Does anyone have an opinion on a submental excision?

Question

Googling (+ DR who suggested) tell me a submental excision is very rare, but recommended . Another DR suggested ultherapy. I had ultherapy once, 18 months ago. Hard for me to judge U, but certainly not overwhelming. Also, 4 years ago, fat injections. As the SE is so rarely done, it is hard to feel entirely comfortable. And unavoidable vertical scar in middle of neck. Was told the few patients who had had SE were happy, scar acceptable. Hard to envision what it would look like. TIA

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Direct excision is a reasonable solution to improve the contour of a neck.  I reserve this treatment option for men who do not what to have a facelift.  In my opinion, direct surgical excision is not appropriate for women desiring improved contour of their neck.

Michael I. Echavez, MD · Answer

There are some patients where a submental excision of skin may be recommended.  In some cases, this type of procedure may be more cosmetically acceptable than a face/neck lift.  In some cases, it is possible that the submental excision would produce more benefit as well.  An exam would be needed to determine if you might be a good candidate for the procedure or not.

Oliver Pope Simmons, MD, FACS · Answer

Direct excision of submental area is an acceptable way for a cervicoplasty. It however is not done as a straight line it's done as a Z-plasty with the two limbs being directed directly over the hyoid bone. this leads to the best contour in the neck and the least likelihood of scar contracture in the region I reserve it for patients that are typically older and typically  male because the downside of a facelift in these patients I also recommend that it be done if the person has extremely thin skin and is not interested In any rejuvenation above the jawline

Barry L. Eppley, MD, DMD · Answer

I am assuming by your question that you are referring to the direct neck lift, a vertical excision of skin and fat from under the chin downward. This may also be called a vertical submentoplasty in some patients. It would be helpful to see pictures of your neck to see if this is really a good option for you. It would also be helpful for you to see picture of direct necklift scars so you can judge the aesthetic outcome for yourself. It is a tremendously effective procedure if you find the scar and the risk of potential scar revision acceptable. It is really a procedure for older men and women whose more loose neck skin scars much better than younger skin.

Sean Freeman, MD · Answer

nada0000, I routinely use a submental "incision" that is horizontal in orientation. I would only do a submental "excision" with a vertical (actually a bit jagged) scar in an older male with a heavy beard who wanted his turkey neck gone but refused or was not a candidate for anaesthesia. In general this problem is handled with a  neck lift or a facelift of some sort. I've been exclusively doing facial plastic surgery since 1988 and have maybe done 2-3 submental "excisions". So see several facial plastic experts with years of experience and get a few opinions. Good luck!

Francis R. Palmer, III, MD (retired) · Answer

Hi, I'm not certain why your surgeon told you that sub mental skin excision is rare.  It's performed with every minimal incision facelift and formal necklift that we do.  It's actually very common.

Richard W. Fleming, MD (retired) · Answer

First I need to know what problem you have and how old are you. Submental excisions are common, but with a horizontal, not vertical incision. By the way, excision of what?

Robert T. Buchanan, MD (retired) · Answer

The doctor who told you that a submental excision is rarely done was correct. This is a form of neck lift and everyone likes to hide the scar as much as possible, so the neck is corrected at the time of a facelift or the scar is basically a facelift scar except for a small transverse scar hidden under the chin. There are, however, some circumstances where direct excision offers the best, and certainly the easiest and least expensive, option. In those select patients, using a Z-Plasty type incision, excellent results can be achieved and all patients I have done it on, though few, have been very happy. This is definitely a procedure that requires careful discussion with your plastic surgeon.

Does anyone have an opinion on a submental excision?

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