The short answer
Swan-neck surgery is not incision-free. At Clair Plastic Surgery (클레어성형외과), near Gangnam Station in Seoul, the fat just under the skin is removed by liposuction through small openings behind both earlobes and under the chin. A deeper layer of fat behind the neck muscle is removed by hand, piece by piece, in the same operation. Tightening the platysma, the thin sheet of muscle under the chin, needs an incision of about 1 to 2 cm under the chin. The representative director, Dr. JinHo Han, a board-certified plastic surgeon, closes the incision himself, and the stitches come out on day 5 after surgery.
Scars differ with skin characteristics and with how healing goes, so no one can tell you in advance exactly how your scar will look. What you can do before surgery is know where each opening will be, and plan the aftercare and your trip so the stitches are dealt with properly. Flying home is possible from the day after surgery. If you leave before day 5, the clinic writes a doctor's note for stitch removal, and the stitches can be taken out at a clinic or hospital in Taiwan. Being able to fly is not the same as being recovered. The recovery period the clinic gives is about one week.
Two kinds of opening, and why there is an incision
People who ask about a less noticeable option usually want to know one thing first: where will the cuts be? In swan-neck surgery there are two kinds.
Openings for liposuction. A fine cannula is passed through small openings behind both earlobes and under the chin to remove the fat that lies on top of the muscle. The clinic's blog describes these as incisions just large enough for a cannula to pass through.
An incision for the muscle. When the platysma has loosened, it is gathered toward the middle and stitched in place. This step needs an incision of about 1 to 2 cm under the chin. If the scar is your main concern, this is the part of the operation to ask about in the most detail.
The incision is part of the muscle step. Whether the deeper fat behind the muscle is also reached through it is not stated in the clinic's published information. If the examination finds that the platysma is not loose and the deeper fat is not part of the picture, liposuction on its own may be discussed instead, and that plan does not include this incision. We explained how fat and a loose muscle are told apart, with an ultrasound check and an in-person examination, in Double Chin: Liposuction Alone or Swan-Neck Surgery?.
The exact position and size of the openings and the incision can vary with the method and with the individual. Two details are not covered in the clinic's published information, so confirm them for your own plan: whether the opening under the chin and the incision are in the same place, and which of the openings are closed with stitches.
What is known about scars, and what is not
This article uses only one of the clinic's statements about scars: scars differ with skin characteristics and with the healing process, and Dr. Han explains the incision position and what to expect of the scar at consultation. It gives no timeline for how the scar will change, because that differs from person to person.
General guidance from medical societies points the same way. The American Society of Plastic Surgeons (ASPS) describes scars as an unavoidable result of surgery whose development can be unpredictable, and notes that a scar cannot be completely erased. The American Academy of Dermatology (AAD) explains that a new scar is usually pink to reddish, and that as it matures it often turns lighter or darker than the surrounding skin. Some people's skin makes extra tissue as it heals, which gives a raised scar. When that tissue grows beyond the edges of the original wound, the AAD calls it a keloid.
A few practical points follow:
- The scar you see when the stitches come out is a new scar, and it keeps changing after that. Day 5 is not the day to judge it.
- If you have had raised or thick scars before, from any surgery or injury, mention it when the incision is discussed.
- Ask how your scar will be checked after you go home, especially if you fly back to Taiwan early.
Caring for the incision after surgery
The instructions you receive after your own operation come first. Once your surgery date is set, the clinic checks your current medicines and surgical history and explains the precautions. What the clinic has published for this operation:
- For seven days after surgery, avoid alcohol, smoking, saunas and jjimjilbang (Korean bathhouses), and exercise that makes you sweat heavily.
- Do not massage or rub the area.
- After the muscle tightening, avoid sleeping face down and moving your jaw excessively in the early period.
- The clinic's blog mentions wearing a compression band for a period after muscle tightening. How long is explained by the clinic, so ask whether you keep wearing it once you are home.
- If you go home early, follow the same instructions in Taiwan.
In the first days you may notice stiffness, pulling, a feeling of pressure or changes in sensation, and prescribed pain relief is taken if needed. Early swelling can make the area under the chin look fuller for a while, which is another reason not to judge the incision too soon.
The AAD adds two general points. For a wound that needs stitches, the AAD's advice is to follow your doctor's instructions on how to care for it and when to have the stitches removed. Its home tips for minor cuts, such as petroleum jelly and bandages, are written for small injuries. For a surgical incision, the clinic decides what goes on the wound and from when, so ask before applying any cream or product. Once the wound has healed, protect it from the sun. The AAD notes that sun protection on a healed wound may help reduce red or brown discoloration, and recommends covering scars with clothing or using a broad-spectrum sunscreen with SPF 30 or higher.
Stitches on day 5 and your flight home
The clinic's figures are easier to plan with in this order. Flying home is possible from the day after surgery. Stitches come out on day 5. The recovery period is about one week. Early swelling and bruising are possible and generally begin to ease after 3 to 7 days, depending on your constitution and the extent of surgery. We set out the whole first week in Swan-Neck Surgery: What It Is, Who It Suits, and the First Week.
The stitches are the date that shapes the trip. There are two ways to fit them in, and the table puts them side by side. Both are possible, and which one fits depends on your dates.
| Stitches out in Seoul on day 5 | Flying home before day 5 | |
|---|---|---|
| Who removes the stitches | The clinic, on day 5 after surgery | A clinic or hospital in Taiwan, using the doctor's note for stitch removal that the clinic writes |
| When you can fly | After the stitch removal | From the day after surgery |
| What you take home | Your aftercare instructions | Your aftercare instructions and the doctor's note |
| What to arrange before surgery | Enough days in Seoul to reach day 5 | Where in Taiwan the stitches will come out, and on which day |
| What to ask the clinic | Whether the incision is checked at removal, and what to do afterwards | What language the note is written in, and what the clinic in Taiwan needs to know |
| The same in both plans | Recovery of about one week, and the seven-day precautions above | Recovery of about one week, and the seven-day precautions above |
Which plan suits you depends mostly on how many days you can stay and where you will be afterwards. Share your arrival and return dates with the clinic when you first get in touch, so the surgery day can be planned around the stitches. If your return date is fixed, say so early. It does not change the medical assessment, but it changes what can be planned around it.
Questions to settle before you book
These are worth writing down before the consultation, so the incision gets as much attention as the amount of fat:
- Where exactly will the openings and the incision be on my neck, and how long will the incision be?
- Is the opening under the chin in the same place as the incision, or separate?
- Is the fat behind the muscle removed through the same incision?
- Which openings are closed with stitches, and do all of them come out on day 5?
- What should I put on the incision, if anything, and from when?
- Is a compression band part of my aftercare, for how long, and do I keep wearing it at home?
- If I fly before day 5, what language is the doctor's note in, and where should I have the stitches removed?
- Is there anything I should do or avoid on the flight home?
- I have had raised scars before. Does that change what I should expect?
- Who do I contact, and how, if something about the wound worries me after I am home?
What this article does not decide
Everyone's fat, muscle condition, skin and pace of healing are different. Whether surgery suits you, which parts of it you need, where the incision goes and which anesthesia is used are decided after a doctor's assessment. Swan-neck surgery is done under intravenous sedation. Sedation is still anesthesia. It carries risks such as slowed breathing and a drop in blood pressure, and reactions to anesthesia and recovery from it differ from person to person. Possible side effects of the surgery include bleeding, infection, inflammation, bruising, swelling, changes in sensation and skin irregularities. According to the clinic, a Taiwanese interpreter works on site, and questions can be sent through LINE.
This article was prepared from Clair Plastic Surgery's published information on swan-neck surgery, Dr. Han's explanations on the clinic's own channels, the clinic's answers to our questions about this operation, and general guidance from the ASPS and the AAD. It is general information, not a diagnosis or a treatment recommendation for any individual.