Jaw, definition, add possible neck lift (Photo)

The most profound results are going to be with surgical techniques. Based on the pictures, the procedure that would work best is a deep neck lift, which includes superficial liposuction, removal of subplatysmal fat, a digastric shave and a platysmaplasty. I don't see great results with nonsurgical energy devices and would not recommend them.

Based on your photos, you are a great candidate for a lower face and necklift. Excess fat can be removed directly, and possibly a small chin could be added for definition while performing the lift. Be sure to see a facial specialist for consultation.

The pictures demonstrate early skin laxity of the face and neck that manifests as facial decent - squaring off your lower face and neck. You also have fulness of your central neck.

There is a chance you may be able to get away with a mini lift to tighten along the jaw and upper neck. To re-establish the aesthetic triangle, however, a modified mini face and neck lift with deep plane tightening of the SMAS and platysma - to lift the jowls and sharpen the neck - would give you the best improvement.

You may also need another round of lipo of the central neck to improve the fullness in that area.

Typically, I do those procedures as part of our Wide-Awake-Surgery program – surgery done under local anesthesia in the office.

Check out the link below.

The same surgery is also available in the OR under anesthesia.

Consultation with a surgeon certified by the American Board of Plastic Surgery would be the next best step.

Dear soholauren,
Thanks for your question. A facelift/ neck lift procedure is used in patients with moderate to severe skin laxity and excess in the neck and lower face. You have some submental fullness under the chin. If this is fat you may get benefit from repeat chin lipo or perhaps morhpeus 8 to help melt fat in the area. I would suggest a consultation with a board-certified plastic surgeon for further information and recommendations.

I would recommend a deep plane face/necklift. This will help remove some of the deeper structures of the neck that are stretching the overlying skin. You have to include the face because this will allow pulling up of the deeper structures to tighten the neck contour and also permit removal of any excess skin. I would recommend finding a board-eligible or board-certified REAL plastic surgeon with actual training in plastic surgery residency/aesthetic fellowship. In addition, a surgeon that you believe has excellent outcomes.

Yes, a necklift (with or without a facelift--a difference to discuss at your consultation) would be the best way define your jawline and smooth the skin of your neck. If you were opposed to the idea of a necklift, then the alternative would be to use skin tightening devices like Facetite and Morpheus8, potentially with the addition of a jawline filler like Radiesse.

For a more defined jawline to strengthen your profile (and help prevent the dreaded jawline "jowl" sagging), we use injectable fillers like Revanesse Versa - a filler known to limit swelling and give subtle, soft enhancements - or Radiesse. Using a cannula to limit pain and swelling, we inject on the bone in strategic points to get more lift and shaping, resulting in a more contoured lower face and defined, structured jawline. I would suggest getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Based on these photos it appears that neck lift will improve your neck appearance more efficiently than any other procedure. It is likely that chin augmentation with implant would further enhance overall result. Hope this helps.

The neck lift will give you the best outcome for achieving jawline definition and improvement of the chin. Unfortunately liposuction alone can only address the superficial fat of the neck (fat above the platysma muscle). The neck lift allows for correction of the platysma laxity and sculpting/removal of any deep neck fat (below the platysma muscle). The deep plane neck lift also allows for correction of any enlarged digastric muscle which can provide additional fullness/heaviness of the anterior jawline. Nonsurgical skin tightening devices (e.g. morpheus, renuvion) can improve lateral jawline contour, but unfortunately cannot eliminate/tighten skin and muscle laxity as effectively as surgery.

It's very important to understand that there are two compartment of fat in the neck located both above and below the platysma muscle. Liposuction can only accomplish removal of the fat deposits above the muscle. A surgical neck lift is required to remove the fat deposits below the muscle which also includes a platysma plasty to significantly improve the jawline. In our practice, we do not use compression garments, we use surgical drains left in place for two days which removes blood out from underneath the skin.