I am thin, do not have a lot of hanging skin on my neck, just directly under my chin I have some loose skin that I can only see in certain lights and mirrors and never in pictures. Are these pretty successful?
What is the Cost of a Direct or Isolated Submentoplasty?
Doctor Answers (4)
Tighten Skin On Neck Non-Surgically or with Submentoplasty
A small amount of skin can still be a challenge to improve. Your choices include radiofrequency such as Pelleve Skin Tightening (we use this in our practice in New York) as well as "submentoplasty: which is a combination of muscle and skin surgery performed through a small incision at or near the crease under your chin. Meet with a surgeon who offers nonsurgical as well as surgical solutions so you avoid any bias. A proper consultation will help the surgeon determine what the best treatment for you is and after you should discuss cost.
It would be helpful to see photos showing your area of concern. You could be an candidate for a minimally invasive procedure. The cost varies based on what needs to be done.
Skin Elasticity is key for isolated Submentoplasty
An isolated submentoplasty does not remove any skin from the area under the chin; therefore, good skin elasticity is crucial for a submentoplasty to contract the skin under the chin to reduce any hanging. An isolated submentoplasty is essentially a platysmaplasty (sewing together the thin muscles under the chin to create a firm foundation for the skin to lay over) with or without liposuction or fat reduction. If the patient is already very thin, I am reluctant to further defat their neck, because the fat under the skin helps to prevent crepey skin. Keeping a healthy layer of fat is helpful in keeping the texture of the neck skin youthful. My guideline age cut off for an isolated submentoplasty is 45 years old, some patients younger than 45 may have so much sun damage and loss of elasticity, that a regular necklift may be of more benefit for these patients, while some patients older the 45 years old with minimal sun exposure and baby like skin may be the exceptions to the 45 year old cut off age.
The nice thing with the submentoplasty is that there is only a single incision in a crease under the chin. I have seen some surgeon make a 1-1/2" to 2" incision under the chin, which would make the incision under the chin appear to be a negative; however, with a good headlight and retractors, I am routinely able to perform the submentoplasty in a 1/2" to 3/4" incision. A simple liposuction incision may already be 1/4" in width, so the additional 1/4" more to sew the muscle bands together seems to be a good risk/benefit ratio.
I'm assuming that you were asking about a direct necklift when you asked about a direct submentoplasty. This is a direct skin removal under the chin. Essentially the hanging skin is removed and the cut edges are sewn together. While the skin is open, the platysmaplasty can also be performed. Of note, if a direct necklift or submentoplasty extends beyond the transition from the area under the chin to the beginning of the neck (the cerviomental angle) then the incision should not be a straight line. Some kind of zig zag incision may need to be performed right at the junction of the chin to the neck to prevent a contracture scar which forms a web along this incision. This procedure requires more sewing of the skin than the isolated submentoplasty, as well as care in designing the incision properly to prevent a web from forming along this incision.
The price ranges will vary from the middle of the country as compared to parts of the East and West coast. My guess is the range would be as low as $2000 for liposuction alone to up to $5000 and upwards for a direct submentoplasty. This typically may not include any operating room or anesthesia fees if performed in an ambulatory surgery center. Their fees also vary from region to region and are typically billed by a flat first hour rate, then by the half hour for the remaining time. Having said that, on a thin patient with minimal excess skin and fat, this could also be performed as an office based procedure under local anesthesia with oral sedation (valium). Since this is essentially a skin and fat surgery, once the skin is injected with local anesthesia, the patient doesn't feel any pain, only the pushing and pulling of the soft tissues to perform the operation.
I hope this helps. Good luck with everything!
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Less is more
Without the benefit of a picture and based on your description I would say you fall into the wise surgical dictum of "less is more". A submental liposuction or modified (isolated, direct) platysmaplasty could be used to address your concerns.
Prices do vary from region to region and practice to practice but on average a modified plat will cost somewhere in the 2,000 to 4,000 range - mostly towards the lower end of that range.
Thanks & Good Luck!