What is the best option for targeting double chin? Can this be combined with a brow and cheek list? (photos)

Question

Hello, I’ve got some skin and some fat that I want to remove under my chin. Some doctors have said that I need to do a chin implant and liposuction and sutures.. someone else said I can do liposuction and facetite, some kind of laser t treatment. What’s the best option for me from what it looks like? My double chin is usually there even when loosing weight, however it’s smaller. Also I thinking of doing an eyebrowalift and cheek lift at the same time. Are those too much with recovery ?

Raffy Karamanoukian, MD, FACS · Answer

Ultherapy is a non-invasive procedure that lifts the neck, chin and brow, and improves lines and wrinkles on the upper chest. As we age, collagen breaks down, resulting in loss of skin strength and elasticity. For tissue tightening, Ultherapy is ideal for the lower face and neck and we often combine it with CO2 laser or Morpheus8 to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

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"

Lucian Ion, FRCS · Answer

Thank you for your enquiry and sharing your photographs.

The fullness under your chin seems to be related to the floor of the mouth rather than fatty tissue. It can be controlled through a short scar neck lift or anterior neck lift which involves an incision and therefore scar under the chin. Through this access it is possible to address the volume under the chin very effectively.

There is slight laxity along the jawline and chin implant could help to absorb it. Micro liposuction can also help but is more variable. It can of course also be targeted through a facelift intervention.

If you are contemplating a cheek lift procedure, you need to define very well what you wish to achieve with it. My impression is that a minimal access facelift might be more alignment with your aesthetic goals but because this is in the absence of a proper conversation on the subject.

Daniel Barrett, MD · Answer

Dear Annaannam,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from chin liposuction. 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

Tanveer Janjua, MD · Answer

Chin liposuction helps reduce the bulge under the chin and can be done for the whole neck. Once the fat is removed the skin can become loose and saggy in some cases. It can be avoided by combining it with Thermitight which is a radiofrequency heat delivered under the skin to tighten it. Both chin liposuction and Thermitight can be done at the same time. The recovery is fast and it can be done under local anesthesia.
Click on the video link below
Regards
Dr. J

Kevin Tehrani, MD, FACS · Answer

thank you for your question and posting appropriate pictures. You seem to be a good candidate for neck, liposuction and skin tightening using Renuvion or J plasma.  
in addition, MyEllevate procedure will give you a neck lift without any external scars. I believe you can achieve chin augmentation with filler/your own fat without the use of implants. Moreover, you may have a cheek lift/brow lift at the same time under sedation. It is best to have a virtual consultation to discuss options, of course.

Mats Hagstrom, MD (license on probation) · Answer

Each persons unique facial characteristic is purely based on their skeletal structure. The soft tissue covering of the face is very consistent from person to person with the exception of facial aging where soft tissues play a much bigger role.
People who have concerns about their facial appearance should start by getting a formal assessment and understanding of their facial skeletal structure because this is the foundation of why each person looks the way they do.
At least 95% of people who seek chin and neck liposuction have issues with her size and shape of their mandible. they tend to all have a normal fat distribution. The reason for the double chin is a small mandible that causes the underlying platysma muscle to drape the neck in an oblique fashion creating a double chin, lack of jawline definition and eventually premature jowls.
To formally treat the primary problem may seem overwhelming, daunting and simply too much.
I fully understand that most people may not be interested in having their facial skeleton rearranged through cranial facial surgery. it is however important to recognize the treatments that do not treat the primary problem will always give you a partial improvement and do not address the primary problem.
This is the issue with most soft tissue treatments for a patient whose bone structure is at the core of the problem.
Adding a chin implant elongates your chin but does nothing to compensate for the body of the mandible which is where the platysma muscle is attached.
That shit implant will extend the Chin but not move the mandible forward.
Are wild far more complex Judvan spin surgery does move the entire platysma muscle forward along with all of your lower teeth.
Most people who have an under sized mandible tend to have an overbite occlusion. On profile picture their upper lip almost always projects substantially more than their lower lip. In most people it’s the other way around.
I would recommend you have a few consultations with local oral surgeons. They tend to see things more from the skeletal perspective and can help give you A better assessment of the primary problems including treatment options so you will be better informed and know all of your options.
Once you know all the options and understand what’s causing the problem you’ll be in a much better position to make decisions about what seems appropriate and what does not. it also helps people accept the inherent limitations of procedures like chin and neck liposuction because the problem is not based on fat distribution. this is not to say that Schimaneck Liposuction can’t give improvements. For some individuals especially those who have fat to work with when done by a really talented provider can give striking improvements.
Having a clear understanding of what the primary underlying issues are also helps explain why different doctors will give you different opinions. Recognize that most plastic surgeons are not in a position to do assessments or the treatment for craniofacial surgery.
In the end finding the most skilled and experienced provider with a proven track record and going with their recommendations is your best option. The best way to find the right provider generally involves having a lot of consultations.
During each consultation ask each provider to open up their portfolio and show you their entire collection or as many as they’re willing to do in regards to before and after pictures. Ask him to find as many pictures as possible of patients who have similar facial characteristics to your own.
Being shown a handful of sample pictures which most likely represent the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of that provider. Being shown a large number of pictures also confirms the true experience and how many cases the surgeon has actually done.
That plastic surgeons thoroughly and don’t be afraid to push them to show you more pictures. This is a very important part of the consultation process. You should also ask about the revision rate policy about revisions etc. 
Best,
Mats Hagstrom MD

What is the best option for targeting double chin? Can this be combined with a brow and cheek list? (photos)

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