Bad submental but don’t qualify for lipo

[ODog]

Hi guys... this is more about general aesthetics.

My submental area is saggy under the chin and jawline and screws up my profile. It looks like fat, buts it’s not. I’ve consulted about coolsculpting and even lipo but was told the sagging skin is mostly muscle and sagging skin that happens with age.. I’m only 29 btw.

It wasn’t always this way. Not in the slightest. My hyoid bone is not low. I’m not going to post past or present pics because I’m sure it’s easy to imagine the problem. I think it was from some weight gain a few years ago, which I’ve lost since then, but under my neck hasn’t changed at all with the weight loss!

I was down to 7% bodyfay this summer, 6 pack abs, ripped, yet the neck sagging remained!!!

I just got bi-max last week which has uptaken some of the skin, but the problem is very much still there.

Is there anything I can do ? Surgically or otherwise? I’m wondering if I stay at a really low bodyfat for a long period of time, this might tighten the skin. Neck lift or something? Thanks!

[kavan]

Hi guys... this is more about general aesthetics.

My submental area is saggy under the chin and jawline and screws up my profile. It looks like fat, buts it’s not. I’ve consulted about coolsculpting and even lipo but was told the sagging skin is mostly muscle and sagging skin that happens with age.. I’m only 29 btw.

It wasn’t always this way. Not in the slightest. My hyoid bone is not low. I’m not going to post past or present pics because I’m sure it’s easy to imagine the problem. I think it was from some weight gain a few years ago, which I’ve lost since then, but under my neck hasn’t changed at all with the weight loss!

I was down to 7% bodyfay this summer, 6 pack abs, ripped, yet the neck sagging remained!!!

I just got bi-max last week which has uptaken some of the skin, but the problem is very much still there.

Is there anything I can do ? Surgically or otherwise? I’m wondering if I stay at a really low bodyfat for a long period of time, this might tighten the skin. Neck lift or something? Thanks!

If it's muscle slack or excess than the surgery for that is 'deep cervico-mental plasty'. Something where they go below the superficial platysma muscle to tighten up and or shave the DEEP muscle layers and sew the whole thing up with a 'corset platysmaplasty'.  Very $$$ for the docs who can give a really 'clean' angle with that.

[Lazlo]

If it's muscle slack or excess than the surgery for that is 'deep cervico-mental plasty'. Something where they go below the superficial platysma muscle to tighten up and or shave the DEEP muscle layers and sew the whole thing up with a 'corset platysmaplasty'.  Very $$$ for the docs who can give a really 'clean' angle with that.

Interesting. Who are the top guys for that sort of surgery?

[kavan]

Interesting. Who are the top guys for that sort of surgery?

Doesn't matter. Ample info was given as to the type of neck work to look for.

[ODog]

Doesn't matter. Ample info was given as to the type of neck work to look for.

Thank you Kavan.

[ODog]

What bugs me is I don’t understand how it’s not fat. How can one have a seriously revolting double chin issue simply with some sagging skin? Doesn’t make sense as to why there is so much damn extra skin there. It’s not just sagging skin on profile view making the submental angle obtuse, like I literally have a roll of skin under my chin in front view. Most of the front view problem was fixed with jaw surgery but it’s still disconcerting how bad it was before the surgery.

I’m going to get to a very low body fat and see if it helps. Would rather save money for osteotomies not goddamn neck lifts in my late twenties. At least lipo is reasonably priced.

But honestly, there is a huge improvement when I fix that submental angle on photoshop. So I may have no choice.

[april]

Well I feel ya because I have submental issues too and it really brings down the whole appearance. I've seen a PS about a neck lift and he thinks the issue may be a combo of muscle sag, superficial fat, and also fat deep under the layers, not so much a skin issue. A neck lift is needed to tackle all that.

Did you have both jaws moved forward and by how much?

[Post bimax]

If you lift, you may want to consider neck training (neck curls and extensions). I did this for a while out of curiosity and I added a couple inches to my neck circumference (I stopped in preparation for JS). This could help tighten up the skin/muscle below your chin.

Also, not saying you’re lying but 7% bf is pretty tough to achieve and you’re pretty far form that now. Are you sure you got that low? I think with your new jaw and chin it would be worth trying again before pursuing surgery.

[ODog]

Well I feel ya because I have submental issues too and it really brings down the whole appearance. I've seen a PS about a neck lift and he thinks the issue may be a combo of muscle sag, superficial fat, and also fat deep under the layers, not so much a skin issue. A neck lift is needed to tackle all that.

Did you have both jaws moved forward and by how much?

What do you mean by deep fat. Fat that is not reachable with PS procedures but can be burned off with weight loss? I would ask about your hyoid bone placement as well or else a neck lift, weight loss, lipo, etc. Won’t do much to fix it.

Yes, my movements were bi-max advancement 6 mm and a 4 mm genio with some bone shaving to prevent the labiomental fold from increasing. Not sure the bone shaving was a good idea, I could have benefited from a slightly more projected chin and taken care of the fold with fillers.

[ODog]

If you lift, you may want to consider neck training (neck curls and extensions). I did this for a while out of curiosity and I added a couple inches to my neck circumference (I stopped in preparation for JS). This could help tighten up the skin/muscle below your chin.

Also, not saying you’re lying but 7% bf is pretty tough to achieve and you’re pretty far form that now. Are you sure you got that low? I think with your new jaw and chin it would be worth trying again before pursuing surgery.

Thanks I’ll look into neck training. Been meaning to start that anyway.

I don’t know officially how low I got but it was probably below 10%. I’ll PM you pics of last summer and let you judge. I did a dexa scan about a month and a half ago and it showed 15% BF, which is not ideal but it’s still average.

[Tezcatli]

If you lift, you may want to consider neck training (neck curls and extensions). I did this for a while out of curiosity and I added a couple inches to my neck circumference (I stopped in preparation for JS). This could help tighten up the skin/muscle below your chin.

Also, not saying you’re lying but 7% bf is pretty tough to achieve and you’re pretty far form that now. Are you sure you got that low? I think with your new jaw and chin it would be worth trying again before pursuing surgery.

It's probably from skin fold measure method. I got 6% BF with that method, it's obviously wrong, I'm naturally skinny or lean but probably 10% or more. That method linearity seems to break down with slimmer people although it works with fatter people.

[Post bimax]

It's probably from skin fold measure method. I got 6% BF with that method, it's obviously wrong, I'm naturally skinny or lean but probably 10% or more. That method linearity seems to break down with slimmer people although it works with fatter people.

He sent me pics, he was very lean.

[kavan]

What do you mean by deep fat. Fat that is not reachable with PS procedures but can be burned off with weight loss? I would ask about your hyoid bone placement as well or else a neck lift, weight loss, lipo, etc. Won’t do much to fix it.

'Deep fat' is just one of the many things found below the superficial platysma muscle which is approached by 'deep cervico-mental plasty'. The surgeon needs to open up the area to see what is in there causing the problem and address appropriately. It could be deep fat. It could be droopy glands. It could be a variety of different muscles etc.  There is no way for them to tell for sure what exactly is kicking up the problem to the cervico-mental area until they open up the area and explore. A much HIGHER skill set is needed to address the variety of structures found DEEP to the superficial platysma muscle (neck muscle). Lipo only works ABOVE (anterior to) the superficial platysma muscle when fat is in the SUBCUTANEOUS layer.

[Lazlo]

'Deep fat' is just one of the many things found below the superficial platysma muscle which is approached by 'deep cervico-mental plasty'. The surgeon needs to open up the area to see what is in there causing the problem and address appropriately. It could be deep fat. It could be droopy glands. It could be a variety of different muscles etc.  There is no way for them to tell for sure what exactly is kicking up the problem to the cervico-mental area until they open up the area and explore. A much HIGHER skill set is needed to address the variety of structures found DEEP to the superficial platysma muscle (neck muscle). Lipo only works ABOVE (anterior to) the superficial platysma muscle when fat is in the SUBCUTANEOUS layer.

Kavan is absolutely correct on all of this. Mark Wahbelrg, Vin Diesel all even when they have very low fat still have a droopy neck.

[april]

What do you mean by deep fat. Fat that is not reachable with PS procedures but can be burned off with weight loss? I would ask about your hyoid bone placement as well or else a neck lift, weight loss, lipo, etc. Won’t do much to fix it.

Yes, my movements were bi-max advancement 6 mm and a 4 mm genio with some bone shaving to prevent the labiomental fold from increasing. Not sure the bone shaving was a good idea, I could have benefited from a slightly more projected chin and taken care of the fold with fillers.

The terms he used were pre-platysmal and sub-platysmal fat. They can access that fat during the procedure. I assume if you lost a lot of weight you could also burn that fat, but you could still have other issues going on, not fat related, like muscle laxity and glands as Kavan has explained. I don't want to scare you off just doing lipo, but if you happen to have a lot of deeper stuff going on too then doing just lipo may only serve to expose those problems further. That's a risk you'd have to take.

I always thought I had an extra skin issue - that skin needed to be removed - but he said that once the deeper layers are dealt with then the skin is re-draped and taken up by the new contour. I was also reading one of those excerpts from textbooks on google books which explained some of this. I'll find the link.

Thanks of info re: the hyoid bone. Not sure if mine is low or not. I've heard the position gets worse with age