Double Chin Surgery: Why Removing Fat Alone Isn’t Enough (Case Analysis)

Hello.

I’m Lee Won, the chief director of 21 Plastic Surgery.

When consulting on double chins,

I often get asked, “Is liposuction enough?”

But in many cases, it cannot be explained by the thickness of fat alone.

This is because a double chin is formed by the combined effect of fat, the platysma muscle under the chin,

and salivary gland volume.

The case I’m introducing this time

is also one that could not be viewed as a simple fat issue.

According to the preoperative diagnosis,

the patient had a folded appearance under the chin from both the front and side,

with a prominent double chin.

Although there was some fat layer,

the more important causes were a loosened platysma muscle and

a relatively prominent salivary gland volume.

When the platysma relaxes,

the force supporting the jawline weakens,

and the lower face can appear to droop downward.

Also, when the salivary glands are relatively prominent,

the area under the chin can look thicker.

In this kind of structure,

removing only the fat may make it look thinner temporarily,

but because the support structure remains the same,

there are limits to fundamental improvement.

So the surgical plan was set as follows^^

Surgical plan

Double chin liposuction + muscle tightening + salivary gland Botox

On postoperative day 7,

swelling is still present.

At this point, it is difficult to say the double chin has completely disappeared,

but the direction of the fold under the chin changes,

and the tendency for the lower face to droop downward begins to organize upward^^

Through muscle tightening, the jawline gains support,

and the direction of the line changes first.

Two weeks after surgery,

the swelling subsides a little more,

and the boundary between the jawline and neck line gradually begins to emerge.

Rather than the thickness of the double chin itself,

the blurred boundary that made the jaw and neck appear separate

is showing signs of being refined^^

One month after surgery,

most of the swelling has gone down,

and the surgical results become more clearly visible.

The double chin was not simply made thinner;

the angle between the jaw and neck became more defined,

and the line settled more stably.

The effect of salivary gland Botox also began to appear gradually,

further refining the thickness under the chin.

Three months after surgery,

as the soft tissue stabilized,

the line is being maintained most naturally.

The area under the chin no longer looks flat or sunken,

and the impression of a heavy sagging appearance has disappeared,

while the angle of the jawline and neck line has been formed stably.^^

This change was possible not just because the fat was removed,

but because the support structure was addressed together.

A double chin is not only a problem of fat.

It is a structural result of fat, muscle, and salivary glands working together!!!

Therefore, rather than approaching it with simple liposuction,

it is important to selectively combine liposuction, muscle tightening, and salivary gland Botox

according to the patient’s structure.

At 21 Plastic Surgery,

we do not view the double chin as a single area,

but analyze the entire lower face’s structure and center of gravity together,

and plan patient-specific surgery.

If you are wondering whether your double chin is simply a fat issue

or a structural one,

I recommend getting an accurate diagnosis.

Thank you.^^

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