The direct excision is sometimes called a platysmaplasty. Fat directly below the skin can be removed through liposuction. Platysmaplasty can remove excess fat under the chin and possible for tightening. These procedures can be performed separately or in conjunction. An in person consultation with an experienced and expert board certified plastic surgeon would allow you to understand your options.
As others have said, it depends on what you have too much of or where the laxity is. Often patients have too much fat under the skin, and this can be lipo sucked or cut away. If the muscle deep to this layer is saggy (platysma) either alone or in combination with excess fat, it may need tightening as well as the fat removed. Sometimes there can be excess fat and laxity in the tissues deep to the platysma. This requires a more involved approach with significant surgery to the delicate structures of the neck. Not to be undertaken lightly. Hope that helps.
Without any pictures and no more of a verbal explanation that you have a double chin, it's hard to say exactly what surgery you need. It appears your RealSelf surgery team of experts is forced to make assumptions as to what the problem is. Some feel you need a neck lift, some a chin implant, and some a platysmaplasty.
The plastic surgeon you spoke to gave you two options. I suggest you ask him or her if they are of equal value, will one do a better job than the other? He or she is the one best able to answer your question. I would be cautious of doing the cheapest surgery if it is not the best.
If you were my patient, I would do the least invasive surgery that gets the job done.
Liposuction removes fat that is below the skin. There can also be excess fat below the platysma muscle. This can only be removed by making an incision under the chin. At the same time, the edges of the platysma muscle can be sewn together to improve neck contour. The procedure would be called direct fat excision with anterior platysmaplasty.Determining which procedure is best for you requires an in person consultation.
Hi, I have performed many Chin Augmentations using dermal fillers, chin implants and/or liposuction for over 30 years. Non smiling photos of your face from the front and side would help in the evaluation. A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin. Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. Liposuction can be combined to reduce excess fat under the chin. I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty. I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone. In my opinion, you are a good candidate for chin implant surgery.
Hope this helps.
Most patients have fatty deposits located above AND below the platysma muscle in the neck. Liposuction can remove only the fatty deposits above the platysma muscle. A neck lift involves surgical removal of the fat below the platysma muscle, and then a platysma plasty is performed. The platysma plasty involves placement of sutures to tighten the muscles of the neck which also improves the jawline after the fat removal. This procedure in our practice is called a neck lift. No skin removal is necessary on patient's less than 50 years of age. When there is excess, skin loose and inelastic skin in the neck, and then a lower face and neck lift is required for skin removal. For more information and many neck lift before and after results from our practice, please see the link and the video below