Considering Neck Lift, Implant, Liposuction to neck area. (photos)

I have always been insecure about my weak jawline and double chin, and as I've gotten older it's only become worse. What procedures would you recommend to give me a smoother, more sleek profile and jawline?

Doctor Answers 6

Considering Neck Lift, Implant, Liposuction to neck area.

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Hi, I have performed facelifts and Neck Lifts for over 30 years and have performed many minimally, invasive type facelifts.  From the photos your cheeks are flat anteriorly (in the front), there is excess fat in front of and below the cheeks, jowls are present, the posterior portion of the mandible is weak, the chin is weak and there is excess fat under the chin.  These factors combine to create a rectangular shaped face.  Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.  I would combine liposuction of the face and neck for further facial shaping.

 A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 "Jowls” are sagging facial tissues and an indication for some form of a SMAS facelift (when present, they preclude a Neck Lift from being performed alone without some form of lower Facelift based upon the direction the neck tissues are lifted).  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

 My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
 I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.  I would use a reliable (fat is far less reliable than a dermal filler or facial implant despite the popularity of fat injections) dermal filler to augment the posterior (back section) of the jaw line as an office treatment about 1 week post facelift to create further facial harmony and balance once the initial swelling had subsided.

Hope this helps.

Profile Refinement

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Thank you for your question. There are many options for you. You should see a surgeon who can perform computer imaging. That way you can see what is realistic to expect. You appear to be a good candidate for a chin implant, liposuction and a platysmaplasty.Best wishes

Greg Chernoff, MD
Indianapolis Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

Necklift and chin implant combination

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In our practice, a neck lift involves removal of fatty deposits above and below the platysma muscle, in addition to a platysma plasty to improve the jawline. If there is poor skin tone and excess skin  located in the neck, a lower face and neck lift is required. Chin implants are placed for patients who have a weak and recessive chin profile to give added projection to the chin to help  with facial balance, proportions and give the appearance of a longer  mandible which significantly improves the jawline. For many  before-and-afters of neck lift and chin implants, please see the link and the video below

Neck Lift, Liposuction, and Chin Implant

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You do not mention how old you are but based solely on the pictures it appears that you would get a very nice result with neck liposuction and a chin implant. The need for a neck lift would depend on the laxity of your skin evaluated during a consultation. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Jawline and neck

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from the photos it seems as though you would be able to get away with just liposuction under the chin and a very small chin implant.  Easy recovery and easy procedure.  If you want more significant results then I would consider a deep plane vertical neck lift.  Any lift less than that would not be worthwhile on your neck.  You can see photos on my site or other sites to compare the differences. 

Ben Talei, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 50 reviews

Procedures for the jawline

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Very good question, and one that often patients have when they come for consultation. There is everything from minimally invasive through more advanced, surgical procedures.  It all depends on your comfort level, how good a candidate you are for each particular procedure or option, and, at the end of the day, just "how far down the rabbit hole" do you want to go ;).  As you look fairly young, I would stick with the more minimally invasive first before jumping into neck lifts.  As much as I like doing them, I feel like you should know about all options as well.  In regards to chin augmentation, an implant works great.  It's quick, simple, easy, and can be done even under local anesthesia.  To improve the jawline, you can do a variety of things from a minimally invasive standpoint.  This all depends on your skin elasticity, the amount of adipose tissue and where its located, etc. These are all things that can be answered during your consultation and evaluated with a physical exam. Kybella, an injectable which melts fat, can be used in the area under your chin to help improve the highlight and contour of your jawline.  Microliposuction can also be done to remove that fat as well.  I personally have now moved more into using ThermiRF for patients - it melts the fat as well as tightens the skin, providing long lasting results that continue to get better over the span of a year.  Also, you can treat the jowl formation around the lower aspect of the cheeks as well which is an added benefit. I really have been very happy with it for a "minimally invasive" procedure.  Anyways, long story short, you have lots of options out there, and I do believe you would do great.  I hope some of this helps.  Best of luck!

Miguel Mascaro, MD
Delray Beach Facial Plastic Surgeon
5.0 out of 5 stars 16 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.