How is the loose neck skin under the chin addressed?
Facial aging changes commonly include the development of prominent neck cords under the chin. These cords, or bands, form two vertical folds that consist of loose platysma muscle edges underneath (Figure 6, left). These bands also contribute to poor neck contour from the side (Figure 6, right). Minimal bands do not require specific treatment other than pulling the platysma from the side as part of SMAS cheek tightening (see above). However, most patients benefit from sewing the loose muscle edges together in the middle through a separate incision under the chin (Figure 8). This eliminates the visible cords and also improves neck contour on the side view (Figure 7). Removing excess fat under the chin through this same incision further improves neck shape.