What is the correct placement of the submental incision for platysmaplasty in order to avoid further double chin deformities?

Most surgeons seem to place it in the 'natural crease' to try to hide the scar, but this often emphasises the bulge below, creating an 'extra' double chin, especially from the side view. I recently read somewhere that it should be placed about 1cm below the crease to avoid this problem, which seems logical, but hardly any surgeons seem to do this. Why not? Mine is in the crease and it feels too far forward creating an extra double chin between the incision line & adam's apple. It's also puckered

Doctor Answers 5

Platysmaplasty incision

This is an insightful question. We all have our little tricks. I place my incision just about 0.5mm posterior to the natural crease. This is, just as you pointed out, to NOT deepen that crease. There is a scar but it is typically well hidden. 

1cm seems a bit far to me and this is because of two reasons. # 1 the scar may be visible if it is posterior to the natural crease and # 2 if it is too anterior you won't have proper access to the platysma muscle. Exposure is key in this surgery.

Hope this helps.

Best of luck,

DrC


Chicago Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

What is the correct placement of the submental incision for platysmaplasty in order to avoid further double chin deformities?

Although counter-intuitive to many patients the best placement of the submental incision is below or inferior to the natural crease.  Placing the incision in the crease can deepen the crease and create a contour issue like the one you may be describing.

The attached link provides more information.

I hops this helps

Timothy R. Miller, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Incision under chin for neck lift

This incision is virtually never an aesthetic problem as long as sound planning is met with meticulous technique. There is not the one "right" or "wrong" placement; in fact, this incision should be customized for the patient's anatomy. Some people do not have a deep crease depression and the incision can be placed there without causing any issues. Other people have a rather retracted crease which benefits from filling with fat injections to soften it. 

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 45 reviews

What is the correct placement of the submental incision for platysmaplasty in order to avoid further double chin deformities?

Thank you for your question.  You are correct, the submental incision in my opinion should not be placed in the chin crease because the scar will contract and emphasize the depression and create the appearance of a double chin below the incision.  I always place my incision away from the crease either in front of the crease or just behind decrease depending on the location of the crease and how much room there is in front of the crease.  When possible I try to go in front of the crease. For more information on face and neck lift please read the link below:

What is the correct placement of the submental incision for platysmaplasty ? = I do not place it on the crease #necklift #tuck

In my practice, I place the submental incision for a platisma pasty NOT at the level of the submittal crease but 1/2 cm beyond the crease. I learned that on my aesthetic surgery fellowship. The reason behind not placing the incision at the crease is because it will make the scar more visible and also in some ( many) cases it could make the neck to acquire a double chin deformity due to the incision healing. 

John Mesa, MD
New York Plastic Surgeon
4.9 out of 5 stars 110 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.