Weight loss, unfortunately, doesn’t occur proportionately throughout the body, and this is often pre-determined genetically. Despite the weight loss, it isn’t uncommon to have residual fat under the chin.  If patients have good skin tone, as most people under 40 do, traditional liposuction will suffice to remove those stubborn fatty deposits. After age 40, skin elasticity naturally decreases, and simply suctioning out excess fat will often create a new problem, sagging neck skin. Before Smart Lipo, liposuction with a neck lift to remove excess skin was the only option. With SmartLipo, a laser fiber is inserted under the skin, which not only melts the fat and minimizes bleeding and bruising, but, more importantly, stimulates collagen production, which is progressive over 2 to 6 months post-treatment. The tightening effect on the neck can be dramatic yet natural. Traditional neck surgery is still the best option for patients with very poor skin elasticity, as often seen after lap-band or gastric bypass surgery in patients who have lost 100s of pounds. The same follows for patients older than 65, as their skin elasticity won’t improve sufficiently with SmartLipo.  A second reason that the face, not the neck, can look fat post-weight loss is that we can lose good fat from vital supporting areas of the face, such as around the cheeks and jawline. Loss of support can cause the skin to sag, creating heaviness in the face. Fat injections, cheek implants, or injecting fillers can restore this lost volume.  If Dr. Beran thinks you are a good candidate for Smart Lipo on your neck he will refer you to his colleague Dr. Ran Rubinstein a facial plastic surgeon who specializes in cosmetic surgery of the face and neck.  Dr. Rubinstein uses a newer laser called Precision Tx Laser Lift to treat those areas. Dr. Rubinstein may also recommend a deep plane neck lift or deep plane facelift if he thinks this may be a better option for you.