Explore Plastic Surgery

A sharply defined and tight neck is associated with a youthful and healthy appearance. Loss of a good neck angle certainly does occur with age as the neck skin loosens and jowling along the jawline develops. However, poor neck shapes and an obtuse neck angle occurs in the young as well but for different reasons. Necks with a lot of fat above the platysma muscle, with or without a short chin, creates a neck appearance that is full and ill-defined.

A very effective ‘cure’ for this type of neck problem is the combination procedure of chin augmentation and neck liposuction. Submental and neck liposuction can be very effective at thinning out a full neck. As the fat is removed, the skin contracts up and back above the thyroid cartilage (adam’ s apple),  decreasing the wide open neck angle and creating more visible horizontal and vertical neck lines in profile.  Bringing out the chin, ,if short, will make the horizontal part of the neck line longer both in appearance and in actuality.

Neck liposuction and a chin implant is another example of a ‘ying and yang’ plastic surgery procedure. The neck angle becomes sharper and the jawline becomes longer. Each procedure alone produces an improvement, but together the effect of each is even better. This is easy to see before surgery through computer imaging. See the results of each procedure separately and then together.  You will convince yourself if one or both is better.

The other benefit of combination neck liposuction and chin augmentation  is that they are done through the same incision. Right under the chin in the submental skin crease, a small stab incision is made and the neck liposuction performed through it. The stab incision is then lengthened to about an inch through which an implant is introduced in front of and on top of the chin bone.

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www/ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

Fat in the neck and jowl area would certainly classify as a Type LipoDissolve problem. I find that LipoDissolve injections in the neck to be a particularly effective treatment, probably the best use of an injectable fat reduction method. It works in this area for one good reason, the neck has a small surface area to it and therefore the fat problem is likewise limited. It fits in well with my concept of the ‘hand’ evaluation method to determine LipoDissolve candidacy. If the area fits into the size of my hand (size 6 ½) then it is reasonable to treat with LipoDissolve. In many necks that I have treated, the results with LiposDissolve can be close to that of liposuction.

The concept to grasp about LipoDissolve is that it is an inefficient method of fat treatment, albeit non-surgical. Unlike liposuction, fat injections require months of treatments to achieve its final results. So while it can be effective, it is not efficient. Liposuction surgery achieves its results in less than 30 minutes, albeit through a surgical process. Generally, the inefficiency of LipoDissolve would not be an issue if the treatment was hidden and not socially obvious. However, in the neck and jowl area, the effects of LipoDissolve treatment are for all to see and I am not just talking about the final results. After each LipoDissolve treatment session, the injected area will immediately swell and stay that way for about five days. And when I mean swell…think of doubling in size! Yes I did say double in size, you will have a bullneck. And this swelling process must be repeated each time that a treatment session is done, generally around three treatment sessions are needed to get the best result. For many patients, this neck swelling and how to explain it is enough for them to choose liposuction over LipoDissolve. For others, the importance of not having to go to surgery, and the additional expense, is worth the temporary neck swelling.

Besides the neck swelling, the other consideration is if the neck fullness is an isolated problem. LipoDissolve makes no sense if you are having other procedures anyway. The whole purpose of LipoDissolve is to avoid a surgical procedure. If you are getting on the operating room table anyway, then opt for liposuction and enjoy the benefits of the efficiency of surgery. One final consideration is how much much loose skin you have in the neck. While LipoDissolve can tighten some skin, do not think of it as an alternative to other truly neck tightening procedures such as a facelift. In older patients with more loose skin, these procedures are likely better and neck liposuction is part of every facelift (necklift) anyway.

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

Not infrequently I get requests from patients for the desire to transform a round face into a more shapelier one. One cause of a round face is that the patient is overweight. A full neck, round cheeks, and a lot of subcutaneous fat throughout the face creates a generalized fullness that creates a fat and round face. These patients know full well that they are overweight and some liposuction of the neck and buccal lipectomies may make some difference. But weight loss will probably make the most difference in these cases. And these procedures should not be performed until some weight loss has been achieved.
But the overweight patient is not what usually makes up the ’round face’ patient. Most commonly these are younger patients that are not significantly overweight and are usually closer to being more height and weight porportionate. They may have some mild fullness in the cheeks and neck but often their bony prominences (cheeks, chin, or jaw angles) may be somewhat deficient. The approach to these patients must deal with both hard and soft tissues issues to be effective at improving the face’s angularity and definition.
In addition to the fullness of the cheeks and neck, the next most important consideration in facial shape improvement should look at the chin. Often it may only be midly short in the horizontal dimension but the width of the chin is also important, particularly in the male patient. Chin implants today can provide more projection as well as width in many different sizes. Placed through a small incision under the chin bone, a chin implant can lend more definition and squareness to the lower face from subtle to dramatic results.
Upper facial fullness, more specifically midfacial fullness, can be achieved through cheek implants. Placed into position by incisions inside the mouth under the upper lip, cheek implants can provide good highlights through three-dimensional enhancement of the bone as it wraps around the area below the eye. An amazing aray of cheek and midface implants is available to provide a lot of enhancements around this important facial landmark. When paired cheek implants are combined with a chin implant, an upside down triangle of change is created that directly opposes a more round or oval facial shape.
Jaw angle implants are always a possibility but these are rarely needed in most really round faces. They can produce some lateral facial fullness but this is not usually helpful in ‘de-rounding’ the face.
The procedures of buccal lipectomies, neck and jowl liposuction, chin and cheel implants make up the usual plastic surgery tools for facial rehaping. Which one or combination of procedures is most helpful for improving facial definition is best determined by careful computer imaging study between the patient and their plastic surgeon.

Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis