Whether it be the younger patient who has always had a fuller neck or the older patient who has developed a neck ‘waddle’, the double chin appearance is an undesired facial look. It can be caused by either too much neck fat, loose neck skin, or a short chin or jaw. In the young patient, it is usually a result of too much fat and a smaller chin. In the older patient, the issue of loose neck skin becomes more prominent.
Surgically changing the double chin look is a highly successful procedure that usually has a fairly dramatic change in one’s appearance. This is most evident in profile or side views, the view that most people see us as but one we rarely perceive ourselves in. There are three plastic surgery procedures that address the double chin deformity; neck liposuction, chin implant, and a neck lift. Which one(s) are used in each patient depends on their age and what is the anatomy of the underlying problem. Sometimes only one procedure used, in other cases all three may be necessary. To help me match the right solution to the problem, I classify double chin patients as follows:
Type 1 Young patient, fat neck, normal chin = neck liposuction only
Type 2 Young patient, fat neck, short chin = neck liposuction + chin implant
Type 3 Middle-age, full neck = neck liposuction, limited or full facelift
Type 4 Middle-age, full neck, short chin = neck liposuction, chin implant, facelift
Type 5 Older, neck waddle = full facelift, chin implant, +/- neck liposuction
This treatment planning algorithm helps me think through what is best for each patient to create that well-defined jowl and neck profile. All procedures are done as an outpatient under sedation or general anesthesia. Surprisingly, there is very little discomfort with these procedures but there is some social recovery (appearance of swelling and bruising) Once corrected, the results last a long time. In most cases, there will never be a complete return to the original look….ever.
Dr Barry Eppley
Indianapolis, Indiana