How to improve sub-mental area after Facelift? (photos)

Question

I had a facelift over 4 years ago. It much improved my "turkey neck," and my double chin is mostly gone, but the sub-mental area looks so weird. I tried morpheus8 hoping it would tighten the skin, but it did not help in the least. Are there any non-surgical ways to improve it? I am very unhappy and self-conscious about it. I would rather not have a revision facelift, but I suppose I will if that's my only option.

Richard G. Schwartz, MD · Answer

Based on your photos, I don't think you need another facelift.  I think you have some increased fibrosis (scarring) and perhaps some remaining fat on the surface of your platysma muscles in the submental area.  It may also be due to inflammatory tissue that formed around sutures placed in the muscle.  I have seen this in the past, and it was corrected by a minor procedure through the old submental scar to carefully remove the offending tissue.  This was able to smooth down the contour nicely.

Thomas A. Mustoe, MD, FACS · Answer

You have a challenging problem and the best result Woukd come from some kind of surgical revision.  However it looks like you have some redial fat, perhaps in the deeper layers and laser assisted liposuction (Precision laser) has been helpful as a minimally invasive technique I. Throughly removing fat and getting some mild skin tightening so that there are no irregularities. It is a minimally invasive office procedure with just a couple of days of downtime.  I Woukd seek more than one opinion by a surgeon very experienced in facelift.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. While I would need to see you in person to make a definitive recommendation, it does appear you might be a good candidate for facial liposuction to remove the submental fat remaining after your surgery. However, if skin laxity is also a concern, you may need to combine the liposuction with surgical excision of the excess skin to ensure the smoothest result. I encourage you to schedule a consultation with an experienced, board-certified facial plastic surgeon for a thorough examination and customized treatment plan.

Scott Tucker, MD · Answer

There are numerous skin tightening devices out there that are touted as being able to tighten the skin of the neck, however the most reliable way to correct what you have going on is to revise your submental incision to take out a little bit of submental fat and tighten the skin through your same facelift scars.Good luck, Dr. T

Tanveer Janjua, MD · Answer

The skin under the chin can be excised and closed with either a W-plasty or Z-plasty. I have also done a long straight linear along the chin and jaw line and works great. 
Regards
Dr. J

Brian K. Machida, MD, FACS · Answer

It’s too bad that someone sold you Morpheus 8 because most surgeons would tell you that it wouldn’t help. The problem is with the muscle under the skin. The swelling under the chin has to do with the muscle layer under the skin. Unfortunately I can’t give exact advise without an examination but revision surgery is often needed for improvement.

Barry M. Weintraub, MD, FACS · Answer

I would not advise you to spend any more money on non-surgical procedures. Judging from the photos only (and you would need to be seen in person for a proper diagnosis) it appears that you have residual fat which is made more obvious by apparent scarring. A revision surgery of some sort would likely be the solution. The scar tissue under your chin makes the hanging skin and residual fat look worse. In the past, when patients have come to me with this issue, I’ve surgically excised the excess skin and have removed the excess fat. In revising your scar, sometimes fat transplantation is needed if the prior surgeon didn’t cherish the need for topographical confluence. You may not need a full-facelift revision at all, more like a revision neck lift. I would recommend that you consult with a board certified plastic surgeon who often performs revisions so that you can be properly examined, and a treatment plan devised that will benefit you.

How to improve sub-mental area after Facelift? (photos)

Answers (7)

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