There are many causes for fullness of the neck in the area below the chin, called the cervicomental angle. An accurate diagnosis must be made so that the correct treatment can be used. The most common reasons for fullness in this area are:
Subcutaneous fat: fat beneath the skin pushes the skin forwards and creates fullness. This is corrected by removing the fat, usually with liposuction of the face and neck.
Laxity of the platysma muscle: this muscle lies just below the skin and can almost be considered a part of the skin. If it is weak, or the fibres have separated in the midline, it will bow forward. The platysma muscle is tightened or cut to remove the bowing effect.
Fat below the platysma muscle: fat deep to the muscle will push the muscle and the skin forwards. This is corrected by removing the fat often with liposuction. When the skin has good tone, especially in younger patients , this can produce dramatic changes.
Receding or small chin: if the chin does not protrude adequately the angle with the neck will change. A chin implant is often used to change the jaw size but many patients require repositioning of the bone itself.
Low hyoid bone: the hyoid bone is a free floating bone in the middle of the neck. Several neck muscles are attached to the bone and its position dramatically changes the appearance of the front of the neck. The position is usually a family characteristic. It is difficult if not impossible to change the position of the hyoid bone. Some surgeons have tried to cut the muscles in the neck which hold the bone in position.
Loose skin of the neck: this often makes all of these problems appear worse. It is called a turkey gobbler deformity and is treated by facelifting. Often additional surgery is needed in the midline, especially in men.
alternative names: neck fullness, obtuse cervicomental angle, loose skin of neck, low hyoid bone, receding chin, fat below the platysma muscle, laxity of the platysma muscle, subcutaneous fat