Loose skin after jaw surgery - what are my options? (Photo)

Hello! About five years ago (I'm now 28) I received jaw surgery to correct my mandibular prognathism. I now have skin that appears to "hang" around my jawline, creating a kind of double chin issue, and I am so unhappy with my current profile. I am not sure what would be the proper procedure to create a more pleasing appearance: a facelift and rhinoplasty? Rhinoplasty alone? I appreciate your taking the time to answer. Thanks!

Doctor Answers 28

Don't like my neck and profile after jaw surgery

Based on the submitted photos, it may be possible to improve your neck with a limited surgical approach such as liposuction, or potentially injection with Kybella. Regarding your profile and nose, it is difficult to make a meaningful comment based on the information I have. Given the multiple areas of concern, your young age, as well as previous surgery, I would definitely suggest a formal consultation with a board-certified plastic surgeon so your specific concerns can be gone over in detail, a physical exam be performed, and individualized recommendations be made. Good luck!


A facelift can help address excess skin in the mandibular border region and give you a tighter more defined neck appearance.  You are young for this procedure but an inpatient consultation can help address the pros and cons of this procedure on someone your and and see if it is right for you. 

Options for loose neck skin at age 28

Your options are non-surgical or surgical in nature. Non-surgical neck contouring could combine neck fat reduction and skin toning (ie with Ultherapy). The changes will be modest in nature.

A necklift is the surgical alternative. The results will be more dramatic and long-lasting and requires a recovery. At 28 you are quite young for surgery; in exceptional circumstances, the desired outcome requires this approach.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 45 reviews

Loose Skin After Jaw Surgery

The best recommendation to improve your chin, jawline and neck appearance following jaw surgery depend on your needs, desires, and most importantly an examination to determine the best procedure for you. Your plastic surgeon will evaluate you for five main features that will determine your best options for neck line improvement:
  1. Amount of excess fat typically found beneath the chin, and in the upper neck. This requires liposuction with small cannulas or direct removal especially if the fat is beneath the platysma muscle.
  2. Presence of Significant (Platysmal) Banding – this requires bringing the muscles together in the upper/mid neck to a more youthful position and occasionally their release. This procedure is called a platysmaplasty or platysma plication. Mild banding can be treated non- surgically with Botox or Dysport but this requires injections 3-4 times a year for maintenance.
  3. Amount of excess/redundant skin (cutis laxa) and condition of your skin. In advanced stages this is called a Turkey Waddle or Gobble deformity. For example, younger age, darker skin colors and no large weight loss history most likely means there will be better elasticity and therefore better post-surgical contraction. In milder cases if not too much fat is present there will be enough skin shrinkage with just lipo alone. Mild to minimal skin tightening using non-surgical means like the Sciton Laser SkinTyte procedure, Ultherapy or Thermage could also be considered. My personal preference for non-surgical skin tightening of the neck is the Sciton Laser BBL SkinTyte® procedure as there is no down time, more comfortable procdure, is effective and is a more targeted treatment. For redundant upper and mid excess neck skin: I prefer the LiteLift® (lower facelift ) procedure or MACS for skin re-draping for mild to moderate excess skin management as there are minimal scars and the skin is lifted vertically allowing for minimal hidden scars resulting in a natural appearance “non pulled” appearance. However: for moderate to severe skin redundancy , a neck lift or traditional lower facelift (e.g.Lite Lift®, MACS and others) is needed with or without lipo for best results. For advanced Turkey Waddle correction wither a traditional facelift or posterior neck lift often with a platysmaplasty is required with more extensive scars that extend at the hairline behind your ears. The advantage of a facelift procedure rather than a posterior neck lift is that your lower jawline (e.g. jowls and marionette lines) are also improved at the same time.
  4. Chin deficiency. If you have a weak chin then you will not have adequate chin support to your neckline skin which affects your entire neck line. Sometimes especially in younger individuals this is all that is required and this can be done in the office under local anesthesia. There are a number of different sizes and shapes and your plastic surgeon will pick the optimal one for you.
  5. Presence of prominent Digastric Muscles or Submandibular gland fullness from laxity or enlargement. Although not a major concern for most patients, if present then partial resection is usually the best solution.   #jawlineimprovement

Facial surgery

You are definitely too young to get a facelift in my opinion.  As far as rhinoplasty is concerned, your photos don't make it obvious one way or another whether a rhinoplasty would be worthwhile in your situation,

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 24 reviews

Sub-mental fat elimination may be a good option

Instead of a facelift or rhinoplasty, you may benefit most from liposuction beneath your chin or non-surgical Kybella™ injections to melt that excess fat. At your age, and judging from your photos, a facelift doesn't seem to be needed. A rhinoplasty may make you feel happier with your profile, but I recommend consulting a board-certified plastic surgeon who can discuss what the results would look like. Congratulations on the results of your jaw surgery!

Adam L. Basner, MD
Baltimore Plastic Surgeon
4.8 out of 5 stars 35 reviews

Loose skin after jaw surgery and rhinoplasty candidacy

Dear Melissa, A consultation and examination is needed to determine if you are a candidate for sub-mental liposuction. If you are interested in having a rhinoplasty surgery then I do agree that rhinoplasty will help balance your profile nicely. During consultation computer imaging can be done which will show you the proposed changes of these procedures and then you can make a very informed decision if you want move forward. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 196 reviews

Jaw loose skin

If indeed there is loose skin. The skin needs to be adjusted to the new volume of your face now the mandible has being set down. Look for a good train surgeon with experience to have your surgery

Post orthognathic surgery

I agree with the other physicians, the surgery is a real good result. As far as your nose is concerned, you have a fairly good profile view with a nice smooth nasal bridge. A good facial plastic surgeon will look at the overall facial structure and not only the nose. Look for a surgeon who mainly focuses on noses and they can help you, through computer imaging, see how your nose would look like. Good luck! -Dr. Miguel

George S. Miguel, DO
Troy Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Loose skin after orthognathic surgery.

From the photographs I don't really see anything significant relative to redundant soft tissues. The orthognathic surgical result is quite good. As far as a rhinoplasty I would consult with the surgeon who is experienced in his operation and use video imaging to give both you and the surgeon and idea of what to expect.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.