I've had my neck liposuctioned yet my neck still lies well under my chin. Doctors and others have said that I have a weak chin profile. I'd rather not get a chin implant though. I've heard of this platysmal suspension. Is it a permanent sling?
What is Platysmal Suspension?
Doctor Answers 4
Liposuction alone does not address one of the major changes that occurs to the neck/facial complex with aging. The platysma, which is considered one of the muscles of facial expression, loses tone and literally becomes looser over time. We refer to the cords that form below the chin as "platysmal bands".
A platysmaplasty, which can be performed in isolation, or in combination with a Facelift, tightens and re suspends this muscle. A "Giampapa" suture, which is an interlocking mastoid to mastoid suture, can improve neck definition. I would avoid using Goretex or other sling materials, and prefer sutures for this purpose. For patients with small chins, the addition of an anatomically shaped chin implant can add significantly to neck definition and improve the result.
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There are many different techniques for platysma suspension. Dr. Giampapa popularized the suture chin/neck sling. His technique is performed from an anterior AND posterior approach. Other techniques just rely on the posterior (behind the ear) technique with stitches placed to lift and secure the frontalis muscle. Some techniques utilize skin resection but this depends on the amount of skin laxity.
Chin augmentation can help, but a good Neck Lift can tighten the loose neck
A chin implant and augmentation can improve the lax tissue under the chin by pulling up the tissues that are causing the sagging double chin. It can improve the neck lift even more than when a neck lift is done alone.
A neck lift done well though can significantly tighten the neck. The key is how the platysma muscle is treated. This muscle is essential to how the neck looks. When doing a neck lift, the platysma must be tightened from just under the chin to the bottom of the neck area. This changes the structures of the neck for a better shape.
There are also other adjunctive techniques that can be done to the fat, tissues and the muscle under the chin which can also improve the way the neck looks. Another very important key to tightening the neck is by making sure that the skin of the neck has a place to go. Elevating the skin to a certain degree is essential to allow the skin to shift to a more shapely appearance. All of this takes experience and knowledge on the part of the surgeon.
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Submental Platysmaplasty and Chin Implant
After a certain age, submental liposuction can be counterproductive making the laxity under the chin worse. The platysma and neck skin sag together. In most cases, submental platysmaplasty is the best way to approach this problem. This procedure creates a muscle sling which will lift the neck. This will produce a long lasting jaw neck line without redundancy. However, if there is a true skeletal deficiency causing a weak chin, then a chin or mandibular implant is extremely helpful in establishing a more defined jaw neck line.