Should I go for chin lipo or neck lift? I want a chiseled counter (photos)

Question

I want a chiseled counter but have a lot of fat under my chin/ hyoid skin. What will help me?

Anna Chacon, MD, FAAD · Answer

I completely understand what you’re aiming for here—a sharper, more defined jawline and neck angle can make a big difference in overall facial balance.

The key thing I look at first is what is actually creating the fullness under the chin, because “double chin” concerns are not always just fat.

There are usually three components I evaluate:

Fat volume under the chin
Skin laxity (how tight or loose the skin is)
Position of the hyoid/neck anatomy (your natural neck structure)
If the main issue is fat

Chin liposuction can be very effective. It directly removes the fat under the chin and along the jawline, which often gives a more defined contour fairly quickly.

This works best when:

The skin is still fairly tight
There is good elasticity
The fullness is mostly fat, not loose skin
If there is skin laxity

If what you’re calling “hyoid skin” is actually loose or drooping skin under the chin, then liposuction alone may not give you the result you’re hoping for. In some cases, removing fat without addressing skin can actually make looseness more noticeable.

That’s when a neck lift (or a lower facelift component) becomes more appropriate, because it:

Tightens the underlying neck muscles
Redrapes and removes excess skin
Defines the jaw-to-neck angle more structurally
If it’s a combination of both (very common)

A lot of patients fall in this category. In those cases, I often consider:

Liposuction + skin tightening (energy-based or surgical tightening depending on severity)
Or a limited neck lift if skin laxity is more significant
My honest clinical perspective

For a “chiseled” look, the goal isn’t just removing fat—it’s creating a clean jawline transition with good skin redraping underneath. If I only remove fat in a patient who already has some skin laxity, they may end up slimmer but not necessarily sharper.

So the decision really depends on whether your skin will contract well on its own after fat removal.

From your description, this sounds like something that could be either:

Liposuction alone if the skin is tight, or
A combined approach if there is visible laxity under the chin

The best results always come from matching the procedure to the actual tissue problem—not just the appearance of fullness.

Lucian Ion, FRCS · Answer

Thank you for your inquiry and sharing your photographs. If you are looking for more definition for the contour of the jawline and the upper part of the neck, the anterior neck lift or short scar neck lift provides control of the volume in two layers: under the skin, and deep to the platysma muscles.

Liposuction can only control the volume under the skin, and using it deep to the platysma muscle exposes to risks that are more difficult to evaluate. The volume situated deep to the platysma muscle is not just fatty tissue. In the central part, it is represented by fatty tissue. Further laterally, it is the volume of two muscles, the digastric muscles, and further out, it is the volume of the lower part of the submandibular glands.

The anterior neck lift can address all these volume elements, and this does lead to more definition in the contour of the jawline and neck.

Carmina Cardenas, MD · Answer

The lack of neck angle, lack of jawline definition and bulging skin means: large and protruding submandibular glands, bulging digastric muscle, malposition of the hyoid bone, excess of sub-platysma fat and almost never excess of subcutáneo us fat. 
So you are a great candidate for Deep plane neck lift to treat all elements: glands, muscles and submuscular fat. 
Be encouraged!!
Dr. Cardenas

Mats Hagstrom, MD (license on probation) · Answer

Facial aesthetics are primarily determined by facial bone structure.
It is the facial skeleton that determines each persons unique individual look and characteristic.
Soft tissue coverage tends to be very consistent from person of person.
Issues related to the lower 1/3 of the face are generally related to the shape and size of the mandible.
You don’t have an abnormal fat distribution.
You have a mandible that is slightly smaller than those with ideal facial aesthetics.
 Liposuction can help to some degree and so can a facelift/necklift. 
Soft tissue solutions to problems, primarily based on bone structure, tend to give partial improvements.
For this reason, Liposuction may not give you the chiseled appearance that you wish for.
If you look at very attractive people, they tend to have supporting bone structure, which gives the foundation for the soft tissues to rest upon.
For an attractive, female jawline Carmen Dell'Oreficeis a good example of the importance of a well-developed mandible. George Clooney It’s a good example of a man who has a strong mandible with good facial appearance of the lower 1/3 of his face.
You can consult with plastic surgeons in your community.
I’m sure most of them will be happy to remove your fat.
Some people do liposuction better than others and some providers are better at giving an accurate assessment than others.
Recognize that you don’t have an abnormal fat distribution so removing fat is only gonna do so much.
Best,
Matt Hagstrom, MD

Should I go for chin lipo or neck lift? I want a chiseled counter (photos)

Answers (4)

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