Double Chin Treatments

What causes a Double Chin?

The three main factors are age, genetics & diet.

• Age. As you start to age, your metabolism slows down. Fat- adipose tissue accumulates in different areas throughout the life cycle. Submental fullness or double chins/chin fat starts to accumulate in the late 20s & peaks in the 40s. Loss of collagen compounds this problem. This results in skin laxity. Hence with double chins it is both accumulation of fat & skin laxity.

• Genetics. If you have the genetic tendency to have more fat cells in the chin area, chances are you will get a double chin as you age. Other factors that come into play include chin projection & jawline definition, as both tie in with the under-chin area. Underdevelopment of these structures can accentuate the appearance of double chins.

• Diet: Over time fat accumulates in this area, partly due to a change in metabolism. Losing weight may help reduce the appearance of double chins.

What effective methods are there to reduce double chins?

• Diet & lifestyle changes (see below)

• Fat dissolving injections

• Dermal fillers

• Liposuction

• Skin tightening with BodyTite Liposuction

• Thread lifting

How does fat dissolving injections work?

Fat dissolving injections or deoxycholic acid is a naturally occurring bile acid produced by the body to metabolise fat. This chemical can be injected in double chins to reduce fat. The advantage of injections include; minimally invasive procedure (injections), relatively easy to perform. The cost can be spit up over a series of injections. The disadvantages of injections are significant. This is my least favourite method for the following reasons.

• Significant pain during the procedure (this can be alleviated by numbing injections)

• Significant swelling & bruising that last 5 to 8 days (this is universal)

• Fat dissolving is delayed & not predictable in the outcome

• 2-4 sessions are required

• Skin tightening is not predictable

• Facial nerve injury in 4.9% of cases

The biggest disadvantage of this procedure is the total or cumulative  downtime, one week recovery multiplied by three equals three weeks of swelling.

How does BodyTite Liposuction work?

Tighten, tone and rejuvenate your skin without surgery.

With BodyTite, you can reduce fat without having to worry about sagging or wrinkly skin.  Patients can now achieve surgical-like results with no large incisional scars, less downtime and long lasting, beautiful results.

BodyTite is a great solution for individuals who are looking to reduce fat without the saggy, wrinkly skin. It also helps improve skin laxity after weight loss or due to aging. BodyTite is a minimally invasive procedure that shapes, contracts and lifts without the scalpel or scar. You are left with surgical-like results without the added downtime.

BodyTite uses RFAL (Radio-Frequency Assisted Lipolysis) technology that addresses some of the shortcomings associated with traditional liposuction or surgical body lifts.

WHAT AREAS CAN BE TREATED?

If you can imagine it, you can do it: stomach, arms, chest, knees and inner/outer thighs are some of the most common treatment zones. Multiple areas can be treated in one visit. Each zone will take approximately 15 minutes of treatment.

HOW QUICKLY WILL I SEE RESULTS?

Results can be seen immediately, with best results noticeable after 6 months, and continuing up to 12 months.

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WHAT IS THE DOWNTIME?

Depending on the treatment area, downtime can be from 1-2 days up to 10 days.

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BODYTITE EFFECTS:

BodyTite gently treats fat in stubborn areas while tightening the skin, helping you sculpt your body into its ultimate shape.

What does liposuction do & why do I prefer this treatment?

I totally get non-surgical treatments as these are less invasive & less scary (hence why I offer half a dozen alternatives to treat double chins). The flipside is that I prefer liposuction for the following reasons:

• Predictable outcomes: Other treatments rely on your immune system to remove fat. Liposuction relies on me to physically remove fat. I trust my skill sets more than your immune system. On average I remove between 20 ml to 140 ml of fat from the under chin area.

• Only one session needed: 95% of patients require only one liposuction procedure. This compares favourably with Belkyra (2-4 sessions), & Coolsculpting (2-3 sessions).

• Fast recovery times: Believe it or not, the recovery is over 8 times quicker than fat dissolving injections. After liposuction, you are in a neck support brace for 24 hours. There after it is worn at night for another week. Swelling goes down within 36 hours post surgery. Bruising takes a little longer.

• No pain: Seriously, this treatment is painless (unlike fat dissolving injections). I perform this procedure under mild sedation. The entire procedure is well tolerated.

• Skin tightening: Liposuction can provide skin tightening via controlled dermal remodelling. In some cases I use RF during the procedure, in other cases I use HIFU. These procedures act synergistically with liposuction to contract collagen in the neck & under chin area.

• More cost effective: It is not uncommon liposuction patients to have trialled (and failed) all non-surgical modalities. By the time one adds up treatments & time taken off work, liposuction is still one of the most cost effective & clinically effective treatments for double chins.

Do thread lifts really work?

Yes. Threads have a somewhat predictable outcome if used correctly. Namely in patients with little sun damage & mild to moderate laxity. I use both monofilament PDO MINT threads as well as suspension threads. I also combine threads with devices like HIFU, RF, & other skin tightening methods.

The downside of thread lifting is the limited duration of efficacy, they typically last 3 to 6 months. A one year duration is exceptionally good, rather than the rule.

What can RF microneedling achieve?

RF microneedling can tighten loose skin under the neck. The best system is Morpheus8 as it is the only system that has a penetration depth of 7 mm.

What RadioFrequency devices do I use to tighten the chin & jaw line areas?

RF devices are best combined with other modalities including collagen stimulating fillers, threads, & lasers.

• RF delivers heat. This contracts collagen & provides skin tightening

• Heat can be delivered slowly with multiple sessions – Pelleve or Tempsure

• Heat can be delivered fast in one session- Thermage

• Slow heating gives more predictable results, namely Tempsure or Pelleve

• Slow heating is more cost effective

• If I require fast high power heating, I do it with ultrasound guidance, namely Ultraformer III or with Ultherapy

Are the results permanent?

The majority of results are long lasting. The most predictable results are with liposuction as I am physically removing between 20 to 100 ml of fat from the area. This means fat cells are physically extricated. The remaining fat cells do not multiply, so by definition the results are permanent.

The caveat is that the remaining fat cells (approximately 10% of adipose tissue), may increase in size with lifestyle changes. Hence if you gain weight (fat), these cells may increase in size, but not number. Keep your lifestyle healthy, & this is not a problem.

What is a problem is getting older. This I have no miracle fix for. Remember the second aspect of treating the submental area is skin & tissue laxity. Over time tissue will loosen. The speed of loosening & collagen breakdown is determined by your genetics (I don’t control this) and your lifestyle choices (smoking, UV, increases collagen breakdown).

Another important fact to grasp is with bone resorption with age. 2 key elements to consider are chin projection & jawline definition. Reduction in bone mass will result in loss of traction of the skin for the under chin area. Solution? Dermal fillers. If you are opposed to dermal fillers, consider seeing a maxillofacial surgeon for implants.

What is the relationship between chin protection and jawline definition & double chins?

This is an easy concept to understand. Having a small or recessed chin & poor jawline definition results in a poor supportfor the underlying chin area.  If you provide traction & support in these areas you ‘stretch out’ the skin overlying the double chin. Think of it as countertraction when you support a tent.

By building up a recessed chin you place traction in an anterior or forward vector. This stretches your under-chin skin forward. By supporting & contouring your jawline area, it provides lateral support to stretch skin sideways (on both sides).

I use dermal fillers to recreate contours & re-volumize. In some patients this may be enough to reduce the look of submental fullness without actually removing the fat.

Why are the benefits of lifestyle modification for double chins?

You can potentially reduce your double chin by losing weight. More importantly, to maintain the effects after liposuction& other fat removing methods, keeping a healthy BMI will ensure that fat cells do not increase in volume.

Sun protection is especially important as UV damages collagen. This results in skin laxity of the face & neck, accentuating the bulge of double chins. Simple sunscreen coupled with skincare vitamins will preventfurther damage.