What Causes Side Effects After Chin Surgery, Such as a Double Chin? - Explained by a Specialist

Hello, I’m Director Jo Hyun-woo of 입체성형외과.

Today, I’d like to explain the side effects of chin surgery.

Among the side effects of chin surgery are problems such as a “double chin” and “sagging.”

In my previous column, I compared T-osteotomy and lower border osteotomy (LBO), two of the representative surgical methods for chin surgery.

Before talking about the side effects of chin surgery, let me briefly explain:

Depending on the osteotomy method, chin surgery includes various types such as T-osteotomy, ㅅ-osteotomy, lower border osteotomy (LBO), W-osteotomy, and sandwich osteotomy.

Before lower border osteotomy (LBO)

1 year after lower border osteotomy (LBO)

However, I explained that these are all simply slight changes to the osteotomy line, and that the surgical principle and intended direction are largely the same: they are procedures that make the chin narrower by reducing or repositioning the width and length of the front jawbone.

At this point, when patients ask about the side effects of chin surgery, such as a double chin and sagging, they often ask about the relationship to the osteotomy method.

It seems they think that because the dissection area differs slightly depending on the method, the procedure with less dissection would be better.

(left) lower border osteotomy (LBO), (right) T-osteotomy

A common statement is that T-osteotomy has a smaller dissection area than lower border osteotomy (LBO), so the likelihood of sagging is lower.

Strictly speaking, it is true that T-osteotomy involves less dissection.

However, the difference is not large in degree, and because the muscles are fixed upward during surgery, if the procedure is performed properly, the degree of sagging should not be large enough to be visibly noticeable.

1 year after lower border osteotomy (LBO)

Then what causes cases where a double chin appears as a side effect of chin surgery?

Before T-osteotomy

1 year after T-osteotomy

The reason the saying that a double chin can appear as a side effect of chin surgery keeps circulating is probably because there really are patients who experience sagging or develop a double chin after surgery.

When the volume of the bone is reduced through chin surgery, the soft tissue covering it (muscle and fat) can become unbalanced in relation to that volume.

When the bone is reduced surgically, the soft tissue covering it may remain and sag downward.

This is a general principle of sagging after contouring procedures, not only chin surgery but also cheekbone and square jaw surgery.

However, it is difficult to say that chin surgery will definitely cause a double chin, or that T-osteotomy causes less sagging because it has a smaller dissection area.

First, the causes of sagging are related to several variables such as the patient’s age, skin thickness, skin elasticity, and the amount of bone removed.

1 year after T-osteotomy

The more bone is removed, the greater the possibility and degree of sagging.

However, if the patient has good skin elasticity, the sagging issue can be overcome more easily.

Conversely, even if the amount removed is small, sagging can still occur if the patient’s skin elasticity is poor.

Even if the same amount is dissected, the effect may be 1 for one patient and 10 for another.

A person with good skin elasticity may not experience sagging even with more dissection than someone without it, while a person with poor elasticity may experience sagging no matter how much the dissection area is reduced.

Therefore, cases where cheek sagging or a double chin appears after contouring surgery may be due to dissection that exceeded what the patient could compensate for, or to improper surgery causing damage to the muscles and retaining ligaments.

Finally, to prevent these side effects of chin surgery, such as a double chin and sagging, the first priority is

for the surgeon to minimize tissue damage through accurate surgery and, through a thorough preoperative examination, find a surgical approach that maximizes the effect while minimizing side effects.

Thank you.