I would like to know is a direct submentoplasty would work for me? i am a 50 year old active male. workout 4 or 5 days a week. i lost 50lbs about 2 1/2 years ago and was left with loose skin under my chin that bothers me greatly!

The : The best method to address your neck/chin loose skin depends a lot on your anatomy. If you have excess fat deposits in the area liposuction (or direct excision) may help. The concern would be that the overlying skin may not contract appopriately in the area to redrape it, though. This aspects depends on your overall skin elasticity. A neck lift can be done to furterh tighten the tissues in the neck area and if there is an excess of skin that needs to be removed a facelift may also be indicated. With patients who have quite a bit of weight loss like you did there is often an excess of skin that ends up hanging there under the chin.

Only : Only 2 options to treat significant loose skin in the neck: 1. A traditional face/neck lift with incisions around the ears to elevate, redrape and remove the excess skin along with tightening/suspension of the underlying muscle (smas) layer, often combined with a submental platysmaplasty or tightening of the neck muscle 2. Less commonly in men a direct excsion of the loose skin and muscle tightening can be preformed only at the submental area but a longer more visible scar is the result you should consult with a plastic surgeon who will be able to assess you in person and more accurately discuss the best option for you.

In : In assessing which procedure is best for you, it is important to know whether it is just the skin cover alone that is loose or a combination of loose neck skin and some banding of the platysma muscle. This fan shaped muscle stretches from the collar bones to the lower jaw and occasionally may appear as some banding when you clench your teeth hard and pull your cheeks down at the same time. Depending on what finding we may encounter, there are several ways to solve the issue of loose skin underneath the neck with or without excess fat with or without excess muscle banding with or without bulging salivary glands in the area underneath the lower jaw. In determining what procedure is best suited for you, it is important for the surgeon to assess several factors. First, at age 50, the elasticity of your skin and your neck muscle tone need to be assessed to ensure they are optimal for surgery. Next, the angle between your neck and your chin should form an obtuse angle. It is also important to consider the position of your hyoid bone (horseshoe-shaped bone situated in the front center of the neck between the chin and the thyroid cartilage (adam's apple)). If your hyoid bone is located too low and anterior (bulging forward), then even if a submentoplasty or some neck tightening is performed, the result may not be satisfying. Underneath the floor of the mouth on either side (near the edge of your lower jaw) there are two salivary glands (one on either side). It is important to assess any droopiness of these glands prior to any surgical intervention because tightening the neck with a submentoplasty can accentuate the appearance of the submandibular glands and they become visible lumps in the neck. What are your options: first, a neck or face lift may be performed which after careful evaluation of the all the above factors, if you are the ideal candidate you can expect long lasting cosmetically pleasing results with removal of the excess skin. Second, direct submentoplasty is ideal in younger patients (30-40) with good skin turgor and elasticity, preserved muscle tone in the neck muscles and an obtuse neck chin angle as well as a hyoid bone that is slightly higher and not bulging forward. This procedure does not involve removal or excision of skin and may include minor tweaks with it. Other procedures that may be decided upon depending on the anatomy of your neck include flattening of your submandibular gland and treatment of the deep neck fat which (not usually not addressed during liposuction.).