Why do a lot of facelift patients end up with a worse double chin after surgery, even if they have a platysmaplasty?

It's happened to me to some degree, and I've noticed it on reviews on realself, and even on surgeons' own website photos. I can't understand why or how there could be MORE fullness under the chin after any type of full (not mini) facelift - where does the extra fullness come from? How can it be corrected?

Doctor Answers 13

More fullness under the chin after facelift

You are quite observant.

The chin and neck are the least satisfying results from facial rejuvenation surgery.

For months after the operation there may be persistent swelling or the skin here fails to contract.

Some surgeons do not open the neck to deal with deep fat and stitching the platysma together can make things worse.

The neck is a challenge even to the most experienced facelift surgeons.

Facelift

Thank you for your question. Kybella is the most effective injectible drug for eliminating submental fullness under the chin and contouring the jawline. It is the only FDA-approved injectible drug to do so and is a very safe procedure. I suggest that you move forward and consult with a board certified facial plastic surgeon.

Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 95 reviews

Double chin post facelift

Frankly, I have never had a facelift patient with a worse double chin after surgery. It sounds as if your surgeon maybe didn't fully correct your neck -- yes, the muscles were tightened, but the excess tissue wasn't removed. Obviously that is just a guess since I have not assessed you in person. So sorry that you aren't totally thrilled with your results. You can always schedule an appointment with your surgeon to discuss.

Kindly,

Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 21 reviews

Fullness under the chin after facelift - inadequate removal soft tissue

Hi there. Fullness under the chin is usually due to an excess of tissue (fat below the skin and deep to the muscle, swollen salivary glands). Tightening the platysma muscle in the middle or pulling it up at the sides does nothing for this fullness unless the extra tissue is also removed at the same time - surgeons with results you describe may be underrating the neck!

Increased double chin after full facelift.

The only anatomy under the chin is skin, subcutaneous fat, platysma muscle, sub-platysmal fat, diagastric muscles and submandibular glands.  During a facelift, these structures are contoured, trimmed and tightened to achieve the best neck contour possible.  If there is a worse double chin after surgery, it may be from incomplete contouring or possibly swelling of the area.  Your surgeon knows exactly what was done so it's best to check with your surgeon about possible corrections.

Worse Double Chin after Facelift Surgery

What is achieved with a facelift operation will depend on the technique that is used. I have never had a facelift patient with a worse double chin after surgery when a complete lift is done. All patients should ask their surgeon what will be achieved because there are many different types of facelift procedures.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Chin fullness

First it can be caused by a witch's chin from making the cut within the crease, it can be due to swelling, it can be due to fluid.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Double chin after facelift surgery

One important piece of information is how long has it been since surgery.  It should not be a common occurrence to have a worse double chin after facelift or facelift with platysmaplasty.  In the initial weeks after surgery as the swelling reabsorbed and heals, there can be some fullness under the chin.  In a standard rhytidectomy/facelift or a facelift with platysmaplasty, the skin is elevated all the way across the chin and upper neck.  As a result there can be some temporary swelling and fullness in the area during healing process.   This should resolve by a month after surgery.  

Catherine Weng, MD
Denver Otolaryngologist

Double Chin after Facelift Surgery

You should have a nice chin/neck contour following facelift.  The reasons for fullness this area can be many depending upon the technique used.  Fullness in this area even with a playtsmaplasty could be due to excess subplatysmal fat, drooping submandibular glands, or hypertrophied digastric muscles.  All of these issues can be addressed through the same platsymaplasty incision.   Finally pull of the platysma toward the midline by plastymaplasty in some patients can lead to this fullness.  In these cases I pull the platysmal muscle up and away from the neck from the preauricular facelift incision using the deep plane approach without suturing the muscles together.  Some surgeons advocate partially sectioning the platysma muscle or completely removing it.    Revision facelift can address the issues you are concerned with.  I hope this helps.

James C. Marotta, MD
Long Island Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews

Double Chin After Facelift

A facelift alone should not worsen a double chin but it may not improve it enough. A thorough necklift will provide you and other patients with a meaningful and long-lasting benefit. 

I am sorry that I cannot explain your observation/ experience

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