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

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.  

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,

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!

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.

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.

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

Thank you for your question.  After a face and/or necklift, you typically should not have a 'double chin'.  One of the advantages of surgery is the ability to eliminate this fullness.  Usually a platysmaplasty and/or submental liposuction can be performed in addition to the facelift. If you are considering surgery, I would seek out consultation with a board certified facial plastic or plastic surgeon who specializes in facial rejuvenation.  Be sure to look at his/her before and after photographs, and share you concerns about the chin region. I hope that this helps!-David Gilpin 

In my opinion, it is rare that a patient would end up with a worse double chin after a facelift.  There normally is some swelling in the healing period, which could make the area under the chin appear fuller, but this would be temporary.  Liposuction under the chin is frequently done at the same time as a facelift to reduce the fullness in that area.  

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

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.