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I am 54 years old and look as young as 34 years old. I have had a double chin as far...

Q:

I am 54 years old and look as young as 34 years old. I have had a double chin as far back as I can remember, even in my early 20’s, and it appears to be a family trait because I see it in other family members. I have a small fat deposit in the submental area and I was told that if I had liposuction in the area that it would leave a “turkey waddle.” Is the liposculpture enough to make the skin retract or would I need more procedures? My skin is not loose in that area nor is it hanging.

A:

This is an excellent question. In considering any cosmetic procedure, we want to make safety our #1 concern. Next, we want to be sure that we match the most appropriate procedure with the patient, with the goal of achieving the desired result. The best case is where we do the least invasive procedure to get the best result. Having that in mind, it is quite possible for you to achieve your result with just liposculpture alone. The two basic requirements for a good liposculpture result are good skin elasticity, and fat to suction. In the first case, the skin must have enough recoil so that when the fat volume is removed, the skin will shrink down, and re-drape aesthetically. In the second case, we must be sure that the apparant "double chin" is due to fat, and not some other cause, that is not amenable to liposculpture alone. Other causes include: relaxation of the skin, relaxation of the neck muscles (platysma), short lower jaw, weak chin, and far forward (anterior) trachea. I would recommend that you visit with a board certified plastic surgeon in order to get properly evaluated, and to review what options would be best for you.

Unknown

A:

Without a consultation it is impossible to know exactly what you need. But it sounds like you could be a candidate for submental liposuction or a suture suspension lift.

 

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.

 

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