Q: Dr. Eppley, I would like to have double chin surgery. I am just 42 years old and have a roll of what feels like fat under my neck that never goes away. I am actually very slim and this is my only problem area on my entire body. What treatment is recommended in my case? Thank you.
A: The type of double chin surgery that one needs must take into account four anatomic factors. How much fat is in the double chin? Is the chin short or has inadequate projection? Is the plastyma neck muscle separated or split apart allowing deep fat to protrude through? Is the neck skin loose? This corresponding treatments could include submental/neck liposuction, chin augmentation, a platysmaplasty or a full necklift.
For a patient in their early 40’s who is unlikely to have much loose skin (unless you have lost a lot of weight) the most likely anatomic culprit is fat, making liposuction a primary treatment. If you have a weak chin, a chin implant will significantly help with the liposuction with a diametric benefit to the jawline. (neck goes up, chin comes forward)
If you have a very heavy neck, a playsmaplasty (tightening the neck though a small incision underneath the chin) will improve the angle of the neck more than liposuction alone.
Dr. Barry Eppley
Q:Dr. Eppley, Can you tell me how to get rid of my pesky double chin? It bothers me tremendously. I am only 43 years old and my neck looks twenty years older! I am too young to look like this. I am at a good weight and haven’t been able to shake these two chins off no matter what I do. What do you recommend?
A: The ‘double chin’ appearance comes from two upside down hump areas. The first is the chin, which everyone has, but in the double chin patient it is often short or set back. This can make it appear that it is part of the neck when it should be a more distinct forward prominence of the jaw. The second hump or sag is the soft tissue of the neck. This may be just a lot of fat but is usually mixed in with some loose skin as well. This is particularly so in older patients who may have overall neck skin laxity. Given your relatively young age, I would envision that the anatomic composition of your double chin is a bony chin shortness and a collection of fat with some mild amount of loose skin in the neck.
Therefore, correction of your jaw and neck contour could be done by a combined chin augmentation and neck liposuction. It may also be beneficial to do a little neck muscle (platysma) tightening at the same time to get the best neck angle. I doubt if you need any removal of skin at your age and we would rely on the natural skin tightening that occurs after liposuction in good quality skin.
Dr. Barry Eppley