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Subangular Deep Fascia Fixation for Submental U-Shaped Cogged Thread Lifting.

Gi-Woong Hong¹, Kyu-Ho Yi²

¹Samskin Plastic Surgery Clinic, Seoul, South Korea.

|June 22, 2026

Summary

This summary is machine-generated.

Submental thread lifting for double chins can be risky near the jawline. Anchoring threads in a deep fascial layer beneath the platysma may improve safety and lifting stability.

Keywords:

Antegonial notch Cogged thread Double chin Great auricular nerve Subangular deep fascia Thread lifting

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Area of Science:

Anatomy
Cosmetic Surgery
Minimally Invasive Procedures

Background:

Submental
double-chin
deformity has multiple causes, including fat volume, platysmal variations, and aging.
U-shaped cogged thread lifting is a minimally invasive option for submental contouring.
The mandibular angle/antegonial notch region poses risks due to facial vessels and nerves.

Purpose of the Study:

To provide cadaveric anatomical insights for submental thread lifting.
To propose a fixation concept using the
subangular deep fascia
to minimize injury risks.

Main Methods:

Cadaveric simulations of U-shaped submental thread lifts were performed.
Layer-by-layer dissections identified anatomical relationships.
Key structures included the platysma, facial vessels, nerves, and surrounding muscles.

Main Results:

Thread trajectories toward posterior fixation approached deeper planes near the mandibular angle.
Direct arterial penetration was observed in one specimen.
A dense fibrous layer (subangular deep fascia) was found beneath the platysma, offering a potential fixation point.

Conclusions:

The mandibular angle/antegonial notch is a critical zone for submental thread lifts.
Fixation in the subangular deep fascia may enhance safety and stability by keeping threads preplatysmal.
Further research, including cadaveric mapping and clinical studies, is recommended.