Age 44, 5'2, 120lbs - what could be one to improve my double chin? (Photos)

Question

I asked a similar question earlier as well and wanted to share more pictures.Also I am looking for least invasive treatment.

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

"For a double chin, InMode FaceTite with VASERlipo would give you the best result.

With significant neck sagging you would need a facelift / neck lift with muscle tightening (platysmaplasty). At the same time, I would recommend lasers (Fraxel, CO2, Halo, or Erbium) and microneedling RF (Fractora, Morpheus8, PiXel8, Intensif) to improve the crepey skin and wrinkles. Overall, the neck can be treated with a combination approach:

1. Microneedling and laser treatments for texture
2. Botox, Dysport, Xeomin or Jeuveau to help platysmal bands
3. Intensif, Fractora, PiXel8, or Morpheus8 microneedling RF for crepey skin and lifting
4. Injectable fillers like Belotero, Restylane Silk, Versa, and Juvederm Volbella to improve lines and folds
5. Face/neck lifting if sagging is prominent or premature, with or without platysmaplasty (muscle tightening)
6. Renuvion (J-Plasma), ThermiRF, and InMode FaceTite/AccuTite for internal tightening
7. Ultherapy and Thermage for external tightening
8. Regular Venus Legacy, Exilis Ultra, or InMode Forma treatments with facials to maintain tightness
9. PDO NovaThreads or Silhouette InstaLift cone threads for lifting and long-term collagen production

See an expert for a formal evaluation and to develop a personalized treatment plan based on your individual situation and goals. Best, Dr. Emer"

Tanveer Janjua, MD · Answer

Chin Liposuction and Thermitight
Chin liposuction helps reduce the bulge under the chin and can be done for the whole neck. Once the fat is removed the skin can become loose and saggy in some cases. It can be avoided by combining it with Thermitight which is a radiofrequency heat delivered under the skin to tighten it. Both chin liposuction and Thermitight can be done at the same time. The recovery is fast and it can be done under local anesthesia.
Click on the video link below
Regards
Dr. J

Sam Naficy, MD, FACS · Answer

The least invasive option is not going to give you a great result. If you still want to pursue that, it would likely involve a combination of injections of Kybella in an attempt to melt some of the fat, as well as some filler to attempt to build up your chin and jawline. The issue with these treatments is that they will be expensive, only somewhat effective, and likely will need to be repeated.

The best result and the most long-term result would be obtained with a combination of a deep neck lift and a chin implant. A deep neck lift, still done through a relatively small incision under the chin, can do a lot more than liposuction alone can do as it can address some of the deeper structures of the neck that are impossible to address with liposuction alone. The chin implant is placed through the same incision as is needed for the deep neck lift.

Daniel Barrett, MD · Answer

Dear Risklife,
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

Leo McCafferty, MD · Answer

Thank you for your question.  I believe your neck is obtuse and your chin slightly recessed and my recommendation would be to address the neck and the chin simultaneously.  Liposuction is a very precise way to address the neck, and utilizing some of your own fat is an option to enlarge your chin or you might consider a chin implant.  Remember liposuction will not tighten your skin and without a face to face examination I am not certain that this would be your best option.  I recommend you see a board certified plastic surgeon experienced in facial rejuvenation.  Good luck!

William Portuese, MD · Answer

From these photographs, there are several issues present which all  need to be addressed in order to give you a very Nice result with a natural look. There appears to be recessive Chin/ mandible, so consider placement of a chin implant to augment your chin forward for better structural support for the Soft tissues in the neck. It's also very important to understand that there are two compartments of fat located in the neck, one compartment above the platysma muscle, and the other compartment below the platysma muscle. Liposuction can only accomplish removal of the compartment above the muscle which would be pretty much ineffective, since most of your fat is located below the platysma muscle. To remove the large deposits of fat below your platysma muscle, that is going to require a new neck lift procedure which accomplishes removal of both compartments of fat and a platysma- plasty to significantly improve the jawline. At age 44, your skin tone should be acceptable, so no skin removal is required. In our practice, a necklace involves three small access incisions. Both a neck lift and chin implant can be performed simultaneously under one anesthesia with one recovery period. Noninvasive treatments Will not be of any benefit for you

Mats Hagstrom, MD (license on probation) · Answer

All of your issues are related to an under developed mandible.
When making and assessment regarding facial skeletal imbalance we need to look at different aspects of the mandible. i’m guessing that the entire mandible is small and deficient for ideal facial aesthetics in your case. when the body of the mandible lacks projection people develop tooth misalignment or a dental occlusion overbite. most likely dentist have told you that you have an overbite. it shows on your profile picture because your upper lip has significant more forward projection than your lower lip in the position of the lips is based on where the teeth are.
The mentalis or chin doesn’t impact tooth position but it determines how much projection your chin has.
In your case the body of the man the bone is small setting your lower teeth back and this also causes the underlying platysma muscle to drape your neck in a more oblique fashion causing the double chin. there are a variety of procedures that can help your situation.
Starting from the easiest moving towards more complex they are augmenting your chin using fillers, Augmentin your chin using a chin implant, advancing your chin with a sliding genioplasty, treating the soft tissues with a neck lift, jaw advanced been surgery. 
If you wanted to go all out and get the best possible outcome then you could do a jaw advancement and sliding genioplasty followed by a neck lift once you’re healed up from the bone surgery.
Most of your issues are related to bone structure and for that oral surgeons may have an upper edge on making an accurate and quality assessment as well as offering treatment options.
Why are plastic surgeons sometimes get involved with doing surgery of the man in the bowl many tend to focus more on soft tissue treatments.
For that reason expect to get different opinions from different providers.You don’t have to have any of these operations but if you choose a procedure it would be good if you understood all the options and had a really good understanding of all the variable dynamics associated with your individual facial bone structure. As well as understanding each of the procedures including what it can and cannot accomplish.
I suggest having multiple in person consultations with local oral surgeons and plastic surgeons in your community. You will most likely get different doctors recommending possibly different solutions to your problem. for that reason having multiple consultations sometimes helps solidify what is probably your best option. Try to find people who have plenty of experience.
During each consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures for the procedure you’re interested in.
Being shown just a handful of preselected images which most likely represent the best results of each provider his career is insufficient to get a clear understanding of an average results look like or how many of these procedures that surgeon has actually perform.
Being shown just a handful of preselected images which most likely represent the best results of each provider his career is insufficient to get a clear understanding of an average results look like or how many of these procedures that surgeon has actually performed.
Continue having consultations until you feel very comfortable that you found the right provider for your needs.
When in doubt slow down and schedule more consultations.
Avoid having virtual consultations and avoid traveling long distances for elective surgical procedures unless necessary.
These are operations do you want to do ones and hopefully not need to do again or have revisions.
Finding the right provider and choosing the correct procedure is key.
Good luck,
Mats Hagstrom MD

Gerald Wittenberg, MSc, DMD (retired) · Answer

The contour of a 'chin' relates both to the soft tissue around it (eg fat pad under the chin) as well as the underlying genetically determined bone structure (eg small chin development). Your images show both as issues. Liposuction under the chin helps to define it; and a genioplasty will 'stretch' out the area under the  chin/flatten it and increase the projection. Fillers may be of limited benefit  but do not address either of the causative issues.

Age 44, 5'2, 120lbs - what could be one to improve my double chin? (Photos)

Answers (9)

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