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Liposuction under the chin (submental) and into the neck is a common enhancement procedure done below the jawline. While it can be a stand alone procedure it is most commonly performed as an ancillary procedure with other regional surgeries such as chin and jawline implants. While the main effect may come from the bone enhancement the fat removal below it improves its definition as well as creates a more visible cervicomental angle.

Despite the well known benefits of submental/neck liposuction there are patients that go through it and, while getting improvement, may still have some residual submental fullness. Because there is an open incision because of the implant placement this provides an opportunity to do direct submental defatting. It has been my experience that despite the liposuction some fat closest to the incision can be inadvertently missed (under treated), due to the length of the cannula and the aspiration holes at its distal end.

Because of the open incision direct defatting can be done and a sizable segment of flat can also be removed. In so doing it is best done with scissors rather than electocautery as the underside of the skin is directly next to the fat removal area. A cobra or concave deformity is to be avoided.

The direct submental defatting is a secondary step after neck liposuction to ensure that maximal submental reductive contouring is achieving. This also provides an opportunity to also do platysma muscle plication since the direct defatting can be carried down all the way down to the thyroid cartilage if desired. (formal submentoplasty) 

Dr. Barry Eppley

World-Renowned Plastic Surgeon

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