There is nothing wrong with focusing just on the mid-face, if one plans just one or two procedures. Anyway, the most dramatic rejuvenation effect can be achieved (in people who indeed just want one or two procedures) by a facelift, and by removing tear bags under the eyes.
But for those who, like me, aim for a maximal effect (looking in one’s early 30s, regardless of one’s age), the time will come when they will have to take care of every part of their faces, and, at a later stage, different parts of their bodies.
The lower face and neck are not as easily restored to an early 30s appearance as are other facial areas. You can have a forehead lift do get rid of forehead wrinkles (and hide the scars on your head where they are covered by hair), you can have repeated facelifts (and have the scars hidden behind your ears).
But when the cosmetic surgeon operates a double chin, there aren’t so many options to hide the scars.
In a conventional necklift, the scars are moved to the back of the neck. But the distance from the chin area and the front of the neck (the double chin) to the back of the neck is considerably farther than from the forehead to the hair-covered area on the scalp, or from the cheeks to behind the ears. And the further the distance, the poorer the results. Therefore, even a strong necklift will only have a limited benefit when the aim is to remove a double chin.
The only area in the face that is both near to the chin and also suited to have scars that are not obvious, is the area just under the chin. But double chin removal scars are not handled as as easily as facelift scars behind the ears.
And those who are serious about getting rid of a double chin and sacking flaps below the jawbones will need a whole series of smaller procedures, rather than one bigger one. And here is why.
Take a sheet of paper, and (using a scissors or paper knife) cut a whole inside. I mean, don’t just make a slit in any one direction. What you should do, is to remove a small area of paper (this is equivalent to removing excess skin under your chin).
Now, when you try to sew the edges of the cut together, you may be a able to do so in the middle of the cut. But left and right there will be some elevation. These elevations, in cosmetic surgery, are referred to as “dog ears”.
Dog ears at the left and right of scars don’t look good. They look a bit funny. And if a person has a double chin removed, these dog ears can be quite pronounced.
The only way to ameliorate these dog ears is to make a small follow-up operation to remove the larger dog ears, which will then result in two very small dog ears for each of the large dog ears operated. These small dog ears then again could be removed, finally resulting in surface flatness.
However, such a sequence cannot be operated in one go. The previous cut will have to heal before the subsequent one, and that means a wait of several weeks, or, even better, several months (as this establishes fully functional blood supply in the operated area).
Most plastic surgeons are not eager to do that kind of series of operations. The reason is that while good results can be achieved in the end, patients will almost certainly be unhappy with the intermediate result of the first operation. And this is very different from what surgeons experience after facelifts.
Facelifts look good after three days. A direct removal of a double chin will look good only after twelve months, and a series of at least three operations. This means that patients who are not that patient will come back after the first double chin removal operation and complain.
I have myself undergone such a direct removal of a double chin, in a series of operations. Please email me if you need advice on questions not covered in this article, or if you need a recommendation for a cosmetic surgeon who may be willing to do this for you.
Because men always can grow a beard temporarily, this is one facial cosmetic surgery procedure for which men are better suited than women.
Raul Loeb M.D., Surgical elimination of the retracted submental fold during double chin correction, Aesthetic Plastic Surgery 1978, Volume 2, Issue 1, pp 31-40
ROBERTSON, JAMES G. M.D, F.A.C.S., F.I.C.S., Chin augmentation by means of rotation of Doudble Chin fat flap., Plastic & Reconstructive Surgery: October 1965 – Volume 36 – Issue 4 – ppg 471-474
Marino, Hector M.D., Galeano, Eduardo JOrge M.D, Gandolfo, Enrique Aldo M.D., Plastic correction of double chin: Importance of the position of the hyoid bone., Plastic & Reconstructive Surgery: January 1963 – Volume 31 – Issue 1 – ppg 45-50
Zide, Barry M. M.D., D.M.D.; Boutros, Sean M.D., Chin Surgery III: Revelations., Plastic & Reconstructive Surgery: Volume 111 – Issue 4 April 1, 2003