A double chin is not a medical term. It refers to the area under the bony part of the chin extending into the neck. Like all things in plastic surgery and medicine in general we need to make a diagnosis before we entertain the concept of treatment.
If the bony chin is of inadequate alignment it may benefit from a chin augmentation using one of several methods including silicone chin implant which I prefer. If the area of fullness as we proceed from the bony chin to the lower neck is hanging, we must identify its cause. Anatomically we have skin, fat, and a variety of muscles with their own sub muscular fat beneath.
Double Chin
In a younger patient provided the bony chin is of adequate structure and position like the suction of the neck may be all that’s needed. If a more definitive issue is present for example loose muscle, then through this same submental incision tightening of the neck muscle or platysma may be needed and of benefit. If this seems sub optimal then there are additional and adjacent muscles with a significant fat pad beneath that may be required to be adjusted.
If this submental approach seems inadequate the patient may need a full cheek and neck lift. This lateral approach will allow access to the deep neck and all its sagging structures. We then will be treating skin, muscle, in fat of the cheek and neck in its totality. This procedure will give the best result. Kybela is a substance that theoretically will dissolve fat but requires multiple treatments over a longer period. This chemical dissolution of fat is unpredictable in its result.
Radiofrequency with micro needling as well as a type of variant called J plasma may also be of benefit. These less invasive procedures also have variable long-lasting results but may be of value to prolong the effect of the full face and neck lift. This area from the bony chin to the lower neck is a telltale sign of aging and we have a full variety of treatments with the face and neck lift being the gold standard.
THOMAS TREVISANI, MD
BOARD CERTIFIED PLASTIC SURGEON
MEMBER AMERICAN SOCIETY OF AESTHETIC PLASTIC SURGERY
