Chin lipo alone or lipo with platysmaplasty? (Photo)

Question

I want a more defined chin and neck. I don't think I have any neck bands showing. I'm 6"2, 203 and a 50 yo. Lipo? Lipo & platysmaplasty? Will I have excess skin? Thanks.

Jane M. Rowley, MD · Answer

Chin lipo is a procedure that I offer with local anesthesia which makes it easy and inexpensive.  I tell all my patients that I can suck fat almost anywhere, the problem is what happens to the skin after the fat is suctioned.  Looking at your pics you seem to have thick relatively elastic neck tissue.  I think you would have a good result and it will buy you time until you have more skin laxity and at that time would consider more aggressive work on the neck.   A platysmaplasty is generally done in conjunction with a facelift and I don't think you need it yet.  Good luck, Jane.

Summit Kundaria, MD · Answer

476612,
Thanks for providing good photographs with your question, as they are very helpful in this discussion.  I think that optimal treatment would involve platysmaplasty as well as a face/neck lift to address the excess skin.  Lipo alone would address the fat but leave you with excess skin, and platysmaplasty with lips would pull your platysma muscles together, but you cannot remove enough skin from a submentoplasty incision (just under your chin) to get the result I think you want based on your pictures.  That's why I think the idea procedure would involve a face/neck lift in addition to the submentoplasty with platysmaplasty and liposculpture.

Best Wishes,
Summit Kundaria, MDCharlotte, NC

William Portuese, MD · Answer

From the limited photographs presented, liposuction will only remove a portion of the fatty deposits above the platysma muscle. There's also significant fatty deposits underneath the muscle. To rejuvenate the neck and significantly improve the jawline, a neck lift with a platysma plasty will be necessary. This includes removal of the fatty deposits above and below the platysma muscle along with a platysma plasty itself. If there is loose and excess skin present in the neck, a lower face and neck lift will be required to tighten loose skin in addition to the fatty removal and platysma plasty. For more information and many examples of both face/neck lifts and necklifts, please see the link and the video below

Robert Brobst, MD · Answer

Thank you for you questions and photos. Both liposuction and Kybella (deoxycholic acid) injections are options for decreasing fat volume that sits between the neck muscle (platysma) and skin. However, I believe you will have an issue with neck skin laxity, likely some subplatysmal fat, and maybe platysmas bands once they are uncovered by fat removal. Liposuction with platysmaplasty will not address the excess skin either, but could address 2 of the 3 possible anatomic factors. An in-office exam and explaination would determine what would best meet your goals. Your 2 best options are a direct  submentoplasty or a neck lift (rhytidectomy). These are the best ways to address all 3. The latter offers better camouflage of the incisions overall result. You seem to be doing lots of research and are asking very good questions. Ultimately, each procedure can offer some benefit toward your goals, it comes down to finding the one that is the best fit.  I hope this helps. Take care.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years.  The photos show a chin that is weak along with excess fat and skin below the chin and across the neck.  No platysma bands are seen, so a platysmaplasty may not be required.  If you are looking for a more sculpted, prominent chin and jaw line, liposuction combined with chin implant placement seems appropriate.  You may also look into shaping the mandibular angle of the jaw line with a dermal filler.  
  Liposuction can reduce excess fat in the neck and skin can be reduced using two options.  The first reduces some but not all of the excess, using a curved incision under the chin.  This is the least invasive and has the smallest scar which can be hidden under the chin.  The next option requires a "full neck lift" which is performed using a curved incision around the front (explained later) of the ear that continues in the crease behind the ear and then 3 inches into the posterior hairline.  The tissue is dissected from that point all the way across the entire neck to the same position on the other side of the head in a dissection that is as long vertically as the entire neck.  The Platysma muscles are tightened using a curved incision under the chin and each side is pulled upward and back again being tightened at a line behind each ear (under the tissues).  Since the skin flap pull is up and back, this will pick up any tissue laxity along the jaw line or "jowls" which must be dissected and flattened out using a lower facelift (incision around the front of the ears).  If this isn't done, pleats of excess skin will appear below each ear.
This is an extensive surgery taking 4 1/2 to 5 hours with large incisions, possible hair loss and months of recovery.  In my experience, most men opt not to have the telltale signs of this type of surgery since they can't cover them with long hair.
Hope this helps.

Chin lipo alone or lipo with platysmaplasty? (Photo)

Answers (5)

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