37, 120 pounds - fat under chin and lower cheek area. Chin lipo or neck lift? (Photos)

Question

Woman, 37 y.o, 120 lbs. I have been accumulating some fat under my chin and especially lower cheeks (which noticeable when I turn my head) spreading down to the neck plus developing jowls. It’s genetic. I’m wondering if traditional chin lipo alone OR Facetite would help me get definition in the jawline and less heavy lower part or I should proceed to deep plane neck lift? Black and white photo is my jawline 15 years ago and the desired result. I understand that a neck lift gives more dramatic result but money is a concern now. I’m also afraid that with traditional lipo the skin and muscles might not shrink back and I would end up in a worse situation. So my questions are: 1) should I risk and do chin lipo/ Facetite now and then get ready for deep plane neck lift in 5 years time? 2) Not waste money on lipo/ Facetite and start saving for neck lift in the future? 3) If I do lipo/ Facetite would that complicate any future neck/ facelifts? P.S. I also did Ultherapy several times and improvement was minimal.

Anna Chacon, MD, FAAD · Answer

Hi,

Thank you for sharing your detailed history and photos—they really help in understanding your goals. At 37 and 120 lbs, with some fat under the chin, lower cheeks, and early jowling, you’re in a situation many patients face: wanting a defined jawline now but also considering long-term results.

Here’s a breakdown of your options:

Chin Lipo or Facetite:
These procedures can reduce submental and lower cheek fat and tighten the skin modestly (Facetite uses radiofrequency for some contraction).
Results are subtle compared to a neck lift, but they can improve definition temporarily and may give you a nice boost now.
Skin elasticity is a key factor—if your skin is moderately elastic, it can shrink back well; if not, the improvement may be limited.
Doing lipo or Facetite does not usually prevent a future neck lift, but the prior procedure can make dissection slightly more challenging, so the surgeon will need to account for it.
Deep Plane Neck Lift:
This is the most comprehensive solution for sagging, jowls, and excess fat.
It addresses deeper tissue and skin laxity, giving dramatic and long-lasting results.
Higher cost and downtime, but once done, you may not need additional procedures for years.

Considering your questions:

Option 1 (lipo/Facetite now, neck lift later): Gives you temporary improvement and lets you enjoy some contouring now. If the skin responds well, it can be very satisfying—but there is a small risk the skin may not shrink perfectly, especially with genetic laxity.
Option 2 (save for neck lift): Guarantees the more dramatic, long-term result but requires patience and a bigger investment upfront. You won’t see immediate change now, but you avoid the small risk of suboptimal results from minor procedures.
Future surgeries: A prior lipo/Facetite doesn’t prevent a deep plane neck lift, but your surgeon will carefully plan around any prior tissue manipulation.

Since you’ve already tried Ultherapy with minimal improvement, it seems that non-surgical tightening alone is unlikely to achieve the definition you want. This is a scenario where a staged approach (Facetite now, neck lift later) is reasonable if cost is a concern, as long as you understand it’s a temporary solution and that your skin’s response may vary.

The ultimate choice depends on your priority—immediate improvement versus the most definitive long-term result—and your comfort with cost, downtime, and possible minor compromises along the way.

37, 120 pounds - fat under chin and lower cheek area. Chin lipo or neck lift? (Photos)

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