What Is The Best Neck/Jawline Reshaping Procedure for Me?

Q: Dr. Eppley, I’m contacting you because I would like a better profile of my face. I feel like I’m just going around in circles and I just need good advice. I hate my double chin. I had submental liposuction and it looks worse. Can I realistically get rid of all the fat under my chin? I have a recessive chin, weak jawline and fat neck (I want this neck fat gone pls). I want a clear distinction between neck and jaw because this is beautiful and looks balanced. I have been told to get a necklift to address the issue but I feel too young. And even if I do get a necklift, it doesn’t resolve the weak structure in the jaw; and it won’t hold up for long, I need volume in the jaw. Also does a necklift include a platysmaplasty? I don’t like the implant scar (2 cm). Although a doc told me a flower implant would be a good fit for me. Yet another doc said an implant could move, or make my chin bone smaller. So is a genioplasty the answer? I don’t know what to do. Another thing I’d like is to remove the bags from inside my eye. A certain doctor told me not to do that,to do a treatment instead. Maybe I should consider necklift? otherwise, it feels I’ll never get rid of neck fat. Am I too young for that? I am more confused than ever, please help me!

A: Thank you for your inquiry and sending your pictures and detailing your concerns. It is actually understandable why you would be confused about your lower face/neck because you are not a standard case. Your thicker tissues combined with your natural jawline and neck shape make it difficult to be successfully treated by commonly done standard approaches that most plastic surgeons use. You ideally need a combination of hard tissue augmentation and soft tissue reduction meaning:

1) Your neck would have initially been better treated by a submentoplasty, not just liposuction. A submentoplasty combines liposuction removal of fat above the muscle, excision of subplatysmal fat with midline muscle plication. This always produces a better result in fuller necks than liposuction alone. You do not need a necklift/ower facelift, you are correct  int that you are both too young and done have the tissue laxity to justify that effort.

2) Augmenting the jawline in some fashion is always a good complementary procedure to separate the face from the neck. Whether that is just a chin augmentation or a total jawline one can be debated depending upon your desired aesthetic outcome. But even if is just the chin, a sliding genioplasty offers a better neck effect than an implant because of the forward pull of the bone on the upper neck muscles. While your chin augmentation needs can certainly be met by an implant, it is how it would better benefit the neck that sways the bony geniopasty in favor for your aesthetic needs. Pulling the chin/neck forward and tightening cervicomental angle would provide the best possible outcome even if falls a little short of your ideal goals as this provides a maximal anatomic reshaping.

Dr. Barry Eppley

Indianapolis, Indiana