Double Chin
THE TREATMENT
The “double chin” is a common concern that troubles many, regardless of age. Despite efforts to lose weight, the fullness in this area can be hereditary and unresponsive to diet and exercise. At Finn Plastic Surgery, we have several options to address this area, including:
- Liposuction
- With FaceTite
- With a plastysmaplasty (Surgical Neck Contouring)
- Direct Neck Lift
WHAT IS LIPOSUCTION?
Liposuction or “lipo” is a surgical procedure that removes unwanted fat from specific areas of the body, such as the abdomen, flanks, thighs, arms, and submental area. Oftentimes, patients refer to these areas as love handles, muffin top, double chin, etc. Patients who are at or near their ideal weight and have good skin elasticity are typically good candidates for liposuction. For the neck, the procedure is performed through very small “stab” incision hidden under the earlobes and under the chin. A small, hollow tube called a cannula is inserted through the incisions and the cannula is connected to a suction device that removes excess fat cells from the body. When performed alone, most patients tolerate submental liposuction using just injected numbing medicine (“local anesthesia).
The results of submental liposuction can be remarkable, enhancing the contour of the neck and achieving a more defined transition from the face to the neck. It is also important to note that while liposuction is a highly effective way to contour and shape the face and body, it is not a substitute for weight loss or a healthy lifestyle, and it is not designed to address loose skin or other structural issues.
LIPOSUCTION WITH FaceTite
In patients with a double-chin who do have excess submental skin (“skin-laxity”) we often recommend combining liposuction with FaceTite. Utilizing the same incisions as liposuction, FaceTite utilizes radiofrequency technology to help tighten skin over-time. It can be performed under the same local anesthesia as submental liposuction alone.
LIPOSUCTION WITH PLATYSMAPLASTY
In patients with a double chin without skin laxity but that have separation of the neck muscles (the platysma), a procedure Dr. Sowder calls “Surgical Neck Contouring” is an option. Surgical Neck Contouring combines liposuction of the area under the chin and possibly the jowls with the tightening of the anterior neck muscles known as the platysma (“platysmaplasty”). This involves very small stab incisions below the earlobes, and a very small incision up under the chin in a native skin crease. When Surgical Neck Contouring is performed alone, most patients do very well using local anesthesia (numbing medicine), though you have the option to use IV sedation administered by our skilled nurse anesthetists if you prefer. When combined with other procedures such as rhinoplasty, the procedure is done under IV sedation to ensure your maximum safety and comfort.
Ideal candidates for Surgical Neck Contouring are those who are at or near their ideal weight and have good skin elasticity (no excess skin), but excess fat and separation of the neck muscles under the chin. are typically good candidates for this procedure.
WHAT IS A DIRECT NECK LIFT?
A direct neck lift, also known as a ”Direct Excision,” is a surgical procedure that aims to improve the visible signs of aging in the neck but does not offer improvement into the midface or jowls. This procedure involves excising skin directly from the area of excess underneath the chin and not via incisions that go around the ears like with a facelift. It also involves the excision of excess fat below the chin and in the anterior neck and tightening the anterior neck muscles to restore a more youthful and refreshed appearance. This procedure has less downtime due to swelling and bruising than a facelift and can be done without sedation anesthesia. The tradeoff is the scars are less camouflaged due to being in the anterior neck instead of in the natural creases in front of and behind the ears.
WHO CAN BENEFIT FROM A DIRECT NECK LIFT?
Direct neck lifts are typically performed on patients who are experiencing visible signs of aging in the neck, such as sagging skin, excess fat, and muscle banding but do not have or are not bothered by aging changes in the face. Notably, a direct neck lift does not improve jowling or deep nasolabial folds. While a direct neck lift can be performed on both males and females, it tends to be more males who choose this option as they are more likely to care solely about the neck (i.e. “Turkey Neck”) and tend to be more tolerant of the scar location than female patients.
Depending on the patient’s desires, direct excision may also include additional procedures such as a chin implant, brow lift or eyelid surgery to further enhance the overall appearance of the face.
WHAT CAN I EXPECT FROM A DIRECT NECK LIFT PROCEDURE?
Performed at our fully accredited on-site surgical suite, most patients tolerate a direct neck excision while awake using local anesthesia. For patients who are worried about being awake during surgery, we have the option to prescribe anti-anxiety medications (Valium or Xanax) or use nitrous oxide (Pro-Nox) during the numbing injections. For those who prefer to be asleep during surgery, we can use IV sedation administered by our skilled nurse anesthetists to ensure maximum safety and comfort for our patients during the procedure.
The direct neck excision procedure involves creating incisions under the chin and along the anterior neck, which allow the surgeon to access the underlying muscles and tissues. Excess skin and fat is removed is then removed, the underlying muscles are tightened, and the skin incisions are closed to create smoother, more toned neck
After the procedure, our patients are closely monitored before being discharged to recover in the comfort of their own homes. For patients traveling from out of town, we encourage you to ask our Patient Coordinator about hotel accommodations for added convenience.
WHAT TO EXPECT AT YOUR CONSULTATION
When you come in for a consultation, you can expect a thorough discussion about your goals and expectations for the surgery. Our surgeons will also review your overall health, medical history, prior surgeries, medications, and drug allergies. We will ask about your goals & expectations and examine the area of concern. Our team will work closely with you to determine the most appropriate surgical technique for your individual circumstances. His goal is to help you achieve your desired outcome while ensuring natural-looking and long-lasting results.
DECIDING TO SCHEDULE
During your consultation, you will receive a detailed surgical quote and any required clearance forms. If you choose to proceed with surgery, our dedicated Patient Coordinator will guide you through the process of selecting a procedure date. To finalize your preferred surgical date, a non-refundable, non-transferrable booking fee will be required upon scheduling. A pre-operative appointment will be scheduled for at least two weeks prior to your surgery date. At the time of booking surgery, we will also schedule your first follow-up visit.
PRE-OP
During your pre-operative appointment, you’ll have plenty of time to discuss your upcoming procedure in detail and have all your questions answered. Your pre- and post-operative care instructions will be reviewed with one of our nurses, as well as any medications you’ll need to take before and after surgery. You’ll review and sign the consent form for the surgery, meet with the surgeon to revisit your goals, and your surgical quote balance will be due at the end of this appointment. Our goal is to ensure that you feel fully informed and comfortable with the upcoming procedure, allowing you to approach your surgery with confidence and peace of mind.
WHAT TO AVOID BEFORE SURGERY
To minimize the risk of bleeding and bruising, it’s important to avoid blood thinning medications and supplements for two weeks prior to your procedure. This includes aspirin or aspirin-containing products, as well as anti-inflammatory drugs such as ibuprofen or naproxen (including Motrin, Aleve, and Advil). Additionally, supplements such as Vitamin E, multivitamins, and omega 3 fatty acids (fish oil and flaxseed oil) should be avoided. For a complete list of medications and supplements to avoid, please consult with your pre-op nurse.
RECOVERY
You will have some pain and swelling immediately after surgery. Most patients will require pain medication for a few days. With any of the above procedures, you will wear a compression garment for several weeks after surgery to help reduce swelling and smooth your contour. You will need to hold off on aerobic exercise for at least 2 weeks after surgery; your surgeon will advise you when strenuous activity can be resumed. Swelling will gradually improve over a period of around 3 months. Though changes are visible immediately, the final results will reveal themselves over several months as the swelling subsides.