Dr. O’Daniel Is Pioneering the Double Chin Surgery Nobody Is Talking About (Yet)
Written by Ethan M. Stone
For anyone trying to improve their appearance, submandibular gland fullness can be a surprising culprit behind a fuller neck, aka a “double chin.” Liposuction and other traditional approaches often aren’t enough to deal with this common cosmetic issue, which can be frustrating, but there’s a promising new option on the horizon. For more than two decades, Dr. T. Gerald O’Daniel has been perfecting a new procedure within his deep neck lift surgery to eliminate the double chin.
That journey began when Dr. O’Daniel, a triple board-certified facial plastic surgeon based in Louisville, Kentucky, realized that existing surgical approaches weren’t serving patients as well as they could.
“About 25 years ago, I was doing what everyone else was doing: liposuction to slim down fuller necks, either on its own or alongside a facelift. There would be some initial improvement, but it never lasted, and it never really addressed the underlying problem,” he says.
“We were removing fat above the muscle and tightening skin, but in retrospect, the fat wasn't actually excess, and the skin wasn't that lax. The real issue was in the deeper tissues of the neck, and nobody was touching those.”So why do patients continue to request a procedure that isn’t particularly effective? Part of the reason is that the initial results can be deceiving.
“Patients look great for a while, which is exactly what shows up well on social media,” Dr. O’Daniel says. “But the gland becomes noticeable again six to 12 months later.”
Over the course of performing thousands of submandibular gland reductions, Dr. O’Daniel developed a seven-step surgical protocol designed to promote patient safety and give surgeons a clearer roadmap to follow. Dr. O’Daniel’s protocol is detailed in a paper that will be published in the Aesthetic Surgery Journal later this year.
It’s never a bad idea to give surgeons a step-by-step protocol, but it becomes especially important when they’re operating on a delicate area of the neck.
“A deep neck-lift operation takes place in a tight space, and the structures sitting close to the gland — the nerves, the arteries, the veins — are ones you can't afford to injure,” Dr. O’Daniel explains. “The consequences are real, and the sequence you follow matters just as much as your skill level.”
His position is backed by medical evidence. “There's real precedent for this kind of thinking outside plastic surgery. The World Health Organization's Surgical Safety Checklist showed a 36% drop in major postoperative complications once surgical teams followed a structured, sequential protocol,” says Dr. O’Daniel.
“What drove that result wasn't the checklist itself. It was the discipline of finishing each required step before moving on to the next,” he adds. “That's the same principle behind this framework.”
Although Dr. O’Daniel is excited about this innovation, he stresses the importance of proper training for any surgeon hoping to offer it.
“I've said publicly that my real concern is submandibular gland reduction becoming the Brazilian butt lift crisis of facial aesthetic surgery,” he says. “The surgeons who originally developed the BBL did so carefully and slowly, with a genuinely low complication rate.”
“Then demand exploded, less prepared surgeons started offering it, and complication and mortality rates climbed to the highest of any cosmetic procedure performed today,” he continues. “I don't want submandibular gland reduction to follow that same curve.”
Dr. O’Daniel’s submandibular-gland-reduction protocol is gaining popularity, but it’s still relatively uncommon. He has a unique and time-limited opportunity to raise the bar on patient safety, and he’s taking full advantage of it.
“My goal is to set new training standards now, while adoption of this procedure is still on the rise,” he says. “I don’t want to sit back and watch it become something surgeons and patients need to be warned about after the damage is already done.”
This article is intended for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. Surgical outcomes vary by individual. Readers considering any aesthetic or surgical procedure should consult a qualified, board certified physician to evaluate their specific circumstances, risks, and options.
