Recently, there has been an increase in the use of suction to remove fat deposits throughout the body. This procedure, suction-assisted fat removal or “liposuction”, was first developed in France. After European patients received favorable results, leading cosmetic surgeons in the United States adopted the procedure and began to offer it to their patients. With the increasing interest in this method of fat removal and the development of safer instruments, liposuction has proven to be an excellent partner with which to improve the results of cosmetic surgery procedure.

I use this technique to enhance the results of other procedures my patients undergo, especially those who have fatty deposits under the chin and along the jowl line. Liposuction may be the sole treatment used for patients who are younger than the usual facelift patient. These candidates have skin which still has enough elasticity to reshape and re-contour the neckline after the procedure has been completed.

Patients who undergo liposuction should be aware that it takes between six weeks and six months to achieve the desired results. This is due to the inherent nature of the procedure which is simply breaking up the fat deposits and fat cells with a blunt instrument, a cannula, and sucking out the loose fat. Because of the swelling and reduction in the number of fat cells, the results take time to become evident.

A supportive bandage will be worn under the chin to one to two weeks. This bandage will also hide the small incision under the chin and below the earlobes. There is minimal discomfort with this procedure.

Your consultation is the time to discuss whether or not you are a candidate for suction-assisted lipectomy. Not every patient has the type of fat deposits that will be helped with liposuction.


“The Problem Neck”

In some people, a fat pocket develops below the chin. When combined with the gradual sagging of the skin, a double chin is formed. This condition tends to destroy the ideal curvature of the chin/neck line, an obvious sign of the aging process. This type of problem can occur in both younger (twenties) and more mature (forties) patients.

In others, there is less of a problem of fat accumulation and more of a problem of excess skin and relaxed muscle, which results in a “turkey gobbler” deformity. This deformity occurs when the weakened muscle forms vertical bands which run from the chin to the base of the neck. This type of problem occurs more commonly in the more mature (forties and older) patient. It is common in female and male patients.

To help correct these conditions, a number of interventions might be performed. The specific recommendation made by me will depend on the anatomic “diagnosis” made at the time of consultation. In some patients where there is primarily an excess of submental fat, fat removal either directly or via liposuction (as described in Liposuction (Suction-Assisted Fat Removal) will be performed.

In patients where a “weak” chin or microgenia contributes to the undesirable neck contour, a chin augmentation may be recommended.

In patients where there is significant skin and/or muscle laxity a different procedure may be recommended. One commonly recommended procedure is as follows: a small incision is made in a crease just below and behind the chin. Through this small incision, excess fat and some excess skin are removed and the neck skin is tightened. The vertical bands of muscle are excised as well. This procedure is called submental lipectomy, or submentoplasty with or without platysmaplasty (correcting the muscle bands). It is frequently combined with a standard facelift or necklift operation since submentoplasty alone will not correct sagging jowls or a “turkey gobbler” deformity. The excess skin that is sagging from the face down onto the neck tends to collect in the midline, and it often requires a facelift in addition to submentoplasty to correct the deformity.

Finally, submentoplasty may be performed as a secondary operation, or a “tuck-up” performed between six months to one year after a facelift surgery. The submentoplasty can be ideal as a touch-up procedure alone to improve the lasting effects of the facelift.

Patient Example

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  • Past President of the American Academy of Facial Plastic and Reconstructive Surgery
  • 30+ Years of Experience
  • Facial Plastic Surgery Specialist
  • High Expertise
  • Individualized Care