Fat accumulation below the jaw line is a common problem for many adults over the age of 40. Because the fat creates a bulge below the prominence of the chin, this problem is often seen and referred to as a “double chin.” It is the result of one ‘s weight and genetics and is a major reason many patients seek treatment for aesthetic improvement of their neck appearance. (loss of one chin)
Laser-assisted liposuction (Smartlipo) is a very effective method for reducing fat along the jawline and neck areas. When done by itself, it can be done under local anesthesia, avoiding general anesthesia and its associated costs. Some doctors tout this treatment as an alternative to a facelift…but this is overstated at the least and frankly dishonest at the worst. No method of liposuction can tighten or lift skin like a facelift. A better question is…can I get away with Smartlipo in the neck alone without needing a facelift? Or…will I be happy with Smartlipo treatment alone. That answer is going to depend on how big your double chin is and how much of that problem is due to loose or extra skin.
While no one can give a precise answer without actually doing an examination, there are several things to look for to determine if you are a candidate for Smartlipo of your double chin. Younger patients under 40 have skin, in quality and quantity, that is most likely to maximally shrink and contract. As one ages much beyond this point, the favorable characteristics of the neck skin of youth diminish. Neck or double chin skin that has visible rolls does not bode well for good skin contraction. If you can put your fingers in front of and/or behind the ears and lifting it makes the neck look better, then you have too much skin for liposuction to improve alone.
For patients whose neck fat with questionable skin, the results from Smartlipo can be improved when combined with other rejuvenating methods. Procedures such as laser resurfacing, chemical peels, and fat injections for facial volume enhancement are good complementary options in some patients with more aged skin or a more aged face look. Combining Smartlipo with these other procedures may delay needing a facelift for 5 or 6 years.
One of the concerns when doing any form of liposuction of the neck is injury to a motor nerve branch (marginal mandibular branch of the facial nerve) which comes up over the jaw line into the side of the chin. If this nerve is rubbed over during the surgery, there can be some temporary weakness to the lower lip. This is most likely to happen when treating the jowl area. While this is rare, it can happen occasionally. It usually takes several months until full recovery of the nerve happens.
One of the very common issues after neck liposuction is firmness and scar tissue that develops. This makes the neck feel tight and full (although less than before surgery) While this will usually go away, early massage of the neck can make it soften sooner as the swelling subsides. If there are some hard nodules of scar tissue, a little bit of low dose cortisone injected into the scar nodules will help soften them up.
Dr. Barry Eppley
Indianapolis, Indiana