Pros and cons please? Considering chin liposuction vs CoolSculpting with filler injections for marionette lines. (Photo)

Doctor Answers 4

Pros and cons please? Considering chin liposuction vs CoolSculpting with filler injections for marionette lines.

 Hi, from the photos of your face your cheeks are flat anteriorly (in the front), there is excess fat in the face and neck, jowls are present as well as excess skin in the neck.  I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years. 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. Think of facial beauty as something that "must" address all layers of the face including the skeletal structure of the cheeks and chin, the overlying SMAS muscle, amount and position of subcutaneous fat and finally the degree of skin laxity. It's an "urban myth" that pulling tissues over flat cheeks and a weak chin can create a beautiful or handsome face. Similarly, dermal fillers or facial implants alone can't lift and remove excess skin from the face and neck. Natural looking beauty is created by the aesthetic vision of what tissue layers need to be adjusted by what technique and amount. Non surgical skin/tissue tightening has limitations of several mm's while surgical skin removal is often 2 to 3 inches.  The difference is 2-3 mm's versus 50-75 mm's (there are 24.5 m’s in an inch) with surgical removal. So, the answer is yes you can have a non surgical treatment but you have to be realistic about the results provided by non surgical techniques.  Dermal fillers would be a great place to start if your cheeks are flat as this alone can feminize the entire face. In order for that to occur, the dermal filler needs to be placed in the front of the cheeks which will create a full round cheek and thereby a feminine, heart shaped face. If however, the dermal filler is placed to the outside of the cheek this broadens and widens the face which is a relatively masculinizing effect and one that will "not" create a more feminine shaped face.I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  From the photos your cheeks are flat anteriorly (in the front), jowls are present.  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.

 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  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.

Hope this helps.


Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Liposuction vs. Coolsculpting

Coolsculpting is good for pinchable fat and it is appealing as it is nonsurgical, but it does not tighten the neck. In this case, surgical intervention that combines liposuction with a surgical procedure to tighten the platysma muscles under the chin would be in order. You may also want to consider a face and neck lift. Consult in person with 3 experienced and expert board certified plastic surgeons to understand your options. 

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 36 reviews

Chin Liposuction vs CoolSculpting for the chin and neck

CoolSculpting has a good track record for improving smaller areas of fat deposits.  For fat removal plus tightening you'd be better off with SlimLipo plus a submentoplasty.  A submentoplasty is a surgical procedure to tighten the platysma muscles under the chin.  All that being said. . .based on your photo you'd be best served with a facelift and neck lift.
Chase Lay, MD

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 72 reviews

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Face and neck lift candidate

The  Limited phototograph demonstrates significant loose and inelastic skin in the neck, fatty deposits in the neck, and loose platysma muscle, in addition to jowls.  To properly rejuvenate the face and the neck will require a comprehensive lower face and neck lift.  Nonsurgical fat removal does not work very well.  In addition, even if it did, more loose and elastic skin would be the result.  Look for a facial plastic surgeon who produces a  very natural result with their face lifting techniques for a comprehensive facial rejuvenation.  

William Portuese, MD
Seattle Facial Plastic Surgeon
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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.