Corset Platysmaplasty for a Double Chin and Neck Bands

A heavy-looking chin can come from three different tissues: fat that sits under the chin, muscle that has loosened and separated, or skin that has lost its elasticity. Corset platysmaplasty deals with the first two in one operation. The fat layer is thinned, and the muscle is drawn together along the middle of the neck so that it supports the area like the lacing of a corset, which sharpens the angle between the jaw and the neck.

Skin is the limit. This operation does not cut away skin, so when the neck skin is loose and hanging, removing fat and tightening muscle beneath it can leave the skin even looser. In that situation a neck lift, which also repositions and trims skin, is the operation discussed. Fullness that comes from the shape of the jaw or chin bone also falls outside what soft-tissue surgery changes.

Two things happen in the operation. First, liposuction through a small cannula thins the fat that sits just under the chin and along the jaw. Second, the platysma is reached through a short incision under the chin, and its separated inner edges are brought together and stitched in the midline, in a pattern that runs down the neck like the lacing of a corset. The corset technique as described in the literature uses an incision in the shadowed crease below the chin.

The muscle step matters because removing fat alone can make bands more visible. In an analysis of 301 patients who had liposuction under the chin, those with heavier submental fat and a particular platysma anatomy, in which the two muscle edges do not cross, were significantly more likely to show bands at the front of the neck afterwards (Kamer, 1993). In a series of 168 patients, midline platysmaplasty was more effective for neck bands and fullness under the chin than pulling the muscle only from the sides (Choi, 2020).

Corset tightening has critics as well. A 2018 review argued that traditional corset-style tightening and side-only fixation can look good early, yet bands often return and the long-term result is disappointing unless the problem in each neck is defined precisely and planned for (Marten, 2018). That debate is the reason the assessment of fat, muscle and skin comes before the decision to operate.

The bill for this operation has two lines. The corset platysmaplasty fee covers the surgery, and IV sedation is a separate line that the clinic adds to every operation it performs. Both are shown before VAT (10% VAT is added at payment), so a complete estimate is ₩3,300,000 plus ₩300,000 for sedation, before tax.

A third card applies to a different plan. When face liposuction is the main procedure, platysma tightening can be added to it as an option at ₩2,000,000 before VAT. The clinic does not offer that muscle step as an operation of its own. Ask for your written quote to show whether the compression garment and prescribed medication are part of it.

Signs that need a call to the clinic straight away are swelling that grows quickly, a firm and painful lump under the chin, difficulty swallowing or breathing, or fever.

• Bleeding under the skin (hematoma), which can need draining.
• A collection of fluid (seroma) under the chin.
• Injury to the nerve branch near the jaw, causing weakness of the lower lip on one side.
• Uneven contour or a hollow under the chin where fat was removed.
• Return of neck bands or jawline fullness over time.
• Loose skin that remains or becomes more noticeable, since no skin is removed.
• A visible scar under the chin, or infection at the incision.

Published series put numbers on some of these. In 168 patients treated with medial and lateral platysmaplasty, nerve palsy occurred in 0.6%, hematoma in 1.8%, seroma in 1.2% and a hollow under the chin in 1.2% (Choi, 2020). Among 1,089 neck lifts at one center, about 10% had a secondary operation an average of 10.3 years later, and returning platysma bands were the commonest reason (Narasimhan, 2016). These are figures from other surgeons' practices and do not predict an individual result.