Evaluation of the Effectiveness of Deep Intervention in the Submental Region in Context of Managing of Double Chin (Clinical Study)

what problem is this study investigating some people suffer from what is called a double chin or the accumulation of fat and sagging skin under the chin which may affect the profile and cause dissatisfaction what is the main objective of this study this study aims to evaluating the efficacy and safety of a targeted submentoplasty surgical procedure. this procedure involves * making a horizontal submental incision * performing midline platysma resection and suturing with lateral platysma plication along defined vectors * Excision of redundant skin potentially extending to the periauricular area as needed. Who can participate in this study inclusion criteria * Be 45 years of age or older * present with moderate to severe submental fullness and skin laxity classified as Dedo type D(prominent platysma bands with significant skin redundancy) * Be in good general systemic health with no contraindication to elective surgery or anesthesia. * Have a stable weight (no significant gain or loss in the past 6 months). .Express dissatisfaction with their submental contour and desire surgical correction. * Be anon-smoker or agree to cease smoking for a minimum of 4 weeks before and after the procedure. Exclusion criteria * previous history of any surgical procedure in the submental area,neck,or lower face(face lift ,neck lift, submentoplasty ,or liposuction). * previous history of any injectable treatment (deoxycholic acid ,filler, collagen stimulators ) in the submental area within the past 12 months. * presence of an active skin infection or inflammatory condition in the treatment area. * Known bleeding disorder or use of anticoagulant medication that cannot be safely paused for the procedure. * unrealistic expectations regarding surgical outcomes. * Significant medical comorbidities that increase surgical risk(uncontrolled diabetes ,severe cardiovascular disease). Final eligibility will be determined during a comprehensive screening consultation with the principal surgeon