Dr. Angela is back today talking all about necks again and how to get them in shape. Take it away…
No matter how young you are, you can have fullness under your chin. Excess skin can be caused by genetics, sun exposure, weight loss or loss of collagen and elastin. Unfortunately this excess fat under the chin is usually genetic. It can appear early in life and just hang out (pun intended) despite improving your diet and exercise. Other people have both excess skin and fat. Our neck hasn’t been such a big issue in the past, but with everyone posting pics online, we have come to notice our jawline more than ever.
So how do you get the neck and jawline you want?
Your best option depends not only on your bone structure, skin type, but also your lifestyle and schedule. Luckily, we have new and exciting technology that can fit almost everyone!
First, you need to get yourself to a weight you can maintain comfortably and consistently. You shouldn’t do any procedure then gain weight and have it return or lose weight and have loose skin. Then we can explore your options.
Option 1: Removing the fat with Liposuction
Liposuction is best for people under 40 years old or with very good skin elasticity, so your skin will retract back where we want it. If you have excess skin or reduced elasticity, we would lift this at the same time to get the best result. We also need to know if you have strong muscles in your neck when you clench your jaw (platysmal muscles). Liposuction alone may “uncover” these muscles and make them more noticeable.
Liposuction is the traditional approach to remove the fat. Small incisions are made behind your earlobes and under your chin and are closed. Discomfort is minimal and any bruising should be gone or almost gone in a week when you’ll be able to return to most activities.
Option 2: Non-invasive fat removal
As we discussed with the last blog, the newest alternative is Kybella, is now on the market! This is deoxycholic acid is a substance already in your body made by your liver to help dissolve fats in your diet to aid in absorption. When it is injected into the submental fat, this substance disrupts the membrane on the fat cells and permanently dissolves those cells. You may have some swelling for about a week, but otherwise minimal downtime. Since this is a series of 2-6 injections about 4-6 weeks apart. Ask about pricing for the whole series, because it can rival that of surgery if you need multiple injections.
Kybella before and after//Submental Liposuction before and after
Option 3: A facelift
If you have both fullness and fat under your chin, this is the best approach. The term “facelift” describes lifting the cheeks and neck to improve the appearance of the cheeks, nasolabial folds, marionette lines, jawline and neck. This does not routinely involve the brows or eyes. However, many people will combine this with other procedures that address the brows and eyes to give an overall refreshed look, in the right people. Ask what your surgeon does as a part of the facelift, because there are other procedures that can be done at the same time to improve your outcome.
Often I get asked if I can just do a “neck lift”. Yes, you can just lift the neck and many people do. However, the neck can be the most involved part of the facelift, including the cheeks is not that big of a deal, it gives you a better jawline since you have lift above and below the jaw (you can tell when you lift the skin with your hands) and gives you a more natural, uniform look.
Facelift before and after
Option 4: Mini-lifts with less dramatic result
“Mini-lifts”
There are so many “mini-lifts: lifts, S-lift, Feather-lift, MACs lift, QuickLift, WhisperLift, Lifestyle lift (which is out of business) that it is difficult to name them all. These procedures start with an incision that is only in front of the ear and lift the cheeks and jawline to a certain degree, but not the neck. The benefit is the procedure is shorter, often it can be done with local or IV sedation, recovery should be shorter and it may be more affordable. On the other hand, the incisions are more likely to be visible and some people do not feel that they have as dramatic results as they would like or that they last very long.
Option 5: Noninvasive options
For those who are not ready for surgery from a mental, financial or time standpoint, we do have noninvasive skin tightening treatments. All of the skin tightening treatments, Ultherapy, Thermage, Thermitight, and Titan use heat to stimulate collagen and promote tightening of the skin and underlying muscle over a period of months. With most treatments you may have some mild bruising and can return to your normal activities in a day or so. They do not involve incisions, anesthesia, or significant downtime and one of them have results that are as dramatic or consistent as surgery.
Ulthera before and after
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Images borrowed from Dr. Angela’s patients and models