2026-05-25
Neck Lift (Double Chin Muscle Plication) & Facelift!
A comprehensive case study of a 50s female patient undergoing a High SMAS facelift and neck lift to address jowls, marionette lines, and a sagging jawline.
* Basic Information
# Female in her 50s
# Concerned about sagging jowls on both sides and marionette lines around the mouth.
# Wants to improve the sagging and drooping jawline area.
* Consultation
# Thread or mini-lifts can yield satisfactory results when skin sagging is not severe, but they have limitations for middle-aged patients or older who have thick skin and significant sagging.
# In such cases, a more definitive lifting effect can be achieved by performing a robust lift of the SMAS (the skin’s support layer) while simultaneously addressing the sagging of the loose skin.
# Let’s look at the following diagram to explain double chin lifting ~
A. Fat
1. The procedure commonly known as Lipo-sound liposuction targets the subcutaneous fat layer.
2. However, as you can see in the diagram, fat also exists beneath the platysma muscle. This includes subplatysma fat, interplatysma fat, etc. Since this is deep fat located under the muscle, it can never be reduced through liposuction alone. This is why some areas still look bulged or retain a blunt appearance even after liposuction. This fat must be removed by making an incision in the muscle and visualizing it directly!
B. Muscle
In some cases, the platysma muscle itself is sagging. This can be congenital or a result of the natural aging process. In these instances, the muscle must be tightened as if wearing a ‘corset’ to create a tight line! This procedure is commonly referred to as ‘double chin muscle plication.’
Since this method has long been used in neck lifts, you can trust its proven effectiveness and safety.
* Surgical Plan
Incisional Facelift (High SMAS lifting)
Neck Lift (Double Chin Muscle Plication)
* Post-operative Progress
# A satisfying lifting effect is achieved by removing the sagging SMAS layer and excess skin through an incision that extends from the temples, along the sideburns, around the ears, and toward the neck. By following the hairline and the natural contours in front of the ear, scarring can be minimized.
# After sufficient dissection of the retaining ligaments, the most sagging part of the SMAS layer must be firmly pulled and fixed to ensure a definitive lifting effect.
# Can you see how much the blunt jawline has improved through double chin muscle plication and liposuction? This was a case where natural yet distinct changes were achieved.
Consultations and surgeries should be performed by a board-certified plastic surgeon!
The VIBE that comes from extensive experience.
Vibe Plastic Surgery, Chief Director Young-moon Yoo
Vibe Plastic Surgery complies with all medical laws. These before-and-after photos were taken under the same conditions with the patient’s consent. Complications and side effects such as bleeding, inflammation, infection, and asymmetry may occur depending on the individual, and caution is required.
Frequently Asked Questions
Can severe skin sagging be improved with mini-lifting?
No, it is difficult. While satisfactory results can be achieved for mild skin sagging, for middle-aged or older individuals with thick skin and significant sagging, mini-lifting alone has limited effectiveness. In such cases, SMAS layer lifting is necessary.
Can all double chin fat be removed by liposuction?
No, that's not the case. Subcutaneous fat can be removed by liposuction, but deep fat located under the platysma muscle cannot be reduced by suction. This fat must be removed by incising the muscle and directly visualizing it.
What kind of surgery is "double chin muscle tightening"?
Double chin muscle tightening is a surgical procedure that, when the platysma muscle is sagging, tightens the muscle itself like a corset to create a tight jawline. This method is used during neck lift surgery and has proven effectiveness and safety.
How are scars managed after a facelift?
Scars can be minimized. Although an incision is made from the temple to the sideburns, around the ear, and down to the neck, by utilizing the hairline and the curves in front of the ear, the scars can be minimized to be inconspicuous.
What is the core lifting method for a facelift?
The core of a facelift is the definitive lifting of the SMAS layer. After sufficiently dissecting the retaining ligaments, the most sagged part of the SMAS layer must be firmly pulled and fixed to achieve satisfactory lifting results.