desired results.

Sam Speron, MD, FACS · Answer

Surgery is not for everyone. In today's day and age, there are many surgical and nonsurgical options to address various concerns one has for their face as they age.In general, surgery is one of the best ways to address jowls. However, skin tightening and all sorts of injectables can definitely help significantly especially for patients that are not interested in surgery. If you're ever interested in surgery, the procedure is much different than what you're probably reading about online. A short scar facelift that addresses the jowls & marionette lines can typically be done under local anesthesia in the office, usually in as little as 20 to 30 minutes. There are usually no drains, recovery is quick and most patients take no narcotics.I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of facelifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and never be pushed out with just one suggestion. Ultimately there are pros and cons to every procedure whether it's surgery or not surgery. It should always be your choice. I have had 80 year old patients be very happy without having had any surgical procedures.I hope this helps and wish you all the best in your surgery and event. If it does, please take a moment to up vote this answer on the “respond” button on the top right.

David P. Rapaport, MD, FACS · Answer

Thank you for your question! For patients who has skin laxity in the lower face and neck, but do not wish to undergo a Facelift, I typically recommend Morpheus8. Morpheus8 is a relatively new treatment which combines adjustable depth microneedling and radiofrequency technology to target deep layers of your skin and remodel collagen. We customize each treatment based on patient goals and needs targeting the different areas of the face and neck with varied microneedling depths to achieve skin tightening or fat loss. We find that after 3 treatments, patients have significant improvement in skin laxity. Patients have minimal downtime and undergo the procedure 3 times, four to six weeks apart. Please consult with a board certified plastic surgeon to see if you are a candidate for this procedure.

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