Chin & Neck

Chin & Neck Cosmetic Surgery & Non-Surgical Procedures

Common issues with the neck and chin areas include:

  • A heavy neck or “double chin”.  This can make one appear heavy. By removing excess fat with liposuction, the balance of the lower third of the face can be restored, and the double-chin appearance can be reduced or eliminated.  We also have two non-surgical methods for dealing with neck fullness:  CoolSculpting and Kybella.
  • Loose neck skin.  Even if the neck is slender, loose skin beneath the chin or on the front of the neck can look aging. Depending on whether this occurs by itself, or in conjunction with jowling and lower facial laxity, a neck lift or lower facelift can be performed to significantly improve the appearance of the neck.  For minor degrees of neck skin laxity, we have several non-invasive external med-spa treatments, such as ThermiSmooth.  For people with mild laxity who aren’t ready for a facelift, the ThermiTight procedure is another excellent option.
  • A weak chin.  Also known as “microgenia”, a weak chin creates an optical illusion that makes the nose look too prominent or the neck heavier.  A chin implant, which is placed through an incision hidden inside the mouth or in the wrinkle beneath the chin, can restore the proportions of the chin, and make the face and neck proportions look better.
  • Neck bands. These cords in the middle of the front of the neck are called “platysmal bands”, and actually are formed by the front edge of the platysma muscle. They can be improved non-surgically with Botox, or treated more definitively at the time of a facelift or necklift.
  • Sun-damage and texture changes of the neck and decollete. Brown spots, skin tone irregularity and fine lines and wrinkles can be improved with fractional laser skin resurfacing, photo-therapy with IPL, or light chemical peels.

Surgical & Non-Surgical Options

The choices of which techniques to use to get the best results are based on the accurate assessment of the patient’s anatomy.  Dr. Fiala will advise you about this at the time of your consultation.  For example, if the is a large amount of lax skin or associated aging changes in the jawline or jowl area, we know that it will require a facelift to properly fix.  Combinations of loose neck skin and excess neck fat may additionally benefit from liposuction of the neck, in addition to surgical tightening.

For people with a mild to medium amount of neck laxity, who still have a youthful appearing face, sometimes an isolated neck lift can be performed.  Dr. Fiala prefers to perform this through the “back-half” of the facelift incision, i.e. the part behind the ears and in the hair.  The procedure addresses both muscle bands in the platysma muscle of the neck, as well as skin laxity in the front and sides of the neck.

If the skin laxity is minimal, tightening with ThermiRF may be appropriate, especially for people who are looking for a quick recovery.  This is also a reasonable procedure for people who are noticing some changes in the neck area, but are too young for a full facelift.

If there is excess neck fat, but the overlying skin is nice and elastic, the appropriate surgical option is liposuction.  Small areas of neck fat can also be treated non-surgically with CoolSculpting or Kybella injections.

Chin augmentation, for those with a weak chin, can be optionally added to all of these procedures.  This procedure uses a permanent anatomically-shaped implant, made of Silastic, which is sized to fit the patient, and placed in a pocket against the bone.  Dr. Fiala typically prefers hiding the incision for this inside the mouth, where it is not seen, compared to having it on the chin.


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