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Steven M. Denenberg, M.D.
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The fat underneath the skin of the neck was removed, and the skin was repositioned up and back.  If a patient is only 30 to 40 years old, I can sometimes perform only a liposuction under the chin, without the face lift.  However, if the skin has lost some of its elasticity, removing only the excess fat won't help, because the skin won't "shrink-wrap" to the neck after the fat removal; it will hang loosely, and the appearance might be worse than if nothing had been done.

The combination of removing the fat and repositioning the skin is our best bet in patients older than about 45 years of age.


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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
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Questioner: Would I be a good candidate for fillers or would surgery be a better choice?
I've always thought I have a big weirdly shaped nose. I don't like the hump on my bridge and how long my nose tip is. I've been considering surgery for a while now but I recently heard about a cheaper alternative, using fillers. And if I should get fillers, where? If surgery is better, what exactly should I change?
(Questioner submitted photos)

Dr. Denenberg's answer: Fillers would ruin your nose
Here are the changes I would make to your nose: bring the tip back closer to your face, elevate the tip up a small amount, take down the gentle bump along the bridge, narrow the tip. All of these changes would move your nose in the direction of smaller.

Filler will make your nose bigger wherever it is placed. It's exactly what you don't need.

Also, the changes recommend are difficult, and not every surgeon can accomplish them. You need to see your doctor's before and after photos, because that's the only evidence you have that he has the skill. The diplomas and certifications tell you nothing.

Hope this helps!

Link to this question on RealSelf.com