Would chin lipo be enough or would I need a neck or facelift also? (Photos)

Question

Looking to get chin lipo. Do you all think a neck or face lift is also something thag would be necessary? Went to one Dr for a consult and did not have a great vibes. did kybella 6-7 years ago with good succes but gained weight as that was prebabies. Thank uou!

Akif Mehmetoglu, MD · Answer

Thank you for sharing your photos and history. Based on appearance of your neck and lower face, concern seems to involve not only excess fat, but also skin and deeper tissue laxity. Because of this, chin/neck liposuction alone may not provide degree of definition or tightening you are hoping for.Even laser-assisted liposuction can improve fat reduction, but it cannot significantly tighten loose skin or address muscle laxity in the neck. In cases with skin and tissue sagging, neck lift, combined with lower facelift, often provides more defined and longer-lasting improvement to jawline and neck contour.Proper in-person examination would be necessary to determine the most appropriate treatment plan for your anatomy and goals.Akif Mehmetoglu, MD.

Carl Truesdale, MD · Answer

This decision comes down to one specific anatomic question &mdash; what's your skin envelope doing? Get that right and the answer becomes obvious.
The pinch test (do this in front of a mirror):
Gently lift the skin under your chin between your thumb and forefinger, hold for a few seconds, then release. Watch how quickly it returns to its normal position.
Snaps back instantly: skin envelope is tight. Liposuction alone can work &mdash; the skin will retract after fat removal.
Returns slowly (1 to 3 seconds): borderline. Liposuction may give a partial result. Neck lift gives the more complete answer.
Returns slowly with visible 'tenting' or wrinkling: skin envelope is loose. Liposuction will make this WORSE &mdash; removing fat leaves the loose skin draping down. Neck lift needed.
The age and skin quality overlay:
Under 35 with no history of significant weight loss: skin retracts well. Liposuction often satisfies if fat is the dominant issue.
35 to 50: variable. Skin quality matters more than age here. The pinch test is the deciding factor.
50+: skin retraction is unreliable. Neck lift gives more durable results in this group, even with mild fullness.
Post-weight-loss patients: regardless of age, skin envelope is usually stretched and retracts poorly. Neck lift territory.
What to also evaluate before deciding:
Platysmal banding. Look in the mirror with your chin tilted up. If you see vertical bands running down the neck, you have platysmal banding. Liposuction makes these more visible. Platysmaplasty (part of a neck lift) is the fix.
Jowls and lower-face descent. If you have visible jowls in addition to neck fullness, a lower facelift gives a more comprehensive result than neck-only work.
Subplatysmal fat. Standard liposuction only removes fat above the platysma muscle. If your fullness is from deeper fat (below the muscle), open neck lift dissection is needed.
Decision framework:
Isolated submental fat + tight skin + no banding + no jowls: chin lipo.
Fat + early laxity + no jowls: chin lipo with combined energy-based skin tightening (Renuvion, FaceTite). One step up from pure lipo.
Fat + meaningful laxity + platysmal banding: neck lift with platysmaplasty.
All of the above + jowls + lower-face descent: lower facelift with neck lift (combined deep plane procedure).
What I'd avoid:
Lipo in a patient with loose skin. Most common regret in this space.
Neck lift in a young patient with tight skin and only fat. Overkill, longer recovery, more cost than needed.
Multiple rounds of Kybella in patients who actually need surgery &mdash; wastes time and money.
Best move: see a facial plastic surgeon who does both lipo and neck lifts. They should do the pinch test in person, palpate for platysmal bands, and give you an honest answer. If the surgeon only does one procedure, you'll get that procedure recommended regardless of fit.

Robert M. Lowen, MD · Answer

Dear Melissaann, 
Definitely, not a facelift at this point.  The best treatment is weight loss.  Then after you have lost a lot of weight, if you have loose skin or saggy neck, you can consider liposuction and skin tightening and a non-incision suture suspension necklift like MyEllevate.

Daniel Barrett, MD · Answer

Dear Melissaann71,

it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Anna Chacon, MD, FAAD · Answer

This depends on one key factor:
➡️ Is the issue fat or skin laxity?

If:

mostly fat → chin lipo can work well
loose skin present → lipo alone may worsen the look
Clue:

If skin doesn’t snap back when lifted → you likely need more than lipo

My approach:
Start conservative, but don’t under-treat—because revision is harder than doing it right the first time.

Would chin lipo be enough or would I need a neck or facelift also? (Photos)

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