Chin lipo, Kybella or mini facelift? (Photo)

Question

Hi, I'm in my late 30s and there's a little pocket under my chin that I don't know what to do about. My whole family has it (regardless of our weight). I got Kybella about 5 years ago and it helped. I think I only had 1, maybe 2 sessions. I thought for years it was just loose skin and maybe a mini-facelift would help. But actually the pouch seems a bit too heavy to just be skin. Would another session or two of Kybella get rid of this, or chin lipo, or is i a mini facelift?

Jeffrey Lisiecki, MD · Answer

Definitely in-person evaluation is necessary to best answer this question.  You look like a great candidate for submental Facetite treatment along with Morpheus8, or potentially a mini necklift depending on your in-person examination.  Both Kybella and lipo alone are the wrong answer because you don't have a significant fat excess in the area.  Your chin also looks a little behind the ideal position, so a small chin implant or chin filler would also help sharpen your jawline and tighten the skin under your chin.

Jason Emer, MD · Answer

"For a double chin, InMode FaceTite with VASERlipo would give you the best result.

With significant neck sagging you would need a facelift / neck lift with muscle tightening (platysmaplasty). At the same time, I would recommend lasers (Fraxel, CO2, Halo, or Erbium) and microneedling RF (Fractora, Morpheus8, PiXel8, Intensif) to improve the crepey skin and wrinkles. Overall, the neck can be treated with a combination approach:

1. Microneedling and laser treatments for texture
2. Botox, Dysport, Xeomin or Jeuveau to help platysmal bands
3. Intensif, Fractora, PiXel8, or Morpheus8 microneedling RF for crepey skin and lifting
4. Injectable fillers like Belotero, Restylane Silk, Versa, and Juvederm Volbella to improve lines and folds
5. Face/neck lifting if sagging is prominent or premature, with or without platysmaplasty (muscle tightening)
6. Renuvion (J-Plasma), ThermiRF, and InMode FaceTite/AccuTite 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 formal evaluation and to develop a personalized treatment plan based on your individual situation and goals. Best, Dr. Emer"

Randal Haworth, MD, FACS · Answer

The best course of action to address the pocket under your chin would likely depend on the specific nature of the issue. If Kybella helped before, it might be worth considering another session or two to see if further improvement can be achieved.

Chin liposuction could also be an option, especially if the issue involves excess fat that is resistant to other methods. A mini facelift might be more suitable if there's also some skin laxity and if you're looking for a more comprehensive improvement in the lower face and neck.

Consulting with a board-certified plastic surgeon or dermatologist experienced in facial aesthetics would be the best way to determine the most appropriate treatment for your individual situation.

Best of luck !

William Portuese, MD · Answer

The photos are rather limited, especially in the different positions that  the photographs were taken. If there's a small amount of fat in the submental area, this can be removed a simple liposuction.

Mats Hagstrom, MD (license on probation) · Answer

That formation of a double chin is usually not a problem related to either subcutaneous, fat or skin. Obviously significant skin laxity will cause signs of aging like jowls, but for the most part young people who have a double chin do so because of the shape and size of their mandible.In particular individuals who have a small mandible or one a mandible that lacks projection in relationship to the Maxilla tend to form a premature double chin. When people say it runs in the family, it is the bone structure that runs in the family not a problem with fat distribution. This typically goes hand-in-hand with having a dental, overbite, occlusion and in profile pictures the upper lip will have more forward projection than the lower lip.
It doesn’t look like you have much subcutaneous fat anywhere on your face or in your chin and neck. If you’ve already had fat removed in the area, then removing more fat is probably going to lead to a point I’m diminishing returns. Excessive fat removal can also create problems, showing premature platysmal bands, and other issues related to overzealous aesthetic treatments, including the use of Kybella and overzealous Liposuction. Sometimes a small area of skin can be removed with direct excision, leaving a fairly minimally visible scar. This may be a good compromise compared to having a neck lift.
I would be careful with aggressive fat removal since doing so, when not indicated, doesn’t make things better, and can cause secondary problems that are irreversible.
I suggest having a few in person, consultations with local plastic surgeons in your community to see what each of them has to say. Sometimes simply accepting the way things are, and not having intervention is also a good option.
Best,
Mats Hagstrom, MD

Chin lipo, Kybella or mini facelift? (Photo)

Answers (5)

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