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Treating a double chin or submental fullness: Liposuction, Chin implant, or Facelift?

A double chin is an undesirable feature than many Washingtonians address with plastic surgery. A double chin can be congenital (genetics), develop with age naturally, or result from weight gain. Submental fullness is another term plastic surgeons may use for a double chin. With the great increase in video and photos from telephones and tablets, patients have more often noticed their double chin, also due to tilting the chin downward which worsens the appearance of the neck. We previously discussed this modern phenomena of the “facetime facelift”.

Due to the regional anatomy, a double chin or submental fullness may require multiple modality cosmetic treatments to achieve a patient’s desired results. – Houtan Chaboki, MD

What is a double chin or submental fullness?
Excess volume under the chin and neck area which creates an appearance of a second chin. An ill-defined jawline or excessively full or round neck and chin can make one appear older or heavier than they actually are. Submental fullness bothers patients almost as much as the wrinkles that develop around the eyes and forehead.

What contributes to a double chin or submental fullness?
First, let’s examine the relevant anatomy of the chin, jawline, and neck. There is skin, fat, muscle, bone, and glands that all contribute to the appearance of this area. Often it’s a combination of factors that contributes to one’s appearance. Excess neck fat is usually present, but not always. A small or weak chin bone may be present from an early age. Loose skin and sagging muscle develops as one gets older, which is often termed “turkey neck”. Ptotic or droopy submandibular glands also create submental fullness.

Below are four different patient examples that demonstrate these various factors contributing to submental fullness. This patient demonstrates multiple factors contributing to her double chin.

Double chin submental fullness anatomy neck fat skin muscle bone

 

 

This second patient has a weak chin bone, excess neck fat, and a droopy salivary gland that contribute to his double chin.

Double chin submental fullness anatomy neck fat skin muscle bone

 

 

This woman has primarily sagging neck muscle and skin, along with a droopy or ptotic salivary gland. This sagging tissue develops naturally with age.

Double chin submental fullness anatomy neck fat skin muscle bone

 

 

This woman, who is younger, has a weak chin and submental fullness from genetic factors.

Double chin submental fullness anatomy neck fat skin muscle bone

 

How to treat a double chin or submental fullness?
Due to the multi-factorial etiology of having a double chin, there isn’t one treatment that is “best” for all patients. The two broad categories of cosmetic treatments are non-surgical methods and surgical methods.

Generally, non-surgical methods use injections (ex. Botox®, Juvederm®, Kybella®, etc) or devices to reduce a double chin. For example, excess neck fat can be frozen, heated, or dissolved via non-surgical methods in the office via local anesthesia. Botox® has been injected into the salivary gland to shrink it and into platysma muscle, otherwise known as Nefertiti lift. Facial fillers may be used to augment a weak chin.

Non-surgical methods still haven’t replaced the more dramatic or long-lasting changes that one may achieve from plastic surgery, but may be appropriate for some patients. As compared to plastic surgery, all non-surgical methods generally produce subtle results that gradually develop over time. Non-surgical results are usually temporary. In addition, these non-surgical treatments often must be repeated to see any appreciable improvements in the neck and chin. Prices range broadly, from approximately $700 to $2500 per treatment.

Plastic surgery for a double chin or submental fullness produces a more significant and long-lasting improvement, often with minimal downtime. Plastic surgery may reduce neck fat, tighten neck muscle, lift sagging skin, or augment a weak chin. Below are a variety of plastic surgery before and after examples to improve submental fullness. Plastic surgery procedures may include any combination of neck lift type procedures including liposuction, chin implant, and a facelift. Liposuction reduces neck fat. Chin implant help augment a weak chin bone. A facelift tightens and lifts sagging skin and neck muscle. Prices for plastic surgery vary much more broadly.

Where are some before and after photographs of double chin or submental fullness plastic surgery results?

This first patient has a submental fullness due to having a small chin. She had a medium size silicone chin implant placed, which augmented the chin to be more proportional and improved the submental fullness.Before and after chin implant silicone Double chin submental fullness anatomy neck fat skin muscle bone

 

The man has both a weak chin and excess neck fat, which have been improved with a combination extra large silicone chin implant and neck liposuction.

Before and after chin implant silicone neck liposuction Double chin submental fullness anatomy neck fat skin muscle bone

 

This woman, who is a little older, has a combination of several factors which contribute to her submental fullness. She also underwent silicone chin implant augmentation with neck liposuction. She may have also chosen to have a facelift with skin and muscle tightening for additional improvement, but she wanted more conservative changes and wasn’t ready for a facelift at this stage in her life.

Before and after chin implant silicone neck lift liposuction Double chin submental fullness anatomy neck fat skin muscle bone

 

This woman has primarily excess skin and sagging muscle which not only creates wrinkles of the neck skin, but also creates a double chin or submental fullness. She has very minimal neck fat and chin size is appropriate. She underwent a facelift procedure with tightening of the neck skin and muscle.

Before and after face lift neck lift Double chin submental fullness anatomy neck fat skin muscle bone

How does a patient decide how to treat a double chin or submental fullness given the large variety options?
First, try to determine what is contributing to your specific submental fullness, ie. skin, muscle, fat, bone, gland. Second, determine your recovery time and budget. Most importantly, consult with a plastic surgeon who performs these various procedures and who can perform a comprehensive evaluation and help determine what is the “best” cosmetic procedure specific for you at this time in your life.

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    Houtan Chaboki, M.D.