Does Non-Surgical Fat Reduction Work? truSculpt® & CoolSculpting® Explained by New Jersey Dermatologist Dr. Robin Levin

Non-surgical methods of fat reduction are more popular than ever, with a very positive global outlook for growth in this sector for the coming years. With the advancement of several different modalities in fat reduction technology, effective and long-term debulking and body sculpting can be achieved with treatments such as truSculpt® and CoolSculpting®. New Jersey board-certified dermatologist Dr. Robin Levin, founder of South Jersey Skin Care & Laser Center, explains how such treatments work.

Losing weight can prove to be more of a challenge for some than others, as genetics, diet, lack of exercise (or even the hindrance or loss of mobility), and age can all play a role. But even for the fittest and most disciplined of individuals, localized pockets of fat can stubbornly hold on.

While liposuction may provide the most immediate and dramatic of results, the risks, recovery time, expense, and discomfort associated with a surgical procedure makes many individuals want to look for less invasive approaches.

Non-surgical methods of fat reduction for the body typically target unwanted fat cells topically, eliminating the need for any incisions. Some of the methods on the market today include technology that is based on radiofrequency, ultrasound, Cryolipolysis®, and infrared light. Injectable medication is also available.

Two completely non-invasive approaches that have been tried and tested successfully for some years include CoolSculpting® and truSculpt®. Both methods are FDA-cleared and involve the manipulation of temperature to trigger the breakdown – and ultimately, death – of fat cells (lipolysis).

CoolSculpting® technology is designed to facilitate Cryolipolysis® – the destruction of fat cells by freezing. CoolSculpting® has come to become one of the most popular methods of fat reduction on the market in recent years – and with good reason.

Fat cells are much more vulnerable to cold temperatures than skin or other types of cells in the body. While the fat cells are frozen, all other tissues are left unharmed by the procedure.

The CoolSculpting® device comes with a number of applicators that are specialized to treat localized deposits of fat in various areas of the body. When applied to an area for treatment, the two cooling panels of the applicator will gently pull the fat deposit closer to itself to gradually cool it to a temperature of about 39° F.

At this range of temperature, fat cells can crystallize, break down, and die. Over time, the body naturally processes the leftover matter and flushes it out, leaving treated areas slimmer.

Patients may feel a slight suction and an intense cooling sensation as the device starts its work, but they quickly adjust to these sensations. In fact, many choose to use mobile devices, read, or even take a short nap during their treatment sessions. The duration of the session depends on the number of areas being treated.

Common but temporary side effects from CoolSculpting® include redness, swelling, or tingling in the treated areas. These effects tend to be mild to moderate, and most patients are able to resume their usual activities immediately after a treatment session.

While each patient may respond to CoolSculpting® differently, results usually start to show roughly three weeks after a treatment session, with complete results visible about three months after the last treatment. The number of treatment sessions required vary depending on the number and size of fat deposits to be treated, as well as how a patient responds to treatment.

For those who are not viable candidates for CoolSculpting®, radiofrequency-based truSculpt® may be a more suitable treatment option. truSculpt® provides both fat and cellulite reduction. The recovery and results from truSculpt® are comparable to those from CoolSculpting®.

Just as fat cells cannot tolerate cold temperatures, they are also sensitive to heat. The radiofrequency energy from truSculpt® delivers deep heating that causes fat cells to rupture and die (through a process known as apoptosis), with their contents being flushed out through the body’s natural processes over time.

Dr. Levin and her staff would be happy to assist anyone interested in learning more about their options for non-surgical fat reduction. To request a consultation, contact South Jersey Skin Care & Laser Center online or by phone at 856-810-9888.

 

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Adam Augenstein, MD, Plastic Surgeon in Charlotte, NC, Discusses Popular Male-Focused Procedures

The latest statistics for the past year from the American Society of Plastic Surgeons (ASPS) show that more and more men in the country are dipping their toes into cosmetic procedures, increasing by nearly 30 percent since 2000. Adam C. Augenstein, MD, dual board-certified plastic surgeon in Charlotte, NC, and founder of Aesthetic Surgery of Charlotte, explains how awareness is spreading among men about the benefits of both surgical and minimally invasive aesthetic procedures.

The latest techniques practised by plastic surgeons today tend to be quick and require little to no downtime. This has also led to plastic surgery becoming much more accessible and offering benefits to men from a variety of backgrounds. Men are also taking more interest in their physical appearance, as exhibited by the metrosexual and hipster grooming habits of today.

The competitive job market often propels men to opt for facial rejuvenation procedures such as BOTOX® Cosmetic (often dubbed “brotox”), dermal fillers, or facelift surgery, due to a fear of encountering ageism in the workplace and wanting to appear more fresh-faced and energetic. Additionally, cosmetic procedures can provide men with a shot of confidence as they increasingly become single later in life and re-enter the dating pool.

Non-surgical methods, such as Kybella® (to reduce chin fat) and the above-mentioned facial rejuvenation injectables, are very convenient options with minimal treatment and recovery time, and provide subtle but effective improvements without the average person being able to tell they had a procedure performed.

Surgical procedures tend to be performed quite differently for male and female patients. Popular cosmetic surgeries for men include:

  • Liposuction: The most often-treated areas in men include love handles and the “beer belly”. Liposuction for the neck and chin area is also becoming popular as a way to achieve a more chiseled jawline.
  • Chin augmentation: Along with reducing chin fat, an augmentation can strengthen the look of the jawline. In 2016, 55 percent of surgical chin augmentations were performed on men.
  • Rhinoplasty: In men, the overlying skin on the nose is typically thicker, which will affect the extent of change surgery can produce. Men’s noses also tend to have a higher bridge and greater width. Men often prefer a more prominent, angular nose with a less delicate tip. Many are also looking to correct injured noses or a deviated septum to improve both form and function.
  • Gynecomastia (enlarged male breast) reduction and pectoral implants: A sculpted and toned chest is the ideal for most men.
  • Eyelid surgery: Skin, muscle, and fat can be tightened, or skin and fat may be removed from the eyelids if they are in excess and cause drooping (which can also cause obstructions to a clear field of vision). Eyelid contours may also be improved. The result is a more wide-awake, youthful appearance.
  • Facelift: As the gold standard in facial rejuvenation, this procedure can tighten facial tissues, remove excess, sagging skin and fat, and boost volume in deflated areas. Brow lifts and eyelid surgeries are often performed in conjunction with a facelift.

Both surgical and non-surgical cosmetic procedures can carry an element of risk, which is why it is important to conduct your own research on both the procedures you may be interested in, as well as potential doctors you plan to visit (ensure they are board-certified in plastic surgery and experienced in the procedures of your interest).

The consultation is the first step to determining what treatment plan would be most beneficial for you. Be prepared with information about your personal and family medical history, which areas of the face or body you would like to improve, and any questions you may have for the surgeon.

Adam C. Augenstein is one of the few plastic surgeons in the Charlotte, NC, area to be certified by both the American Board of Plastic Surgery and the American Board of Otolaryngology – Head & Neck Surgery. He would be happy to advise anyone looking to learn more about cosmetic and reconstructive surgery or non-surgical cosmetic procedures. To request a consultation with him, contact Aesthetic Surgery of Charlotte online or by phone at (704) 837-1150.

What You Need to Know About Lyme Disease, from Victoria A. Cirillo-Hyland, MD, Board-Certified Dermatologist in the Philadelphia Area

With predictions of a longer and more widespread tick season, cases of tick-borne illnesses, especially Lyme disease, will continue to increase. Victoria A. Cirillo-Hyland, MD, a board-certified dermatologist in the Philadelphia area, provides advice and education about Lyme disease.

Lyme disease is the most commonly reported vector-borne illness in the United States. A “vector-borne” disease refers to any infection that can be spread through a “vector”, i.e., a disease-carrying organism. In the case of Lyme disease in the United States, deer ticks and western black-legged ticks are its vectors, as they transmit the Borrelia burgdorferi bacteria to humans through their bite. A tick must be attached to your body for 24 to 36 hours to spread the bacteria to your blood.

According to the Centers for Disease Control and Prevention (CDC), cases of Lyme disease have more than doubled between 1995 and 2015. While the disease seems to be spreading to other parts of the United States, 2015 statistics show that the large majority (95 percent) of Lyme disease cases were reported from 14 states, including Pennsylvania.

 

The increasingly warm winters have improved conditions for ticks to thrive on deer and mice, the animals that perpetuate the life cycle of ticks. The earlier arrival of spring this year has also awakened dormant ticks sooner than expected. These factors are contributing to further spread of Lyme disease, making recognition and early treatment very important.

 

Typical symptoms of the disease include headache, fatigue, fever, and a particular skin rash known as erythema chronica migrans (ECM). Most individuals who develop Lyme disease will exhibit a round red bull’s eye rash within a few days to weeks at the site of the tick bite. Some may never develop a rash, while others may develop ECM in multiple areas.

This rash does not represent an allergic reaction to the bite, but rather a skin infection with the Lyme bacteria, Borrelia burgdorferi. It is a pathognomonic sign: a physician-identified rash warrants an instant diagnosis of Lyme disease and immediate treatment without further testing, even by the strict criteria of the Centers for Disease Control and Prevention. Such target lesions are characteristic of Borrelia infections, and no other pathogens are known that cause this type of rash.

Lyme disease progresses in stages, and the symptoms experienced can vary for each stage. Symptoms may start to occur anywhere between a few days to a month after bites from infected ticks.

Stage 1 – ECM rash (discussed above) and inflammation may occur at the site of a tick bite. Without treatment, it can last four weeks or longer. Stage 1 is called early localized Lyme disease. The bacteria have not yet spread throughout the body.  Symptoms of stage 1 begin days or weeks after infection. They are similar to the flu and may include:

  • Fever and chills
  • Malaise
  • Headache
  • Joint pain
  • Muscle pain
  • Stiff neck

Stage 2 – Stage 2 is called early disseminated Lyme disease. The bacteria have begun to spread throughout the body.  Symptoms may occur weeks to months after the tick bite, and may include:

  • Numbness or pain in nerves
  • Paralysis or weakness in the muscles of the face
  • Heart problems, such as skipped heartbeats (palpitations), chest pain, or shortness of breath

Stage 3 – Stage 3 is called late disseminated Lyme disease. The bacteria have spread throughout the body. Symptoms of stage 3 can occur months or years after the infection. The most common symptoms are muscle and joint pain. Other symptoms may include:

  • Abnormal muscle movement
  • Joint swelling
  • Muscle weakness
  • Numbness and tingling
  • Speech problems
  • Cognitive problems

A blood test can be done to check for antibodies to Borrelia burgdorferi. The most commonly used, is the ELISA test for Lyme disease. An immunoblot test is done to confirm positive ELISA results. Be aware, in the early stage of infection, blood tests may be normal. Furthermore, if you are treated with antibiotics in the early stage, your body may not make enough antibodies to be detected by blood tests.

In areas where Lyme disease is more common, your health care provider may be able to diagnose early disseminated Lyme disease (stage 2) without doing any lab tests.

Other tests that may be done when the infection has spread include:

  • Electrocardiogram
  • Echocardiogram
  • MRI of the brain
  • Spinal tap/lumbar puncture to examine spinal fluid

If you have been bitten by a tick, visit your dermatologist for a thorough skin examination. If you find a tick attached to your skin, it should be removed immediately to reduce the likelihood of infection.

First, use a dry cotton ball to rub the tick in a counter-clockwise direction for one minute to make the tick release its mouth. Use gloves and a clean pair of tweezers as close to the skin as possible to remove the tick. Do not twist – pull the tick straight out gently but steadily. Do not use a heat source, petroleum jelly, or other substances to help you remove the tick, as this could irritate the tick and make it regurgitate infected fluids into the wound.

Once you remove the tick, clean the area with alcohol, warm water, and soap. Save the tick in a container to be taken to your dermatologist’s office for further identification. Take a photo of the tick if you cannot keep it.

If the tick seems to have burrowed into the skin, or you are unable to remove it, see a dermatologist immediately. Otherwise, visit a dermatologist if you develop the symptoms described above within a month after a bite.

If you are diagnosed with Lyme disease, you will be prescribed antibiotics. The type of medication, delivery method (e.g., oral, intravenous) and length of treatment period will depend on which stage is being treated.

Patients who are diagnosed early and treated with appropriate antibiotics typically recover well, with symptoms resolving quickly. If treated at later stages, NSAIDs (non-steroidal anti-inflammatory drugs) may be prescribed along with antibiotics to calm symptoms such as painful, swollen joints. Additional treatments may also be required to address heart or nervous system problems that may occur during the latest stages.

Without timely treatment, chronic issues with the heart, nervous system, and joints may occur.

Dermatologist Victoria A. Cirillo-Hyland, MD, FAAD recommends taking precautions when entering areas where ticks may be present.

Light shades of clothing should cover as much of your body as possible. Wear long sleeves, long pants, and high-top socks. Insect-repelling clothing has been recommended by the CDC for preventing illnesses (note that while ticks are often referred to as insects, they are actually arachnids, along with scorpions, spiders, and mites).

While products containing picaridin and DEET are effective and can be applied on the skin, the CDC has also suggested natural ingredients such as garlic oil, mixed essential oils, nootkatone, and 2-undecanone.

Periodically scan your body for ticks while outside, as they can be as small as poppy seeds and hard to spot. Take a hot shower within two hours of returning indoors and check your skin for any suspicious bumps.

Dr. Cirillo-Hyland and the team at the Bryn Mawr Skin & Cancer Institute would be happy to offer advice and assistance to anyone who is concerned or would like to learn more about Lyme disease or other insect- and skin-related infections. To request a consultation with a dermatologist in Bryn Mawr or Newtown Square, contact the practice online or call 610.525.5028.

Statistics on Facial Plastic Surgery: The Bay Area’s Dr. Stanley Jacobs Notes Increases

The face has been an object of attention for as long as humanity has been around: It graces ancient pottery, fills museums of antiquities, and now is presented virtually on countless smartphones and social media platforms each day. In addition to driving technology’s ability to capture and preserve someone’s looks for posterity, the world’s collective fascination with the face has also given rise to a growing desire to adjust individual features, an endeavor possible now like never before via facial plastic surgery. Bay Area facial cosmetic surgeon Dr. Stanley Jacobs has studied the long and fascinating history of facial aesthetics, which is why he noted with interest the recently released statistics from the American Society of Plastic Surgeons.

According to the published numbers, plastic surgeons in the United States performed about 17.1 million total cosmetic procedures in the United States in 2016, an increase of three percent over the year before.

While the most commonly performed surgery was breast augmentation, three other surgeries in the top five—rhinoplasty, blepharoplasty, and facelift—are focused solely on the face, and the other—liposuction—is frequently used to shape specific regions of the face. Given that the numbers for each procedure were higher in 2016 than 2015, it’s safe to say that facial plastic surgery is on the rise.

Liposuction—a surgical fat-removal technique that can be used on the neck, cheeks, and elsewhere—is in the second slot, with 235,237 procedures reported. That’s an increase of six percent in one year.

The next three most commonly performed procedures ranked as:

  • Nose reshaping, up two percent to 223,018
  • Eyelid surgery, up two percent to 209,020
  • Facelift surgery, up four percent to 131,106

Breast augmentation was the most commonly chosen cosmetic surgery procedure among women. Not surprisingly, this didn’t register at all on the list of male-chosen surgeries. For men, facial plastic surgery ruled the year, with nose reshaping and eyelid surgery taking the top two spots. Liposuction and facelift were at places four and five, respectively, with male breast reduction sitting at No. 3.

As facial plastic surgery is proving increasingly popular, so, too, are minimally invasive procedures that focus on temporarily rejuvenating and refreshing the skin. The uncontested top procedure overall—dominating over all other options, nonsurgical and surgical alike—is an injectable form of botulinum toxin type A. The 7,056,255 injection sessions in 2016 are up four percent from 2015’s 6,757,198.

There are several brand names available in this category (Dysport® and Xeomin® among them), but the most prominent is BOTOX®. Injections reduce muscle contractions. If properly applied with precision by a trained and experienced injector, BOTOX® can slow activity in the specific muscles that cause noticeable frown lines on the forehead, as well as crinkly crow’s feet.

Second to botulinum toxins, but still far surpassing surgical choices are soft-tissue fillers, tallying 2.6 million applications in 2016. This is followed by chemical peels with 1.3 million

Often, patients can combine the effects of facial plastic surgery and nonsurgical options to get a benefit unattainable from a single procedure or treatment. Dr. Jacobs, for instance, combines a surgical facelift with a the carefully controlled application of chemical peels to address both the skin and its underlying architecture in what he’s called a SynergyLift™.

The American Society of Plastic Surgeons compiles its statistics annually by sending out a survey to member surgeons, combing a dedicated database, and extrapolating the resulting aggregated information. The results are considered by many to be the most comprehensive statistics exploring cosmetic and reconstructive plastic surgery in the United States each year.

Dr. Stanley Jacobs is a triple board certified doctor specializing in facial plastic surgery. Bay Area residents may recognize him from his segments on KRON4, as well as his frequent appearances at events in the greater community. For more information, call his office in Healdsburg at (707) 473-0220 or in San Francisco at (415) 433-0303. He also has an online contact form.

Skin Cancer Awareness Extends Beyond May

Each year, dermatologists and other people who care about skin health celebrate Skin Cancer Awareness Month in May, encouraging women, men, and children to spread knowledge of the damage ultraviolet radiation can cause and strategies for preventing skin cancer, as well as skin cancer treatment. In Dallas, Dr. Ellen Turner emphasizes prevention to her patients and the general Texas population, encouraging sun safety not just in the bright days people tend to celebrate from Memorial Day on, but throughout the whole summer and the rest of the year.

Skin cancer is not a strictly summertime problem. Obviously, the sun shines in every season, and even cloudy days allow ultraviolet radiation to pass through and impact the skin cells it reaches. And while cumulative exposure to sunlight is a major factor in its development, the disease also has a genetic component.

In other words, Skin Cancer Awareness Month in May should serve only as a springboard to a greater understanding of its prevention, diagnosis, and cures.

In cases where skin cancer does develop, early detection and a quick start to treatment are important strategies, as the earlier malignant cells are identified, the greater the chance of preserving a patient’s health—and, in many cases, appearance.

Dermatologists like Dr. Ellen Turner are trained to spot and identify problems in the skin, including cancer, but the process truly should begin at home.

While a dermatologist should notice an unusual lesion, this would typically happen during a skin check scheduled for once or twice a year. The patient, however, sees his or her skin every day, and so is best equipped to be aware of potential problems.

The best way to remember what to watch for is to use the first five letters of the alphabet as a way to list characteristics that can be concerning if present in a mole, potentially indicating the presence of skin cancer.

These characteristics are:

Asymmetry: A typical, healthy mole will be circular and round, with the left side matching the right side in shape and size. If someone were to somehow draw a line down the center and fold the mole in half, the two sides would essentially be the same. Of concern is when a mole is asymmetrical, meaning its shape is more amorphous—one side is not the mirror image of the other.

Border: The line where a mole meets the surrounding skin should be clearly defined, marking a definite transition. It may even be raised. Cancerous tissue has a tendency to create a more nebulous border, appearing in some places to spread out with no easily defined edges. A border that is notched or “scalloped” is also a warning sign that deserves a closer look from a dermatologist.

Color: Moles come in a variety of shades, but they typically fall in the brown range, or possibly black. The important thing to notice when examining a mole’s color is whether the lesion is uniformly one shade or whether there are a variety of colors present. Malignant cells can cause multiple colors to appear in one mole, which may feature different browns and grades of black, as well as lighter colors, such as red and pink. Cancerous tissue can even reveal white or blue.

Diameter: It may be a bit simplistic to say that the bigger the mole, the bigger the problem, but that’s not far off. Moles larger than 6 millimeters in diameter (that’s a quarter of an inch across) warrant scrutiny and a possible biopsy. There’s no need to get out a ruler and measure, though. Keep in mind that anything larger around than a standard pink eraser at the end of a No. 2 pencil should be pointed out to a dermatologist.

Evolving: A mole that looks fine one week may develop troubling signs the next. Or it may still appear to be fine—just larger or oval instead of circular. The point is: A lesion that changes over time is troubling. This factor is one of the reasons home skin checks are crucial. A patient can notice something a dermatologist can’t, simply because a dermatologist is not examining that patient’s skin every week—or even every month. Only someone familiar with their own body can notice what’s evolving from day to day.

Any mole showing any of the characteristics mentioned above should be looked at by a dermatologist, but people can generally schedule a skin check for any reason, including annual or biannual checkups to screen for skin cancer. Dallas dermatologist Dr. Ellen Turner provides more information on her website: dermofficedallas.com. Call (214) 373-7546 to learn more.

A Los Angeles Dermatologist Explains BOTOX® and Its History

For men and women alike in Los Angeles, BOTOX® is an everyday reality. While the injectable made headlines a decade or so ago as a novelty, its widespread acceptance in the United States and the world (it remains the most commonly performed cosmetic treatment on the planet, according to a variety of surveys) has since transformed it into a household name. Celebrities, office workers, and anyone looking to relax some wrinkle-forming facial muscles chooses it for its quick application, safety, and proven results.

How did BOTOX® achieve its chart-topping status? The injectable traces its roots all the way back to the 1890s, where a Belgian food poisoning incident first led to the discovery of the Clostridium botulinum bacteria. Researchers quickly learned of its paralyzing effects, but it wasn’t until about 60 years later when scientists began finding that they could develop helpful applications based on the bacteria. In the United States, the Food and Drug Administration saw sufficient promise in the research and gave doctors authorization to run trials involving humans.

The first official reports on what the formula later to be known as BOTOX® could do came in 1981, when an ophthalmologist announced that patients suffering from involuntary crossed eyes or walleyes—a condition known as strabismus—found temporary relief from the vision-disrupting symptoms when injections were made into the muscles that pulled the eyes in one direction or another. More eye-related research followed, leading to a pair of FDA approvals in 1989.

From that point on, BOTOX® could be officially marketed and used to stop the involuntary muscle action behind strabismus, as well as a similar culprit causing involuntary blinking known as blepharospasms.

Since BOTOX® demonstrably prevented signals from triggering muscle contractions—and did so safely—research continued in this vein. The next FDA approval was also for involuntary muscle action, centralized just a bit farther down from the eyes: in the neck. Cervical dystonia can be an uncomfortable-to-painful problem, causing the neck to twist and turn, then stay frozen that way so that patients have to carry their head at an odd angle. This FDA approval came in 2000.

An FDA approval given in the year 2002 stood out as the act that launched BOTOX® into international popularity, and newspapers ran with the headlines for years after, along with photos of needles sticking out of patients’ foreheads. The injectable had branched out from medical to cosmetic applications, cementing its position in the spotlight as it allowed anyone willing to try it to enjoy a relaxed, more youthful appearance.

Just two years later, the FDA gave its nod for the first non-muscle-related use of BOTOX®: treating excessive underarm sweating, known as hyperhidrosis. Six years after that, in 2010, it voiced approval for the treatment of chronic migraines, bringing a chance of some relief to people who spend at least 60 hours a month reeling from the pain in their head. Involuntary muscle action took another blow that same year, when the FDA also provided approval for using BOTOX® to treat upper limb spasticity.

2013 was another two-for-one year, with BOTOX® gaining approval to smooth out crow’s feet on the cosmetic side and help curb an overactive bladder on the medical side. Dr. Derek Jones served as an investigator for the crow’s feet study.

Most recently, in 2016, treatments for the lower half of the body were welcomed into the official FDA-approved fold when the agency announced its green light for doctors using BOTOX® to treat lower limb spasticity.

While board-certified dermatologist Dr. Derek Jones and the other physicians on his team use BOTOX® only for cosmetic applications, they do so knowing that the injectable is backed by decades of careful research, rigorous testing, and FDA-led scrutiny designed to ensure that the product is both safe and effective. Learn more about BOTOX® in Los Angeles from the team at Skin Care & Laser Physicians of Beverly Hills by visiting skincareandlaser.com or calling 310-246-0495.

Four Ways to Rejuvenate an Aging Neck, from Surgery to Kybella®

While a wrinkled and sagging face bears most of the blame for giving away a person’s age—or even making someone look older than their years—the reality is that the neck also significantly contributes to the problem. Considering the 2015 introduction of Kybella®, Boston-area board-certified plastic surgeon Christopher Davidson, MD, has appreciated the increasing availability and popularity of neck-focused procedures and treatments. Here are four to consider:

• Kybella®

A primary aesthetic complaint from both men and women is a double chin, caused by a pocket of fat that can stubbornly refuse to change no matter how consistently someone diets or exercises. This fat is a problem for anyone who wants facial definition, as it softens what would otherwise be angular lines and creates the impression of multiple chins—especially when looking down. Since fat-reducing lifestyle alterations are not always successful, the most effective treatment often involves the physical destruction of the unwanted fat cells. Kybella® accomplishes this by rupturing them with deoxycholic acid, a chemical the body uses to break down fat during digestion. The form used in Kybella® destroys fat cells it encounters in the submental area, and these cells are then eliminated from the body.

Kybella® is an injectable, and a single treatment session can involve up to 40 or 50 injections, all carefully placed in the targeted area. The FDA has cleared Kybella® for use in reducing double chins, and since its powerful active ingredient can damage any cells it encounters, application is limited to specially trained medical professionals who can minimize risk and maximize results, which appear over the course of weeks and months as fat is gradually removed.

• Liposuction

Another option for eliminating unwanted neck fat is liposuction, which involves removing fat cells by suctioning out the unwanted material with a thin tube known as a cannula. This takes the fat cells in question out of the equation and can give the chin-to-neck transition area more definition. With the fat gone, results are immediately noticeable—and will become increasingly apparent as post-procedure swelling subsides. Patients who choose this method are often those searching for a double chin treatment with fast-acting results.

• Neck lift/facelift

Not all aesthetic neck issues are due to excess fat. In fact, the loss of fat can, in some cases, leave loose skin behind. Young, healthy skin readily conforms to body contours, but after years of being stretched out by underlying fat, some skin—especially skin that has lost collagen, hyaluronic acid, and elastin due to aging and environmental factors—simply won’t shrink back down.

Sagging skin on the neck creates a turkey wattle effect, and drooping skin on the face, due to volume loss higher on the cheeks, can form jowls that appear at the jawline. A facelift is a surgical procedure that lifts away those jowls, while a neck lift focuses on tightening the skin below the chin. Together, these two options can significantly revitalize a patient’s profile, so they are frequently performed in combination.

These procedures may also involve some amount of fat removal via liposuction.

• Juvéderm Voluma®

As noted above, volume loss in the cheeks leads to problems farther down, as the natural structures holding tissues in a firm, youthful position give way to laxity. By reintroducing volume with the hyaluronic-acid-based injectable Juvéderm Voluma®, support can be temporarily rebuilt, rounding out what is known as the “apple” of the cheek and effectively pulling up the sagging tissue that forms jowls.

Any of these options can be performed as a standalone procedure, but they may also be combined to produce a desired youthful effect over time.

Learn more about any of the neck treatments and procedures mentioned here, including Kybella®, from Boston-area plastic surgeon Christopher Davidson, MD, who has more than a decade of experience in the field. Call his office at (781) 237-7700 or visit his contact page.