Do I need incision under my chin? (Photo)

Question

I was under the impression I needed incisions in front of and behind ears as well as under the chin for a deep plane face and neck lift. However, someone suggested because I am thin, my neck can be significantly lifted and tightened by the same incisions around the ears. Thoughts?

Jacob Tower, MD · Answer

Hello, hope you are well. An incision under the chin allows for two important tasks to be accomplished: deep neck contents can be contoured and muscle banding can be addressed (platysmaplasty). The photo you included is a bit limited, but there does appear to be muscle banding. For that reason, I would plan to incorporate a submental incision to perform the platysmaplasty to eliminate that issue.
Best,Dr. Tower

Gianfranco Frojo, MD · Answer

Yes, the incision under the chin allows for direct access to the subplatysmal structures of the midline neck and also to address the platysma bands. It is rare for someone to be a good candidate for avoiding the submental incision.

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photograph. The images suggest platysma muscle bands rather than skin laxity alone. In this type of scenario, tightening from the side does not usually affect the platysma muscles in the same way as when there is an incision under the chin. Most of the time, the platysma muscles are treated by stitching them together in the midline, and if the activity of the muscles is very strong, releasing the platysma muscles at the base of the neck is also beneficial. Of course, you can also address the platysma muscles with botulinum toxin treatments, but Most of the time, tensioning from the side has limited and relatively short-lived effect on the platysma bands in the neck.

Donald B. Yoo, MD, FACS · Answer

Although it's difficult to assess without a view of your neck and face from the profile view, you do have some visible platysmal bands on the photo you submitted. Often these bands can be greatly improved by lifting and tightening laterally through the incisions around your ears, but depending on the severity of the bands, and the strength of your platysma muscle, tightening the muscle in the midline of your neck through a submental incision may be the better option for a  longer-lasting result. Other considerations in terms of a midline incision include the presence of significant sub-platysmal fat, ptotic submandibular glands and fullness from the strap muscles.

Erman Ak, MD · Answer

If you are uncomfortable with the plastysmal bands on your neck, it may be necessary to perform platysmaplasty with a small incision.But it should not be forgotten that strong bands cannot be dissolved 100% even if repairs are made.
Best Erman Ak MD

Stephen Prendiville, MD · Answer

Although the photo is somewhat limited, it does appear to show significant platysmal banding, or cording of the superficial layer of muscle in the neck.  This is best addressed in the setting of a deep plane facelift by also performing an anterior platysmaplasty.  This does require a horizontal incision underneath the chin.  Without this step, you are not likely to be as pleased with your result.

Andrew Miller, MD · Answer

Based on your photos, you need the small incision under the chin. Usually, this incision heals up very well. A surgery that does not do this will not give a good long term result under for the neck as those muscle bands and platysma in that area have to be sutured together and down. Be sure to see a facial specialist for consultation.

Ronald J. Edelson, MD · Answer

The incision under the chin is necessary to deal with the bands under the chin. Mist plastic surgeons do this as part of a facelift

William Portuese, MD · Answer

In our practice, an incision underneath the chin is mandatory in order to rejuvenate the neck. If you don't make that incision, you're not gonna have a rejuvenated neck at all. Through that incision, a platysma plasty is performed, and fat removal is also performed when needed to remove fat deposits located both above and below the platysma muscle in your neck.

Do I need incision under my chin? (Photo)

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