If you look in the mirror and see someone with two chins looking back, you are probably unhappy with how it looks. For some people, a double chin is the result of weight gain, the aging process, and progressive laxity of the neck muscles. For others, a double chin is genetic – many people in their family have one. Whatever the cause of a double chin, there are ways you can correct it and improve your appearance.
Traditional Neck Lift
This procedure is indicated for people that have multiple areas on the neck that need to be addressed. It addresses large quantity of loose or sagging skin, hanging muscle bands under the chin or front of the neck (treated with a platysmaplasty technique), removal of superficial and some deep fat tissue, and hanging salivary glands of the neck. The jawline can also be enhanced with this technique. We typically perform a neck lift under a deep sedation or general anesthesia for your comfort. Expect to be sore and bruised for about a 2-4weeks following the procedure. A traditional neck lift is more comprehensive and targeted than other treatments and can yield a more dramatic improvement.
People who are good candidates such as people who have had massive weight loss or within the age range of 50-80 years of age.
Of note, the neck lift procedure does NOT address the quality of the skin and people with signs of aging skin (crepey skin, deep wrinkles, sun or age spots) will need additional procedures to treat these issues after the neck lift to be performed 3 months post op.
Traditional Neck Lift Before and After
The Modern Neck Lift:
At Modern Surgical Arts, Drs. Dastoury or Zwiebel offers an alternative and less invasive procedure for people who are either too young for a traditional neck lift or would like to have a procedure for their neck with minimal down time. This less invasive procedure still addresses the loose skin, fat tissue, and potential muscle banding. Instead of cutting and pulling the skin with the traditional neck lift, the skin is heated with the Renuvion devise to stimulate shrinkage over time (usually occurs over 3-6 months). The Modern Neck Lift may be combined with a Platysmaplasty procedure to tighten the hanging neck bands of the central neck under the chin as indicated by the patient’s anatomy. The incisions are also conservativity placed under the chin only. This procedure may be achieved under a local anesthetic only if the patient chooses to avoid general anesthesia.
There are several advantages to the Modern Neck Lift, including minimal downtime (usually 1-2 weeks), potentially avoiding general anesthesia (patient preference), short procedure (1-2 hours), small incision under the chin about 2-3cm, and improvement of the quality of skin as well. Patients may choose to have a second procedure with the Renuvion skin tightening performed after 3-6 months of healing (or as a maintenance procedure after 1 year) of healing for additional tightening if desired.
The people who would benefit from the Modern Neck Lift procedure are usually younger patients ages ranging from 40-50’s, history of neck problems, cannot tolerate general anesthesia, and cannot take extended time off work.
Modern Neck Lift Before and After
Exercises for a Double Chin
You can find an impressive assortment of exercises for a double chin on the Internet. Popular ones include squeezing a tennis ball between your chin and chest several times a day, rotating your neck in circles, and sticking your tongue out while tightening your neck muscles. These exercises can help to an extent, but most people do not do them consistently. The exercises only work if the problem is slack muscles that need to be tightened. If your double chin is due to excessive fat or normal aging, their effectiveness is limited.
Physical exercise overall can help reduce the fat tissue around the neck and naturally the skin will adapt to its new tighter position. Unfortunately, massive weight loss or weight loss at later in life can lead to loose or sagging skin.
Tightening Creams or Masks
There are products on the market that claim to tighten the skin around your neck and help minimize a double chin. These include facial masks applied to the neck and devices you wear at night that firmly hold the skin of your neck in place while you sleep. There is only anecdotal evidence of these techniques working, and the results are only temporary. Once you stop using them, the effects quickly dissipate.
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These are compounds injected into the chin area to dissolve fat such as deoxycholic acid (known by the trade name Kybella). The treatment is done over six months, with multiple injections done at each session. A qualified cosmetic surgeon should always perform Mesotherapy to avoid possible nerve damage. The results can last for years, providing you do not quickly gain weight and gain new fat under the neck. The main drawback of mesotherapy is that it has to be individualized to the patient’s needs as it does not shrink skin and thus can leave the neck skin to sag once the fat is reduced. Multiple sessions can also lead to scar tissue under the skin which can lead to dimpling and asymmetry; both very difficult issues to correct. The important anatomical areas of the neck are described below. At Modern Surgical Arts we approach aesthetic neck rejuvenation and contouring is planned based upon the individual patient’s anatomy.
This technique is the physical removal of fat cells from the body. While most people think of liposuction to remove fat around the abdominal area or on the hips and buttocks, liposuction can remove excess fat from almost any area of the body, including under the chin and on the neck. The fat is suctioned out through a tiny incision and heals quickly. The results are immediate, although there will be some mild pain and bruising for a few days after the procedure. Most of the liposuction from the neck is the superficial fat only (under the skin), the deeper layer of fat around the muscles cannot be accessed with liposuction alone.
Vibration Amplification of Sound Energy at Resonance (VASER) is a device that uses precisely modulated sound waves to target and emulsify the fat cells of the neck. Additionally, the VASER procedure is followed up by liposuction in order to physically remove the broken-up fat cells and contour the neck/jawline. It is highly effective for removing a double chin to reveal the muscle tone underneath. VASER liposuction can remove more fat with less damage to the surface skin and only minor bleeding. It also stimulates some of the underlying skin for a tightening effect more so than just traditional liposuction alone.
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Renuvion® (J-Plasma) Skin Tightening
Renuvion® is a new and innovative state-of-the art device that uses radiofrequency heat cooled down with helium to produce plasma energy for the ultimate skin tightening on the body, face, and neck.
The plasma energy stimulates the collagen fibrous networks from the underlying skin for a tightening effect more so than just traditional liposuction or VASER liposuction alone.
(*Off label use for skin tightening)
Anatomically here are the layers that define the chin and neck and why some people complain of a “double chin”.
- Skin: There is skin quality (as related to elasticity and collagen density) and skin quantity (pertaining to excess laxity or just too much skin).
- Some people have genetically great skin quality, initially the neck skin will look firm and tight, but unfortunately, over time it tends to lose its collagen density leading to crepey, wrinkled, and lose skin.
- Some people will undergo weight changes in life leading to increase in skin quantity i.e.: too much skin (Skin quantity) on the neck or chin areas to the point that the skin does not match their neck size.
- Fat: There are two layers of fat tissue within the neck and chin (submental fat). The first layer is just under the skin and is also known as insulating fat. It can change rather quickly with diet and weight changes. The Second layer of fat is deeper and positioned below and around the muscles of the neck (subplatysmal fat). This fat tends to be more genetic and can change with dramatic weight fluctuations, it is also more difficulty to treat.
- Neck Muscles: The platysmal muscle is the most important muscle to keep in mind as it contributes to the aesthetics of the neck. During the aging process it presents as “Neck Bands” or platysmal banding. These are the vertical lines under the chin. The other main muscle of the aesthetic neck is the SCM (Sternocleidomastoid muscle). These are the broad define muscular pillars on each side of the neck which help turn the head.
- Hyoid bone: The hyoid bone is considered a “free floating” bone, meaning it is not attached directly to other bones only indirectly by muscles and tendons of the neck. The position of this bone is important in determining the aesthetic angle of a define. I.e.: The more superior and posterior the bone, the more acute the angle of the neck will look from the side view. Genetically some people have a low positioned hyoid bone thus limiting the ability to augment their neckline.
- Chin and Jawbone (mandible): The bony mandible is one of the most important structural component of the aesthetic neck and chin. Anatomically it is responsible for defining the landmarks of the face, neck, and jawline. Some people just have a genetically prominent developed mandibular bone which gives them an aesthetic advantage throughout life. Fortunately, for others who do not have a well-developed jawline, jawbone can be augmented with certain techniques such as a genioplasty or chin implants.
How Long Do Results Last?
In Cosmetic surgery nothing we offer can be considered “forever” as the body will continue to age, and gravity will eventually take its toll on the neck skin. But surgical facelifts and neck lifts, gives patients the best, longest-lasting results. Creams and lotions are only temporary solutions that last 24 hours or less unless you reapply them daily. Liposuction offers results that last 5-7 years depending on the aging process, diet and exercise, and other factors.
A facelift or neck lift gives you the best results. Your cosmetic surgeon can carefully target how much fat and skin to remove for impressive results. Lifts also have the most lasting results, with many patients maintaining their new, trimmer neck and chin for 10 years. Maintenance procedures which enhance collagen density, texture and tone of the skin will help protect your investment and maintain your new youthful appearance. However, no treatment for a double chin is permanent. As we age, our skin loses elasticity, gravity takes over, and some sagging will occur.
If you are unsure which procedure is best to help correct your double chin, please contact our office at Highlands Ranch Office Phone Number 303-470-3400 to schedule a consultation.