What is the best procedure to tighten my lower face/jaw and double chin? (photo)

Question

I am 42 and have started to see my lower face drop. I’m wondering what the best procedure would be to tighten and firm up? I

Carl Truesdale, MD · Answer

Thank you for your photos. Based on the photos you submitted, you appear to be an excellent candidate for a deep plane face and neck lift to address heavier jowls, soften the nasolabial folds, tighten the neck, improve jawline definition, and reduce the appearance of a double chin. This procedure lifts and repositions the deeper facial structures to restore more youthful contours in a natural, long-lasting way.
Adding fat transfer to your procedure would complement the lift beautifully by restoring volume to areas that naturally lose fullness with age. This helps improve facial balance, enhances skin tone and texture, and adds soft, natural contour and definition.
When performed together, a face and neck lift with fat transfer provides the most harmonious and comprehensive rejuvenation, allowing us to lift, sculpt, and restore volume for the best overall result.

David Hansen, MD · Answer

Getting the advanced deep plane mid/lower face/neck lift would do so  well to tighten up everything naturally looking and is easy to  undergo under local with a little iv sedation for complete comfort. Minimize the biggest risks by getting rid of general anesthesia. Under local allows the doc to sit you up occasionally to fine tune the results so you look your very best which you can't do under general. Also get the skin resurfacing package of  Morpheus/ TCA peel done at the same time to the face, neck and chest so you look amazing and totally refreshed when you go back to work in 1-2 weeks.

Lucian Ion, FRCS · Answer

Thank you for your inquiry and for sharing your photographs.
The images show moderate laxity along the jawline and beneath the chin, with a right platysma band being more prominent. There is also visible fullness from the submandibular glands and the digastric muscles, both of which appear more noticeable on the right side.
Based on this assessment, a combination of a deep plane facelift and neck lift is likely to be the most effective approach to address your concerns comprehensively. This combination is well suited to improving the contours of both the neck and the lower face, and is known for producing results with relatively good longevity, as the improvements are anchored in the deeper anatomical structures.
In addition, the images suggest moderate hypertrophy of the masseter muscles. For this, botulinum toxin injections — such as Botox or an equivalent product — would be worth considering. By reducing the volume of the masseter muscles over a course of treatments, this can produce a softer and more refined contour to the lower face, complementing the surgical outcome.

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

Ali Riza Öreroglu, MD · Answer

Based on the photos I’ve seen, you are a good candidate for procedures like Deep Plane Facelift, Neck Lift, and fat grafting. The Deep Plane Facelift is an effective option to address sagging in the lower face and jawline, providing great results for sagging caused by reduced skin elasticity and gravity over time. The Neck Lift is ideal for correcting double chin and sagging in the neck area. Additionally, fat grafting can add volume to your face, especially filling in hollows in the jawline and lower face. These procedures, when combined, can provide both tightening and volume restoration, giving you a youthful and fuller appearance. That being said, to determine the best option for you, a physical examination will be necessary to make a definitive decision.

Jeffrey M. Darrow, MD · Answer

Thank you for your photographs. Your overall facial shape and skin quality look good. You have early jowl formation and platysma banding in your neck.  If your overall health is excellent, chances are your skin quality is very good at 42. For the best result, and the longest lasting result, a mini facelift with a plication of your SMAS layer in a vertical/posterior position should give you excellent improvement in your midface volume, straighten and sharpen your jawline and smooth your neck. This can be performed under local anesthesia with some sedation and the recovery is fast.

Tanveer Janjua, MD · Answer

You have the option of less invasive skin tightening with Sofwave which is an Ultrasound based device. It helps with tightening the jowls and neck. There is no downtime. 
The other option is to do a mini facelift. 
Regards
Dr. J

William Portuese, MD · Answer

Based on your photographs, you have significant laxity of the skin in your neck, you have  jowls and loose and elastic muscles in the neck. A lower face and neck lift procedure can accomplish improvement to rejuvenate your neck and face. This procedure is performed under general anesthesia and takes about 2 1/2 hours. The goal is to tighten loose facial and neck skin, tighten loose facial and neck muscles, lift the jowls and remove any fat deposits in the neck with liposuction.

Nelson Lee Novick, MD · Answer

If you wish to go nonsurgical, you should consult with an experienced, board certified cosmetic dermatologist filler expert to discuss the use of various robust HA fillers to achieve your goals. 
For example, consider the use of a robust, HA lifting filler cheek augmentation to lift the cheeks, create a more feminine Ogee Curve, oval, heart-shaped face; consider a robust HA contouring filler for enhancing the lower third of the face and straightening and defining the jawline (which, in itself, would secondarily help to tighten the submental region).
Both approaches can be performed in experienced hands in about thirty minutes, with immediate results and little to no significant post-treatment downtime. 
Exercise a great deal of buyer beware caution when being hawked this or that expensive, supposedly "next big thing" laser or RF gizmo, since the hard science to support the use of these devices lags well behind the heavy marketing and social media hype to promote them. 
Hope this helps and best of luck.

Zoran Potparic, MD · Answer

Your major problem seem to be a neck, based on these photos. In that case, a lower face/neck lift may be the best option. In person consultation with a board certified plastic surgeon with good reputation in facial rejuvenation is recommended. Good luck.

What is the best procedure to tighten my lower face/jaw and double chin? (photo)

Answers (11)

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