A common concern of patients is the contour of the submental area. Patients desire a strong jaw line and angle between the neck and chin that is about 105-120 degrees. Poor contour of the submental area can be due to any number of anatomical variations including submental fat, recessive chin, lax skin, dehiscent platysma muscle (banding), forwardly placed hyoid bone and more. Traditionally a surgeon’s main tools to deal with an obtuse cervical mental angle have been liposuction or some more complex surgical procedure. We now have additional nonsurgical procedures such as Kybella, Cool Sculpting and Ulthera.
The first step to make the optimal recommendation for a specific patient is an examination that includes analysis of the underlying anatomy. A significant amount of excess skin would make a surgical recommendation more likely as would an older patient with inelastic skin. Smaller amounts of excess skin and more elastic skin would make Ulthera. Patients with a “platysma banding” are best served with surgical tightening. On the other hand, excess fat deposits can be well treated with Kybella injections or Cool Sculpting. Both can provide permanent fat reduction with one or more treatments.
It is important that those evaluating the patient have experience in the many procedures available- surgical and non-surgical -to make the best recommendations. The Larrabee Center has the single largest plastic surgery experience with CoolSculpting in our area and one of the largest Ulthera experiences in the nation. Our surgical expertise with face and necklifts can be summarized by the title of Dr. Larrabee’s most recent lecture in Europe- “My Experience with 5,000 Facelifts.”
The possibilities for submental rejuvenation are many and combinations are frequently the best option. For example one can remove the localized submental fat with CoolSculpting and then “fine tune” the neck contour with Kybella or tighten the skin with Ulthera.
We can discuss all of these options and combinations as needed in a consultation.
