What is the difference between a submentoplasty and platysmaplasty? Would filler be enough to resolve sad mouth area? (photos)
Doctor Answers 9
What is the difference between a submentoplasty and platysmaplasty? Would filler be enough to resolve sad mouth area?
What is the difference between a submentoplasty and platysmaplasty?
The difference is more semantics. Both procedures involve treating the neck area, with a platymaplsty involving suturing of the platyma muscle. A submentoplasty can also include the treatment of the same muscles. Based on your photos, fillers may be a temporizing measure that may not give you the results you are seeking. You may benefit most from another lower facelift with fat grafting to the areas around your mouth. I have included some before and after photos of lower facelift patients. I would recommend consulting with an board certified plastic surgeon who is experienced in performing this procedure. Inquire about their experience and look at their results. Best of luck to you in your search.
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Best Procedure for Facial Aging
I recommend Sculptra
Facial aging continues years after a facelift, so I explain the options to enhance volume and improve neck definition
Facial aging is an ongoing process and there’s continuous loss of bone, muscle and fat. You can have procedures that have a long-term benefit that can last a while. Regardless of what procedure you do, facial aging will not stop.
If your objective is to improve the chin area also known as the submentum, submentoplasty or Z-plasty and platysmaplasty are all procedures that describe ways to improve the neck angle. On the other hand, a typical neck lift involves an incision behind the ear and some parts in front of the ear, then lifting the skin and the platysma. It also tightens it to get improvement of the angle. Submentoplasty or Z-plasty and platysmaplasty may not be as effective as a necklift. Z-plasty involves removal of skin and changing the vectors of tension so that you don’t get a straight scar that can widen. The skin can be challenging. I’ve gotten fantastic results, but also did the same procedure and gotten thickened scars. So there’s a risk involved with that procedure. I’ve been able to help those patients using a method of helping scars called platelet-rich plasma (PRP) and extracellular matrix (ECM) and was able to revise that scar. A submentoplasty can also involve work done without the Z-plasty. A submentoplasty goes underneath the chin to work the muscular layer and the other type of muscles called the digastric muscles.
The other procedure called a platysmaplasty is working on a muscle called the platysma. It is indicated particularly when there are platysma bands - two neck bands that tend to be in the center. I do a small opening, go inside and tighten the muscle of the platysma and do some other work to get the neck angle to improve.
To be able make a recommendation that is right for you, you need a physical examination. From the photo, it looks like you have little extra skin, but in the absence of a physical examination, it’s hard to make a recommendation. You should at least understand the distinction is between those two procedures.
You described something called an Aqua Lipo which is basically a different way to take fat out, but it’s still essentially fat grafting. This is taking fat from one place and putting it in another place and hoping that the volume of fat will hold. Every doctor who does this can tell you between 30-70% of the fat can get absorbed by the body. I always tell my patients who are considering fat transfer that they’ll need at least two procedures. I can place as much fat as I need to, but that fat has to survive. We do all kinds of things such as the use of platelet-rich plasma and other modalities to try to maximize the survival, but when you separate tissue from a blood supply and put it somewhere else, there is going to be variability in the tissue taking.
When you cannot afford to spend a certain amount to maintain your appearance, it can certainly be frustrating. Aesthetics are an area where you can spend a lot of money. I usually tell patients that whatever stage of your life you are in, you need to allocate a certain amount of budget. You might be better served with spending less on a regular basis to get the benefits that you desire rather than spending on surgery which has the implication that it will last longer. Yes, the facelifts can benefit anywhere from 10-20 years, but they are very variable.
I think that you have to learn more about this and you have to be honest with how much you can afford. Meet with doctors who can be honest with you about the outcome, and whether or not you’ll be satisfied. I always tell my patients who come for consultations that I’d rather not do a procedure for you than do a procedure where you’re paying less, getting less of an actual procedure, and not being happy with the results. It’s all about communication and being able to set expectations. I hope that was helpful, I wish you the best of luck, and thank you for your question.
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Non Surgical Face Lift
At age 66, a likely option would be full facelift with moderately aggressive fat transfer to fill in your volume loss.
The platysma work can be done at the time of facelift.
The submentoplasty is limited to under the chin and will likely fall short of what you want.
To be sure what is right for you, see two or more licensed and board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have these treatments.
I hope this helps.