What is the best permanent solution to my genetically heavy neck, neck lift or lipo? (Photos)

Based on your photos, I suggest a standard necklift that includes, skin tightening from behind the ears, removal of excess fat between the skin surface and platysma muscle layer, and tightening of the platysma muscles both in the front under the chin and from the sides near the ears. Treating all 3 tissue planes, plus adding a chin implant to create more chin prominence, should give you much better definition to your neck and jawline.

​A combination of non-surgical options like Kybella, PDO NovaThreads, Ultherapy and Thermage would do well in combination for skin tightening for the neck. VASER Liposuction (with ThermiRF, Renuvion and InMode FaceTite) is a great alternative for contouring and tightening the chin and neck and can be combined with a neck lift at the same time, if you're a candidate. I suggest getting a formal evaluation with a cosmetic dermatologist to develop a long-term treatment plan that works for you. Best, Dr. Emer.​

At age 28, he most definitive procedure would be a minimal incision deep neck lift. This procedure allows for removal of deeper neck fat, trimming muscles known as the digastrics, possible submandibular gland removal, and platysmaplasty. The elasticity and tone of your skin will allow for skin redarping, which won't always be the case.

Although the traditional focus has always been on the subcutaneous fat layer, most patients having poor neck contour may also have various amount of excess deep neck structures contributing to obtuse neck contours. In fact, often it is not enough to perform submental liposuction alone and inappropriate removal of the subcutaneous layer may lead to additional problems such as unpredictable tethering, scaring, and skeletonization of the neck. In such cases, deep neck contouring which includes trimming of the subplatysmal fat, partial removal of additional contributing deep neck structures, such as a prominent anterior belly of the digastric muscles and/or hypertrophied submandibular glands, and additional platysma maneuvers may often be required to achieve optimum results. Opening the neck through a submental incision allows for accurate management of these deep neck structures to create the best neck contour for the patients with an obtuse neck and assists in achieving a desirable smooth neck contour.

Thank you for your question and photos. You are likely a candidate for a neck lift procedure, possibly combined with chin augmentation. Neck lifts can revitalize the appearance of the neck and throat while removing submental fat that often causes a double chin appearance.
Combining this procedure with the insertion of a chin implant can further define the jawline to provide a striking, natural-looking contour. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can help you decide on the best combination of procedures.

Liposuction with Facetite RF would be nice but then you would still have loose skin which would look bad. The lower Face/Neck lift under local with lipo would be awesome and so easy to undergo with dramatic improvement. Spend the money and get it done right from the begining.

Based on these limited photos, your option is neck lift. In congenital cases like yours, beside fat deposits, there is also associated muscle deformity that can be corrected only by means of muscle rearrangement, platysmoplasty. Small chin implant would, very likely, further improve your result. In person consultation with a board certified plastic surgeon, with good reputation in face/neck surgery, is recommended. Good luck.

To better evaluate your anatomy, we need to see your face and neck in different angles (i.e. frontal view, right profile, left profile, etc.). To proceed with surgical treatment, being at your ideal weight and not having too much weight fluctuation is important. We recommend that meeting with a plastic surgeon or facial plastic surgeon near you for a consultation to discuss the different surgical options.

The side profile photographs are rather limited, however you Have a recessive Chin profile and significant fat deposits in the neck located both above and below the platysma muscle in the neck. Consider placement of a chin implant to augment the chain forward. A neck lift procedure Can accomplish removal of significant fat deposits above and below the muscle in the neck, which also includes a platysma-plasty to significantly improve the jawline. Your BMI should be less than 30 before undergoing this procedure.