Options to Correct a Sagging, Wrinkling Double Chin?

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.

Thank you for reaching out with your concerns about the sagging, wrinkling double chin that has developed recently. It's great to hear about your active lifestyle and commitment to staying healthy.

Without seeing photos, it's challenging to provide a definitive recommendation, but based on your description, there are a couple of options that could be effective for addressing your concerns.

Neck Liposuction: This is a common procedure for removing excess fat from the neck and under the chin, helping to redefine the jawline and reduce the appearance of a double chin. Many of my older patients, even those in their 60s, have achieved good results from neck liposuction alone. The procedure involves minimal incisions and has a relatively quick recovery time. It is most effective if the skin still has some elasticity, which helps it to contract after the fat is removed.

Neck Lift: If there is significant skin laxity along with fat accumulation, a neck lift might be a more suitable option. A neck lift involves removing excess skin and tightening the remaining skin to provide a more lifted, firm appearance. This procedure can be more invasive than liposuction and involves a longer recovery period but can significantly improve the contour of the neck and jawline.

Given your active lifestyle and the changes you've observed, it's also important to consider that hormonal changes associated with aging can affect skin elasticity and fat distribution, making areas like the chin and neck more prone to sagging.

I recommend consulting with a board-certified plastic surgeon who can perform a detailed physical examination and provide personalized advice. The surgeon can assess your skin quality and the amount of fat in the chin area to determine which procedure—or combination of procedures—would offer the best results.

Please feel free to look for a reputable surgeon in your area, or if you need assistance finding one, I would be happy to make a recommendation.

Maintaining an active and healthy lifestyle is a great step, and with the right surgical approach, you can improve the appearance of your chin and neck.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Mass,
From the description that you are giving, it sounds like a neck lift is the best option. However, if you provide a picture, we may be able to give you more specific advice. With neck lift, you will have a small incision around your earlobe and behind your ear. Sometimes, you may also need a small incision under your chin. With this method, we can tighten up your underlying muscles and your overlying skin. Good luck with your surgery.

The neck is one of the more complex areas to deal with in terms of aging. Several factors contribute to facial aging involving the neck. Skin laxity, excess fat, and weakening of the muscles and supporting structures of the neck are three of the more common reasons.
A small chin that you may have had your entire life may also contribute to the sagging in your neck that you are now seeing. Diet and exercise are essential, but, only helpful to a point. A thorough evaluation of your neck and face by an experienced physician will enable you to receive the best advice for your particular situation.
One procedure or approach is definitely not appropriate for all patients. A combination including surgery to address the skin and muscles of the neck and liposuction will likely be required at 59 years of age.

Neck rejuvenation is a specialty unto itself. When I counsel patients about improving the neck area I make sure that they understand that the neck has several layers that need to be individually addressed to optimal improvement. The first and, in my opinion, the most important layer, is the skin. Taking care of your skin will make the best statement about you in the end. To this end, I usually recommend healthy water intake, sunscreen with an SPF>30, and medical grade skin care product usage.
In my practice I further improve the skin through the use of laser skin resurfacing and prefer to use Active FX fractional carbon dioxide laser to gently tighten the skin over the course of 3-4 treatments. The next layer to consider is the fat layer directly under the skin. The best way to deal with it is to perform small cannula liposuction.
I use VASER ultrasound technology to try and get some additional skin tightening with the loss of the fat. It is not absolutely necessary though. The final layer to consider is the underlying muscle layer known as the platysma. The platysma muscle with time and use become loose and starts to sag. Here in Denver, women are extremely active with yoga and Pilates.
Those disciplines require some unusual head positions that stretch those neck muscle out and, in my opinion, contribute to sag. A neck lift procedure helps tighten the underlying muscle layer and gets rid of excess old skin to give you better definition to your neck. Hope this helps.
Dr. Shah

Excess fat is removed under the chin with liposuction, but you will probably require a facelift to remove the excess skin that will remain. Your surgeon can tell you if a chin implant would be of benefit as well. Unfortunately, with age and gravity, everything is headed south. Exercise can help tone muscles but won't correct the sagging skin.

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. 

If the skin under your chin feels very loose, liposuction is not the answer.  Usually some sort of a neck lift is best.

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.
 

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