Ask the Plastic Surgeon

Q: I'm in my mid 40's and I seem to have inherited (can that happen?!) drooping skin that hangs down below my chin. I'm really not overweight -- I just have excess skin that droops down. I really want to get rid of it, but I would like to avoid having surgery. Is there anything else that can be done to help?

First of all, yes, you can have a genetic pre-disposition to this type of condition. Fortunately, depending on your age, there are several things that can be done before a surgical neck lift is needed.
    Depending on the elasticity of your skin, at your age, it's likely that fat deposits beneath the chin can be removed by liposuction, allowing the excess skin to shrink back to a smoother contour.            
    If your "drooping skin" is a result of the appearance of tight prominent bands of muscle that extend from your chin down to your neck, they can be made to appear less prominent by Botox injections.
    If lax neck muscles are to blame, a limited neck lift can be done, by surgically tightening the sagging neck muscles without removing any skin.
    If surgery is indicated in your case, two approaches will probably be discussed by your plastic surgeon:
    1. Directly excising the excess skin on the neck is possible, however, this type of procedure is best done on men whose neck skin is thicker and more textured, thus leaving a less visible scar.
   2. If the amount of skin that needs tightening is too great, a true face and neck lift may be required. These scars would be concealed along the hairline.
   As you can see, from the broad range of possible treatment options, it is very important to schedule a personal consultation with your plastic surgeon. Your doctor will evaluate your personal condition, and determine what is causing it. It's also the time for you to honestly share your goals with your doctor. This is the only way to find out which solutions are realistic for you.

Q : I want to make my lips look fuller, but I am reluctant to have a foreign substance injected into them and I don't like the look that comes from too much filler injected into, and around, the lips.  Are fillers the only option?

A: There are several fairly simple surgical solutions that can be done to make the lips look fuller or more youthful without plumping them up with fillers.  There are procedures that would surgically "lift" the upper lip to make thin lips look fuller.  If the corners of your mouth are droopy and sad looking, the corners can also be lifted to a more pleasing position. The surgery would be more involved than injections, but would be longer lasting.

Dr. Robert A. Laughlin is a board-certified plastic and reconstructive surgeon who has been helping people from all over the world for the past 26 years. His practice, Hilton Head Island Plastic Surgery, is located on the campus of the Hilton Head Regional Medical Center where he is a member of the Board of Directors and the active surgical staff.
Dr. Laughlin lives on Hilton Head with his wife Linda, who is also his surgical assistant. They have two grown daughters and four grandchildren. He may be reached at (843) 681-4088 or
Questions should be emailed to his address at This email address is being protected from spambots. You need JavaScript enabled to view it.. Readers should include "Pink" in their subject line.

If your question is selected for publication, your name will remain  confidential and will not be used in the column. This column is for  informational purposes only and not intended to take place of a medical consultation with a qualified physician.

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