Is this neck skin laxity or do I have fat to lose? Would Vaser lipo help? Does a surgical neck lift only last 5 yrs? (Photo)

I lost about 92 Ib in weight last year and have been left with excess skin and pockets of fat. I am only 36 years old and I exercise for between 2-5 hours a day and have quite a balanced diet, yet I don't seem to be able to shift this excess fat. I suffer with severe ulcerative colitis and am on Vedolizimub infusions so would prefer not to do anything too invasive, however, I would like to try and shift this skin/fat as it really ages me. Any suggesions?

Doctor Answers 6

Is this neck skin laxity or do I have fat to lose?

 Hi, 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 and the chin is weak.  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.

 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.  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

Surgery options

When looking into a procedure like this, you need to see what is causing what you don't like in the mirror. The things that can be address surgically are the skin, the fat and the muscle. Definitely seek out a board certified plastic surgeon in your area with an expertise in Facial Aesthetics for a consultation and more details. Without seeing you in person, it is hard to say what your best options are. 


Dean Vistnes, M.D.
Vistnes Plastic Surgery
San Francisco Bay Area

#realself #necklift  #drdeanvistnes

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
5.0 out of 5 stars 45 reviews

Is this neck skin laxity or do I have fat to lose? Would Vaser lipo help? Does a surgical neck lift only last 5 yrs?

Hello nikkicp,
Thanks for your question.
What you are seeing is probably a combination of skin and muscle laxity.  I highly doubt that if you exercise 2-5 hours daily that there is any excess fat in your face.
VASER lipo might help a bit, but not as much as it would in combination with a platysmaplasty (muscle tightening), or proper neck lift.
In your situation, I've found that SmartLipo (laser lipolysis) is also very helpful at improving the nature of loose skin and muscle.
Neck lifts will last for varying amounts of time depending of a multitude of factors including sun exposure, age, smoking, weight-loss, etc.  
You might consider noninvasive therapies such as RF skin tightening or Ultherapy to tighten the skin, but have realistic expectations and be patient with regards to the time it might take to get the outcome desired.
With your history of UC it is probable that you have been exposed to steroids over the years, and as such it is important to know that steroids have a negative effect on skin aging and elasticity.
I hope this helps point you in a direction that makes sense.
Good luck,
Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 47 reviews

Double Chin Treatment / Laxity-- SmartLipo/VASER/ThermiRF, Botox, Venus Legacy, Kybella, CoolMini

This type of neck really needs skin removal with liposuction.  Liposuction/Thermi alone will give improvement  but will not fully contour the neck.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 168 reviews

Is this neck skin laxity or do I have fat to lose?

While photographs cannot take the place of an in-person evaluation, the mild laxity noted can be corrected with a neck lift. I would not recommend vaser liposuction as this may lead to unnecessary scarring and deformities that may be difficult to correct. The neck lift procedure will remove stubborn fat deposits in the neck area, sharpen the definition of your jawline as well as the angle from your neck to the chin. A consultation with your primary care physician would be necessary to ensure that this can/is done safely with the medication you are currently taking. On average most neck lift procedure results will last approximately ten years. Best wishes.

Best option for improving neck contour.

Your photos show a near normal lower facial and neck contour with only some mild blunting of the jawline, slight fullness under your chin and platysma muscle and neck skin laxity.  The most definitive correction of all of these would be a lateral platysmal tightening necklift (which would straighten your jawline and reduce the platysmal bands) with midline platysmal tightening and removal of a small amount of fat beneath your chin via a small incision under your chin.  This would allow correction of all of your concerns.  Done in coordination with your primary care doctor, this should be able to be done safely with the medications your are on.  Results should last 10 years.  I would be cautious of vaser liposuction as it heats the fat and can result in areas of very dense scarring.  My website shows numerous women who have lost weight and underwent facial rejuvenation, so this shows you what can be achieved.

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.