Options to Correct a Sagging, Wrinkling Double Chin?

Is there anything I can do to firm-up or eliminate a sagging, wrinkling double chin that has developed this past year. I've always had a small double chin (from dad), however in the past year, my body is changing - fat is shifting to tummy area, upper arms are puckering and sagging, but most obvious to me is this hideous double chin that jiggles when I talk. I try to eat right and stay active, but am at a loss. I am a 59 yr old female, 5'6", weight:140, walk 3- 5 miles 3 days/wk, do yoga 1-3 days/wk, vigorously clean house and do yard work regularly, do daily water aroebics in the summer, however I do have a desk job during the day. Please, please can you HELP me or direct me to a good resource!!

Doctor Answers 18

Neck aging, double chin

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There are usually two components two "fixing" the neck: tightening the neck muscles, and tightening the skin that leads to the neck. Typically that calls for a neck lift and a facelift. Anything short of that, including mini-lifts, will yield suboptimal results.

Modern facelifts also add volume to deficient areas, redistribute tissues so that the jowls are lightened but the cheek area is strengthened.

When consulting for these procedures, the patient should also consider the balance of their chin with the rest of their face, to see if a weak chin is contributing to business in the neck.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

Options for Neck Lift or neck rejuvenation

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Neck Lift (Cervicoplasty / Platysmaplasty)

Though it is not technically part of the face, a neck with loose, sagging skin can age the face dramatically. A neck lift is a standard part of most facelift surgeries, as the neck skin is mobilized in continuity with the lower face.

Immediately under the skin of the neck is the platysma muscle, which you can easily see in a mirror when you clench your teeth and tighten your jaw. In youth, this paired muscle meets in the midline below the chin. With age, the right and left sides of the platysma often separate, producing vertical 'cords' in the anterior neck. The platysma can be divided anteriorly and tightened during neck lift cosmetic surgery to permanently eliminate these 'cords' and improve the neck contour. One tightened in the midline below the chin, lateral traction on the platysma then creates a 'sling' which elevates the soft tissues below the jawline.

Cervical / submandibular liposuction

Some individuals have 'sagging' necks primarily due to fat accumulation below the jawbone (mandible). In some cases, liposuction alone can significantly improve the neck appearance. Liposuction is also frequently combined with surgical neck rejuvenation, and in selected cases some direct excision of fat (through a hidden incision below the chin) is performed. The reduction of fat in the area below the jawline and in the anterior neck almost always makes the neck appear longer, and makes the patient's profile appear more elegant or refined.

Suture suspension neck lift

In cosmetic surgery patients that do not have a sharp transition in profile between the submental area (area below the jawline) and the anterior neck, and in patients who simply want that transition enhanced, I add a 'suture suspension necklift'. A permanent suture is passed subcutaneously across the anterior neck, at the level corresponding to depth of the angle between the submental area and anterior neck, and is then anchored to the deep soft tissues behind each earlobe. This suspension cosmetic surgery procedure can dramatically enhance the definition between the jawline and anterior neck, producing a more elegant profile.

The neck is without question the primary 'facelift' aesthetic area where subtractive (excisional) and tightening procedures restore a truly youthful contour. Once again, take a look at the fashion magazines: essentially every neck you'll see demonstrates something close to a right angle between the neck and jaw. When it comes to the neck, and only in the neck, flat is good.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Depends on your anatomy, but usually yes

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All the components of your face and neck need to be evaluated prior to giving you a standard type of recommendation. If the jaw bone is too small, this needs to be addressed in one of several ways. If there is too much fatty tissue, this can be suctioned. If there is too much skin, this can be resected in a number of ways. If all of these problems co-exist, usually a single sitting can be used to address all of them.

Alexander M. Guba, MD
Huntersville Plastic Surgeon

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Probably need a neck lift

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At 59 years old with sun exposure from yard work and a family history of "double chin", as well as recent changes suggestive of the aging process, I would suspect that the only solution that would give you significant and long-lasting results is a neck lift. All other modalities can be additive and complementary, but non-comprehensive. Visit a couple of experienced, board-certified plastic surgeons who can customize a solution for you.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Options for fixing a sagging / double chin

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Patients over the age of 50 complaining of a sagging/ double chin are most likely a candidate for a lower face lift. Where liposuction of the chin would work well for younger patients with good skin elasticity, the same procedure would cause more sagging in the area for older people. There is also the option of laser liposuction, which can tighten the skin while removing fat at the same time. A consultation with a plastic surgeon to determine the appropriate procedure would be best. 

Correcting the sagging chin with liposuction

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Liposuction is a safe, popular, and effective way to contour the body. Although it is possible to treat the skin around your chin and neck with liposuction, the most important factor for a successful result is the quality of the skin in this area. If you have a great deal of looseness already, liposuction may make this appearance worse. For this reason, it is essential that you work with a board-certified plastic surgeon who is experienced in liposuction, neck lift, and facial rejuvenation. They will be able to examine your neck and determine if the skin will be able to contract back after just a liposuction procedure to give you a beautiful smooth result. Rest assured that there are many options for your condition, now you need to work with a experience surgeon who can help match the best option for you.

Options in Correcting Sagging, Wrinkling Double Chin

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The pattern you describe has much more to do with aging and skin excess than with excess fat.

In stock trading, stocks usually (forget 2008) earn more but are also riskier than boring municipal bonds. But the two are not at all equivalent even under the best of circumstances.

Similarly, in surgery, every procedure has its own benefits and trade offs and procedures differ in their effectiveness.

When you have a SLIGHT neck skin laxity, some modalities , such as the Sciton BBL- SkinTyte can bring about moderate shrinkage. But if you wanted a really smooth, youthful neck, you should probably have a Neck Lift (Cervicoplasty).

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Liposuction no good for sagging double chin.

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Liposuction is not going to help the condition you are describing.  It sounds mostly like loose skin.  You need a neck lift or even a face and neck lift.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

An excellent fix for your neck

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At your age of 59, describing what you have, the proper fix would be a cheek and neck lift or facelift. Artfully done by a Board Certified Plastic Surgeon, you will get a great and lasting result that will fix the problem extremely well. You will look natural and not operated upon. Please check my photos of this on RealSelf and my web site. There is no other treatment that compares to this. Just be sure you go to the right doctor who can show you many photos of results of their own and that they show the kind of changes you want. Good luck.

Mini-neck lift is an option

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Althought I have not seen your anatomy, a great option for this problem is what we call a "mini-necklift." It is performed under local anesthesia in less than an hour and an incision less than one inch long.

First, using tumescent anesthesia the jowls, jawline, and submental (under chin) areas are liposculpted with micro canulas. Second, the platysma muscle is tightened to further improve the angle under the chin.

This approach is considered "minimally invasive," and offers excellent, natural results.

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.