Do you hate your double chin?

I hate my double chin.

This is one complaint I hear a lot from patients. The dreaded double-chin, which I’ve also heard referred to as a turkey wattle. Not only is the nickname off-putting, but this is an area that leaves people feeling very self-conscious- you can’t wear a turtle neck every day, right? (Okay, well maybe in Cleveland. But we do still have a summer, even if it’s only three days long.)

What causes a double chin?

We like to blame it on being overweight, but this isn’t the whole story. Genetics do seem to play a substantial role. Most of my patients know exactly which parent to blame for their double chin. But there are several different aspects that may contribute:

• Excess skin: Excess skin appears as we age and our skin becomes less elastic. When people refer to a “turkey wattle”, this is ally what they’re talking about.
• Excess fat under the skin. This is the truest incarnation of the double chin. It may cause by carrying some excess weight. But I’ve also seen plenty of thin people who just unfortunately carry extra fat in this area.
• Excess fat under the muscle. The thin sheet of muscle over your neck is called the platysma muscle. And fat accumulates not only under the skin but under the muscle as well.
• Loose platysma muscles. The muscle layer may separate in the midline with age, causing the angle under the chin to become soft and saggy. This is actually quite similar to a rectus diastasis over the abdominal muscles.

So just like not having a flat stomach, the double chin has many causes. You can have one or all of these issues.

How do we fix a double chin?

If the cause is fat just under the skin, or fat under the muscle, weight loss may help. But as I mentioned, even thin people can carry extra fat in this area. If the only issue is  fat under the skin removing the fat with liposuction or Kybella is a great option.

If there are any other contributing factors, however, a neck lift may be the only way to get rid of your double chin.

What does a neck lift do?

• Liposuction removes fat under the chin.
• Fat under the muscle can be surgically removed. Although this only works right in the midline of the neck; it will help a double chin, but it won’t actually make your neck smaller.
• Suturing the platysma muscle in the midline tightens it up and gives better definition to the neck and chin.
• Pulling the excess skin up and behind the ears gets rid of the turkey wattle.

The downtime after a neck lift is only about a month. You need to take it easy during this time, i.e. no running or weight lifting. But the actually pain is pretty minimal. Most of my patients complain their neck feels very tight afterward, but they go back to work in a week or less.

What’s causing your double chin?

You can get a rough idea of what’s going on by tightening your neck muscles and pinching the skin- is it loose enough to wiggle back and forth? Then you definitely have some extra skin hanging around. Or does the skin feel thick (i.e. there’s a lot of fat under it)?  The best way to figure out what’s causing your double chin, and to find out the best way to treat it, is to see a Board-certified plastic surgeon for a consultation.

Dr. Greer is a Plastic Surgeon who practices in Cleveland, OH. Her passion is helping moms regain self-confidence by getting rid of sagginess, wrinkles, and stubborn fat. Read more about her at www.greerplastics.org.