BEFORE AND AFTER PHOTOS
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An extra fat pad under the chin is very common. It is usually an inherited condition and unfairly makes people look overweight by obscuring the jawline. A well-defined jawline is attractive. Just look at any model or actor (there’s a reason Alfred Hitchcock was behind the camera and Cary Grant was in front). It is common for men to use facial hair such as goatees to give definition to their jawline. You can observe this trend among major league baseball players. In fact, men with well-defined jawlines tend not to camouflage their jawline with facial hair, because there is no need. The cheek should not blend in to the neck. The area under the chin is one of the few places on the body where flatness is preferred! The angle between the jawline and the neck, when viewed in profile, should be about 110 degrees, or a right angle if the sternomastoid muscle is used as a reference (See photo).
This procedure may be done on its own or in combination with a chin implant. The procedure is straightforward. It involves an incision just under the chin. There is often a skin crease or an old scar at this location anyway.
Patients often come to see me interested in liposuction of the body or another cosmetic surgical procedure. If they have an extra fat pad under the chin, I don’t mind pointing this out. They are invariably aware of it already. They may have first noticed this unwanted fat collection in a photograph that caught their profile, taken at an event such as a wedding. They often decide to have this fat pad treated at the same time as their other surgery. Frequently, they tell me after surgery that this was their favorite, because the result is so visible.
What Is “Submental Liposuction”?
Liposuction under the chin is known as submental liposuction. Often some additional fat is removed directly by cutting it out (“excision”) at the same time. Technically, when fat is cut out as opposed to just suctioned out, the procedure is called a submental lipectomy, although the terms are close to synonymous. Most plastic surgeons do both liposuction and direct fat excision to achieve the best profile.
Submental Liposuction in Combination With a Facelift
A submental lipectomy does not tighten the skin of the neck and does not treat jowls. For patients under 40, the degree of skin laxity is usually minimal and a submental lipectomy suffices. However, for patients over 40, there is typically some skin laxity. The decision is whether to have a submental lipectomy alone or with a facelift. The submental lipectomy improves the profile, even when there is excessive skin laxity, but the skin tone does not improve. Jowls persist. If the jowls or loose skin of the neck are priorities, there is no substitute for a facelift, which is commonly done with a submental lipectomy.