Submental Incision in Deep Plane Facelift + Neck Lift
The submental incision is a small cut under the chin, just behind the natural chin crease, that gives a surgeon access to the central neck when a neck lift is done with the facelift; it is not part of every deep plane facelift. We hold no study of how often it is needed or how its scar heals, so the healing times on this page are typical ranges, not measurements, and your surgeon decides whether you need one. What DEEPPLANE™ holds as data: 5.440 published before-and-after pairs from 760 surgeons in 58 countries, 30 of them photographed twelve months or more after surgery.
Submental incision (2–3 cm) sits in the natural chin crease — used for platysma plication and neck-lift access.
Submental Incision: A 2.5–4 cm transverse incision placed slightly posterior to the natural submental crease (under-chin shadow line). It is the access point for the central neck portion of a combined deep plane facelift + neck lift: platysmaplasty, sub-platysmal fat sculpting, and digastric muscle reduction. It is not used for the deep plane facelift alone — only when neck-lift work is added.
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What is a submental incision and when is it used?
A submental incision is a small (2.5-4 cm) transverse cut hidden in the under-chin shadow, placed slightly behind the natural submental crease. Surgeons use it as the access point for the central-neck portion of a combined deep plane facelift + neck lift: platysmaplasty (tightening the two vertical neck-muscle bands), sub-platysmal fat sculpting, and digastric reduction. It is not used for facelift alone. Surgeons add it when the central neck needs work that the lateral deep plane lift cannot fully reach; we hold no study of how often that is, or of how visible the scar becomes.
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What is the submental incision in a facelift?
The submental incision is a small (2–4 cm) horizontal incision placed in the natural crease beneath the chin, used for neck liposuction, platysma muscle tightening (platysmaplasty), and submental fat removal as part of the neck lift component of a deep plane facelift. Placed in the chin crease, it is hidden in natural shadow; we hold no study of how visible the scar becomes. This incision allows the surgeon to directly visualize and address the platysma bands, submental fat, and cervicomental angle — neck corrections that cannot be achieved from the ear incisions alone.
Submental scar thickening or asymmetry
Minoră — de obicei se rezolvă de la sine
- •Raised hypertrophic ridge along the scar
- •Pulled or tethered scar that distorts neck contour
- •Persistent pinkness past month 6
- •Visible scar from straight-on or 3/4 view (rather than only from below)
Most cases respond fully to in-office treatment at month 3-9. Hypertrophic ridges resolve with 2-3 intralesional steroid injections (Kenalog) 4-6 weeks apart. Persistent pinkness past month 6 responds to pulsed-dye laser (PDL). Tethering or pulling at the scar is rare and usually managed with corticosteroid + 5-FU mesotherapy or, infrequently, a small surgical revision under local at month 12+. Severe hypertrophic scars in genetically predisposed patients (rare in submental location) may require silicone sheet occlusion + steroid combination protocol.
- •Genetic predisposition to hypertrophic scarring
- •Tension on closure (excess work, undersized incision)
- •Smoking — significantly increases hypertrophic risk
- •Inconsistent post-op silicone use
- •Prior revision or open neck surgery in same area
Prevenție: Surgeon technique is the dominant lever: appropriate incision length for the work being done, layered low-tension closure, and preservation of the dermis-platysma plane integrity. Patient-side levers: silicone gel twice daily from week 2 through month 6 minimum, no smoking for 4 weeks pre-op and 6 weeks post-op (smoking quintuples scar-thickening risk), and avoiding chin-strap pressure beyond what the surgeon prescribes.
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5What is a submental incision in deep plane facelift?
A submental incision is a small, hidden cut placed under the chin in the natural shadow line of the submental crease — typically 2.5 to 4 cm long, just behind where the chin meets the neck. Surgeons use it as the access point for the central neck portion of a deep plane facelift combined with neck-lift work: platysmaplasty (centerline neck-muscle tightening), digastric muscle reduction, sub-platysmal fat sculpting, and direct contouring under the chin. It is not used for the deep plane facelift on its own — only when neck-lift work is added to address central neck banding, an obtuse cervico-mental angle, or sub-platysmal fullness that the lateral lifts cannot reach.
When do surgeons combine a deep plane facelift with a neck lift via submental incision?
Surgeons add a submental incision and platysmaplasty when the central neck has features the lateral deep plane lift can't fully address: visible platysmal banding (the two vertical neck cords), an obtuse cervico-mental angle (the chin-to-neck transition is shallow, often called 'turkey neck' or a heavy neck), sub-platysmal fat (the deep neck fat under the platysma muscle that's not removable with liposuction alone), or digastric muscle hypertrophy contributing to fullness under the jaw. Some patients in their 50s and 60s benefit from a combined neck lift, while younger patients often have enough platysmal tone for the lateral deep plane lift alone; we hold no study that measures how often. The surgeon's pre-op assessment of central neck anatomy is what drives the decision.
Where exactly is the submental incision placed and how long is it?
The submental incision is placed slightly posterior (behind) the natural submental crease — not directly in the crease itself, which would push the scar forward as the neck contour reshapes. Length is typically 2.5 to 4 cm depending on what work is needed: 2.5 cm if only platysmaplasty is required, 3-4 cm if sub-platysmal fat sculpting or digastric reduction is added. The incision is a transverse line oriented horizontally so it sits in shadow even with the head tilted upward. After healing, the scar is positioned in the natural under-chin shadow and sits where it is least seen — which is why surgeons specifically place it slightly posterior to the crease.
How visible is the submental scar after it heals?
The submental scar sits in the natural under-chin shadow; we hold no study of how visible it becomes. It typically heals through three phases: weeks 1-2 a thin pink line behind the chin (sutures usually out at day 7), weeks 3-12 progressively flattening and fading, months 3-12 maturation to a fine line; how visible it becomes varies. Risks specific to this incision: occasional thickening or hypertrophic ridge in patients prone to it (treatable with steroid injection), and rarely a depressed or pinched scar if closure tension is uneven — also revisable. Sun protection is less critical here than at facial scars because the area is naturally shadowed; but daily SPF when outdoors is still recommended through month 12.
Is it better to combine deep plane facelift with neck lift in the same surgery or stage them?
Combined is the standard approach when both are indicated, for three reasons: (1) the central neck and the lateral deep plane lift work together — releasing the platysma centrally lets the lateral lift seat fully, and vice versa; staging risks one half compensating for the other; (2) one surgery means one anesthesia, one recovery, one set of incisions, and one cost — staging multiplies all of those; (3) most importantly, many of the deep plane lift's neck benefits depend on platysmaplasty for full effect — staging often means a less-than-optimal neck result. Staging is occasionally chosen for medical reasons (long surgery time concerns in older patients, complex revision cases, smokers who need a smaller initial procedure), but for a healthy candidate with both indications, combined surgery is almost always the better technical and recovery decision.
The lateral deep plane lift addresses the cheek, jawline, and lateral neck through the pre-tragal/tragal and retro-auricular incisions. What it cannot fully reach is the central neck — the area between the two sides where the platysma muscle splits into vertical bands, where sub-platysmal fat collects, and where digastric muscle hypertrophy can blunt the chin-to-neck angle. Some patients have central neck anatomy that needs direct access — visible platysmal banding, an obtuse cervico-mental angle, sub-platysmal fullness. The submental incision provides that access. It adds operating time, and we hold no study of its added risk or of how visible the scar becomes.
- Lateral deep plane lift cannot reach the central neck adequately
- Direct access for platysmaplasty, sub-platysmal fat, digastric work
- Scar in natural under-chin shadow
- Combined surgery is preferred over staging for technical reasons
The submental incision is the access point for the central neck portion of a combined deep plane facelift + neck lift[1]. Through this small under-chin cut, the surgeon performs platysmaplasty, sub-platysmal fat sculpting, and digastric muscle reduction — work that addresses central neck features the lateral lifts cannot reach[2]. The resulting scar sits in the natural under-chin shadow line; we hold no study of how visible it becomes[3].
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Submental Incision Healing Stages
Days 1-7
Closure
Sutures, taping, mild under-chin swelling
Day 7-10
Suture Removal
Sutures + steri-strips out, silicone starts
Weeks 3-12
Pink Phase
Flattening, silicone+SPF, mostly hidden
Months 3-6
Fading
Pink toward skin tone
Months 6-12
Final
Barely-detectable line in chin shadow
When Surgeons Combine Deep Plane Facelift With Neck Lift
The decision to add a submental incision (and the work that goes through it) is driven by central neck anatomy assessed at consultation. The combined approach is indicated when one or more of these features is present:
- Visible platysmal banding: the two vertical neck cords visible especially when the patient looks up or animates the lower face. The lateral lift partially relaxes these but rarely eliminates them — direct platysmaplasty does.
- Obtuse cervico-mental angle: a "shallow" or "blunted" chin-to-neck transition (the angle is greater than the ideal 105-120 degrees). Sub-platysmal fat removal and digastric reduction sharpen this angle directly.
- Sub-platysmal fullness: deep neck fat that sits under the platysma muscle and is not removable with liposuction or with the lateral lift alone. Direct access is required.
- Digastric muscle hypertrophy: enlarged anterior bellies of the digastric muscle visible as fullness on either side of the midline under the chin, only addressable via the submental approach.
Some patients in their 50s and 60s benefit from a combined neck lift, while younger patients often have enough platysmal tone for the lateral lift alone; we hold no study that measures how often. The surgeon's pre-op assessment — looking up, looking down, animating the lower face, palpating the platysma — is what drives the decision. This is why surgeon experience matters: the call between "lateral lift alone is enough" and "combined approach is needed" is judgment-driven.
Submental Position and Length: Why Slightly Posterior to the Crease
The natural submental crease (the line where the chin transitions to the neck) seems like the obvious place to put the incision — but most surgeons place the incision slightly posterior (toward the neck, ~5-8 mm) to it, not directly in the crease. The reason is the post-surgical neck contour: as platysmaplasty and fat work tighten the central neck, the soft tissue redrapes upward toward the chin. An incision placed in the original crease is pulled forward by this redraping and ends up sitting on the chin proper, where it's visible from straight-on views. An incision placed posterior to the crease ends up exactly in the new submental shadow after redraping — invisible from any normal viewing angle.
Length is dictated by the work required: a minimal 2.5 cm cut suffices for platysmaplasty alone, 3-3.5 cm for added sub-platysmal fat sculpting, 3.5-4 cm if digastric muscle reduction is included. A common patient question — "can you just make the incision smaller?" — has a real trade-off: a shorter incision than the work requires forces the surgeon to operate through tension on the wound edges, which is one of the strongest predictors of hypertrophic scarring. Surgeons who pride themselves on tiny submental incisions often produce more visible scars than colleagues who make a 3.5 cm incision and close at zero tension.
Orientation is transverse (horizontal, parallel to the natural skin tension lines) — never vertical. Vertical scars in this area heal poorly because they cross natural skin tension lines and are pulled open with every neck movement.
What to Avoid During Healing
The submental incision is one of the easier scars to protect because it's in a low-mechanical-stress area, but a few rules apply:
- Soft diet first 48-72 hours. Aggressive chewing, hard or chewy foods, and large bites tense the platysma directly under the closure. Liquid → soft → normal across the first week.
- Avoid head-flexion (chin-to-chest) for 2 weeks. Sleeping with the chin down, crunches, sit-ups, or extended phone use with the head bent forward all stretch the closure. Most surgeons recommend a small neck pillow that keeps the chin slightly elevated for the first 14 days.
- Chin-strap as prescribed, then off. Many surgeons use a soft chin-strap or compression garment for the first 5-14 days to support the platysmaplasty. Wear exactly as prescribed — over-tightening risks closure necrosis and pressure ulceration.
- No shaving directly over the area until cleared. Most patients can use an electric razor at week 2 and a wet razor at week 3-4. The submental skin is naturally hairless or sparsely-haired in most women.
- Silicone gel twice daily from week 2 through month 6. Same protocol as facial scars — strongest evidence-based scar treatment available over-the-counter.
Sun protection is less critical here than at facial scars because the area is naturally shadowed by the chin, but daily SPF 50 when outdoors is still recommended through month 12 for any prolonged sun or beach exposure.
For more on what protects scars long-term, see our scarless techniques guide and the scarring complications page.
Combined vs Staged: When Each Makes Sense
Combined (single surgery)
- Standard approach when both indicated
- Anatomic interdependence — better technical result
- One anesthesia, one recovery, one cost
- 4-6 hours total surgery time
- Healthy candidates, ASA I-II
Staged (separate surgeries)
- Long-surgery concerns in older / higher-risk patients
- Complex revision cases with prior open neck work
- Smokers — prefer to do facelift first, neck after quitting
- Patient preference for shorter individual recoveries
- Some surgeons stage when over 70 or significant comorbidities
For most healthy candidates with both indications, combined is the better technical and recovery decision. Staging is the right call only when specific medical or surgical reasons override the default.
When to Contact Your Surgeon
Reasons to call promptly:
- • Sudden under-chin swelling that visibly grows over 30-60 minutes (possible hematoma)
- • Difficulty swallowing or breathing — call immediately or seek emergency care
- • Wound separation (dehiscence) — submental closure visibly opens up
- • New redness, warmth, or pus around the incision
- • Persistent submental fullness past week 6 (possible seroma)
- • Hypertrophic ridge thickening at month 2-3 (steroid injection works best early)
Frequently Asked Questions
What is a submental incision in deep plane facelift?
When do surgeons combine a deep plane facelift with a neck lift via submental incision?
Where exactly is the submental incision placed and how long is it?
How visible is the submental scar after it heals?
Is it better to combine deep plane facelift with neck lift in the same surgery or stage them?
Medical References
- 01Hamra ST. The deep-plane rhytidectomy. Plast Reconstr Surg. 1990;86(1):53-61(se deschide într-o filă nouă)(Articol de Jurnal)Accesat: 2026-03-21DOI: 10.1097/00006534-199007000-00008
- 02Owsley JQ. Face lifting: problems, solutions, and an outcome study. Plast Reconstr Surg. 2000;105(1):302-313(se deschide într-o filă nouă)(Articol de Jurnal)Accesat: 2026-08-05
- 03
Citează această paginăCC-BY 4.0
DEEPPLANE™ Echipa editorială (2026). Submental Incision in Deep Plane Facelift + Neck Lift. DEEPPLANE™. Preluat de la https://deepplane.com/recovery/incisions/submental-incision
DEEPPLANE™. Submental Incision in Deep Plane Facelift + Neck Lift. deepplane.com. Actualizat 2026-09-30. https://deepplane.com/recovery/incisions/submental-incision
DEEPPLANE™ Echipa editorială. "Submental Incision in Deep Plane Facelift + Neck Lift." DEEPPLANE™. Ultima modificare 2026-09-30. https://deepplane.com/recovery/incisions/submental-incision.
DEEPPLANE™ Echipa editorială. "Submental Incision in Deep Plane Facelift + Neck Lift." DEEPPLANE™, 2026-09-30, https://deepplane.com/recovery/incisions/submental-incision.
@misc{deepplane_om_recovery_incisions_submental_incision,
author = {DEEPPLANE™ Echipa editorială},
title = {Submental Incision in Deep Plane Facelift + Neck Lift},
year = {2026},
url = {https://deepplane.com/recovery/incisions/submental-incision},
note = {Last modified 2026-09-30. Licensed CC-BY 4.0.},
}<a href="https://deepplane.com/recovery/incisions/submental-incision">Submental Incision in Deep Plane Facelift + Neck Lift — DEEPPLANE™</a>
Conținut licențiat CC-BY 4.0. Liber de partajat cu atribuire către DEEPPLANE™.
Fapte Cheie
Common Misconceptions
Myth: A deep plane facelift always includes a submental incision
Fact: A submental incision is added only when neck-lift work is needed alongside the facelift. How often depends on the neck; we hold no study that measures it.
Myth: Smaller submental incisions always heal better
Fact: An incision smaller than the work requires creates wound-edge tension, the strongest predictor of hypertrophic scarring. Right-sized at zero tension is what matters.
Myth: It's better to stage facelift and neck lift to keep recoveries short
Fact: The lateral lift and central neck work are anatomically interdependent — staging often produces a worse technical result. Combined is standard for healthy candidates.
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