The chin and neck angle relationship is one of the most significant facial markers that has a significant influence on the age of one’s appearance. A well defined chin point and a contoured neck angle are what most of us had in the first three to four decades of life. Aging changes the neck angle and, combined with even a slightly weaker chin, creates that loss of youth look.
The combination of neck liposuction and chin augmentation is one the most effective and relatively simple facial procedures. The best patients are generally under the age of 55 (average range 35 to 50 years old) who do not significant neck skin looseness or laxity. The neck skin may have some wrinkling and sun damage but one should not be able to pinch more than an inch of loose skin. (not bunching up fat, just loose skin) The key is patient selection for a good result. If significant loose skin exists, some form of a necklift (facelift) is needed.
Candidates for this combination often seek out or have already had non-surgical treatments like Thermage or SkinTyte. These minimally invasive neck and jowl treatments do not have the capability to really change facial contour. While they do create a minor amount of skin tightening and wrinkle reduction, they often leave patients disappointed. They are not capable of removing a double chin or a jowl sag.
For patients with a good chin profile, neck liposuction alone is all that is needed. I prefer the use of Smartlipo as it can be comfortably and effectively be done under local or sedation anesthesia. With Smartlipo, a 1mm fiber is threaded through a small stainless cannula for insertion under the neck skin. The cannula keeps the fiber from bending and breaking. The tip of the fiber sticks out beyond the cannula just a bit to deliver the heat energy to the fat. The fiber has an aiming beam so one can always see the laser point under the skin and know exactly where the laser is. The key to laser lipolysis is that it is performed with temperature monitoring so the neck tissues do not get too hot. The wavelengths of the laser has three beneficial effects. Its effect on hemoglobin seals off blood vessels which results in less bruising. The heat is very effective for breaking down and melting fat. Additionally, by heating the underside of the skin significant tissue tightening will result. While there is debate about how much skin tightening occurs after laser liposuction, it is fair to say that it is greater than that which is achieved by liposuction alone.
The recovery after Smartlipo of the neck is a maximum of ten days. Often it is within just a week. In some cases, the addition of simultaneous skin resurfacing can be done if there is any pre-existing wrinkles. This will not increase the recovery time at all as less than 50 micron depths are used.
The potential benefit of a chin implant with neck liposuction must be looked at carefully. Many neck contour changes can be enhanced by some more chin projection. Rarely does one need an implant of any significant size, 3 to 5mms of increased horizontal projection can be enough. With flexible silicone implants, they can be placed through the same under the chin incision used for neck liposuction, just slightly larger. Incision lengths less than 15mms are all that is needed.
For the right patient, Smartlipo of the neck with or without chin augmentation provides a very visible neck change, is cost effective, and does not have a long recovery.
Dr. Barry Eppley
Indianapolis, Indiana