How do doctors differentiate between submental and subplatysmal fat? (Photo)

Firstly, thanks a million to all realself doctors who took the time out to answer my earlier questions. I'm scheduled for a consultation with a plastic surgeon in 2 weeks. But in the mean time I'm growing restless about whether to get a liposuction or neck lift. I read that if you clench your jaw and hold the fat with your thumb and finger, and if it doesn't escape then it's submental. Is that right? If it's submental then I would only need a Lipo?

Doctor Answers 11

Sub-platysmal fat

You are correct in your assessment of how to evaluate if your fat is over or under your platysma muscle.  That said, this is certainly not the deciding factor in the decision between liposuction and a face lift.  There are many factors that contribute to the approach for neck rejuvenation, and often this can even be achieved without surgery.  Your surgeon will evaluate your goals, your skin, the relationship between your neck and your lower face, your timeline for recovery, your general health.... I recommend waiting until your consultation before trying to decide your approach- let your surgeon examine you and come up with a plan.  If you are uncomfortable with that surgeon or that approach, get another opinion.  Remember that there are often many different ways to achieve particular goals in plastic surgery, and you want to find a surgeon and a proc\edure that you are happy with.Best wishes, Dr. L

Neck Lift or Neck liposuction

Hi Brokemynose,Thanks for your question and photo. I would agree with your textbook photo. That is a great way to assess the fat. The answer depends on what you want and EXPECT to see after surgery. Lipo helps the skin shrink but exposed more underlying muscle which can look worse. Sometimes a neck is better because your getting the platysma muscle back to a more taught position and removing both submental and subplatysmal fat but the cost is more and more scars but better result in my opinion. You may just need liposuction, but without a photo or physical exam, it is hard to tell.You may only need Kybella or coolsculpting! Good Luck with your PS.   All the best, Carlos Mata MD, MBA, FACS #necklift #fat Board Certified Plastic Surgeon

Neck Skin and Platysmal Bands -- Neck Lift, VASER Hi Def Lipo/ThermiRF, Venus Legacy/Thermage/Ultherapy, Botox/Dysport, Kybella

Submental fat is felt and can be grabbed, this is easily treated with liposuction, kybella or coolsculpting.  I suggest seeing an expert for treatment options.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

Submental vs subplatysmal

Submental just refers to the fat below your jaw (neck above your Adam's apple), and the subpatysmal fat refers to fat deep to the neck muscles that cause the turkey strands in the neck..They really all one and the same.

Submental verses Subplatysmal Fat

Your research is clearly paying off. That is how you assess the difference.That is, however, not the only factor in determining liposuction verses neck lift. The quality of the neck skin is important, the presence of platysmal bands and whether a jowl is visible will all impact the decision making process.Seek out a board certified plastic surgeon to evaluate you and discuss your options.Good luck and I hope this was helpful.

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
4.9 out of 5 stars 121 reviews

Submental or subplatysmal fat?

Thank you for asking about your neck lift and liposuction - and your kind words.
  • It can be difficult to diagnose yourself but this is how it goes.
  • Pick up the area under the chin between thumb and index finger.
  • Clench your jaw or make a grimace - 
  • If the muscle action makes the fullness disappear, the fat isn't under the skin.
  • But a liposuction is done if there is fat under the chin AND the skin elasticity is good.
  • A neck lift is done if the skin and/or muscle are loose - fat is removed at the same time.
  • If the fat is concentrated under the chin and the skin quality is good, you also have the option of Kybella instead of liposuction.
  • You are 100% correct to see a plastic surgeon -
  • Since we do all these procedures, we can give you the best advice.
  • Those who do only Kybella or only liposuction are likely to treat everyone with what they know how to do rather than offer the full range of options.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Fat Pads

Hello,Submental fat is subcutaneous and easy to palpate. Subplatysmal fat is deep to the platysmal muscle and more difficult to palpate. There are other reasons why either liposuction or an open surgery might be best for you. Hopefully you'll see a few surgeons that can explain the reasoning behind the recommendation for a particular procedure and alternative procedures.Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 78 reviews

Subcutaneous and subplatysmal fat and liposuction of the neck

Thank you for your question.You describe the physical exam maneuver that your plastic surgeon will perform to determine the location of any submental fat.  This is only one consideration as sometimes the platysma needs to be tightened or there are platymsal bands that are contributing to the issue.  The neck skin could also be inelastic and not contact following a liposuction.  My advice is to see a few board certified plastic surgeons in your area and let them give you an opinion after discussing your goals.  To get the results you desire it could take only liposuction but it could also require a neck lift.  This one physical exam maneuver will be one component of a thorough examination that assessed the entire face.

Best Dr. L

Andre Levesque, MD
Austin Plastic Surgeon
5.0 out of 5 stars 1 review

Partially Correct

You are partially correct. The test you describe can be used to distinguish subcutaneous from subplatysmal fat. Subcutaneous fat can be contoured with liposuction. There may, however, be other issues that need to be addressed with a necklift that liposuction alone will not cover. These would include loose skin as well as muscle banding. Some doctors may even want to address enlarged glands by contouring them during a necklift. 

George Sanders, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 12 reviews

Liposuction or a Neck Lift

Liposuction for a female with subq fat and good skin elasticity can create remarkable neck contour improvement. Pinching a double skin layer between the fingers with your jaw clenched differentiates subq fat from subplatysmal fat as you describe. Loose skin or the presence of muscle bands and subplatysmal fat will not respond favorably to lipo and consequently require and are part of a face to face assessment and examination.  Meet with a board certified surgeon and discuss options carefully.  Warm regards, Jon A Perlman MD FACS  Certified, American Board of Plastic Surgery  Extreme Makeover Surgeon ABC TV Best of Los Angeles Award 2015, 2016  Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.