Is this skin or fat? Already had chin lipo and FaceTite. (photos)

Dear Glorious5121,
it is hard to tell for sure without an examination. 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

Do you have a natural skin folds with your head in a neutral position. Making an assessment of the chin and neck it’s not as easy as saying is the skin or fat.
The following tissue layers are responsible for the shape and contour in that area of their face in decreasing order of importance.
Mandibular bone structure in relationship to the Maxilla, how to platysma muscle drapes the neck, subcutaneous fat layer, lack of skin elasticities or skin laxity, submandibular salivary glands and summit platysmal fat.
The most important variable is bone structure. 95% of people who seek chin and neck liposuction have a facial skeletal imbalance with a mandible that is small in relationship to the Maxilla.
This is true for you as well.
When the mandible is small or lacks forward projection patients typically having these symptoms.
A dental overbite occlusion, the upper lip has more for projection than the lower lip, formation of premature double chin despite being proper weight, premature jowl formation and lack of jawline definition.
Do you underline platysma muscle contours in the neck based on the origin which is directly related to the length of the mandible. when the mandible lacks forward projection the platysma muscle drapes the neck and an oblique fashion.
This tends to eliminate jaw line definition.
Demandable can be deficient in different areas including the mentalis region or the body of the mandible.
The mandible can be deficient in both vertical and horizontal directions.
Your pictures show skin laxity or loss of skin elasticity. liposuction begins to decline in effectiveness for this part of the face starting at age 35 and after age 50 patients are generally not good candidates.
It’s really important to take the amount of subcutaneous fat and mandibular structure into consideration when making an assessment.
Results are predictable when done by a sufficiently skilled an experienced provider.
I have a little faith that Renuvion or facetite adds anything positive to the overall outcome.
Usually lack of results come from a poorly made assessment or procedure,
Delivering consistent quality results with liposuction including the ability to make accurate and predictable assessments is more difficult than most people believe.
A substantial number of well intended well trained board-certified plastic surgeons with overall good reputation failed to deliver consistent quality results with this procedure.
Patients should be highly selective in choosing providers by having multiple in person consultations before committing to any one provider.
During each consultation ask providers to open up their portfolios and show you their entire collection of before and after pictures. Ask specifically to show your previous patients results who had similar facial characteristics including age of yourself.
This needs to include all of the variables described above.
That is what’s required to have a quality assessment.
Being shown a handful of preselected images which most likely represent the best results of the providers career is totally insufficient to get a clear understanding of what average results will look like in the hands of each provider or what your results will look like. After the fact there’s a little to be done. You certainly do not need more liposuction.
At this point a facelift is probably your best option.
For facelift consultations go through the same process but realize that the variables are a bit different.
All patients for any cosmetic surgical procedure should go through a formal vetting process in selecting a provider.
Choosing a single provider is board-certified and plastic surgery with the overall good reputation is insufficient to confirm that they have mastered any one single procedure.
In the end surgeons are responsible for the surgical outcome and expectations sent while patients are responsible for choosing the provider.
You didn’t include before and after pictures which is always needed to make an assessment on the outcome of an operation.
If you don’t have before and after pictures ask your surgeon to forward the ones they took.
Best,
Mats Hagstrom MD