Platysma fat and digastric muscle removal

Hello, hope you are well. If the procedure is not performed carefully, one of the risks would be a contour irregularity under the chin. It is sometimes called a 'cobra neck deformity' because of the central depression (hollowing) that occurs in the submental area. It is very important to maintain an even plane when contouring in this area to avoid problems like this.
Best,Dr. Tower

Thank you for your question. Reduction of the fatty tissue between the digastric muscles typically requires also a reduction of the digastric muscles. Otherwise, this can lead to problems with the contour in the midline under the chin, usually close to the hyoid, the angle place where the underside of the chin converts to the contour of the neck.

The design of the operation needs to bring together the volume of the fat and the volume of the digastric muscles, as well as the volume of the submandibular glands situated more laterally. This ensures long-term good contours and does not rely on skin tension for improvement of the appearance.

The answer is "perhaps", depending on who you see. I routinely perform these elements of the procedure when performing a facelift and/or necklift and do not have such issues.

If there is a thickened layer of fat underneath the skin or excess fat beneath the chin, and underneath the platysma muscle, judicious trimming of this can help to restore an improved, youthful neck contour. The same applies for digastric muscles, which may be enlarged: partial resection of the digastric muscles can help to improve the area underneath the jawline. However, excessive removal of the digastric muscle, subplatysmal fat or the submandibular glands, can result in a hollowed out neck, which has very sharp, harsh features, and does not restore a youthful contour to the neck. Best wishes.

Only based on in-person evaluation an experienced board-certified plastic surgeon, an expert in face/neck lift, can determine whether deep, subplatysmal fat removal and digastric muscle debulking are necessary. These are not standard components of every face/neck lift and your surgeon should decide, usually in the surgery, whether debulking of these structures is necessary. Hope this helps.