portrait of female natural neck and chin
Have you ever been caught unaware in a photograph from the side and suddenly thought to yourself, “Whoa — that’s what my neck looks like?” Then you are among the countless people interested in ways to eliminate a double chin.
That troublesome neck fat is one of the most ubiquitous cosmetic concerns, according to a survey of 7,315 people conducted in early 2015 by the American Society of Dermatologic Surgery. Nearly 70% of people answering the survey identified excess neck fat under the chin as one of their concerns.
In the past, the solution for eliminating the fat responsible for the dreaded double chin has been liposuction. But last year saw the FDA approve 2 non-surgical treatments that attack neck fat, a welcome development for men and women uncomfortable with the idea of undergoing surgery.
KYBELLA®, the first non-surgical treatment targeting neck fat to hit the market this year, made quite a splash in the media. Network news and local broadcasters alike featured stories about what was dubbed the “double chin shot,” while beauty blogs and magazines created additional buzz.
Later, CoolSculpting®, a system that has been targeting fat elsewhere on the body for years, introduced the CoolMini™ applicator for small areas such as the double chin. This non-surgical treatment created less of a to-do, although it appears anecdotally to be favored by some providers.
An informal poll conducted by Cosmetic Surgery Times asking doctors what they considered the best method for treating fat below the chin — known clinically as submental fat — showed 44% favored CoolMini versus 30% who named KYBELLA.
“CoolSculpting of the neck with the new applicator designed for this purpose is showing excellent results for the submental fat,” Roy Geronemus, a professor of dermatology at New York University School of Medicine, told Allure magazine. “Surprisingly, it works for small pockets of fat and large, very full necks as well. Safety has not been an issue. Patients are thrilled.”
But it was the remaining 26% who answered “neither” in the Cosmetic Surgery Times poll who may reflect the thinking of many more who still believe liposuction is the way to go. That’s because even though KYBELLA and CoolMini don’t involve surgery, they do have drawbacks.
KYBELLA involves multiple injections (typically 20 to 30) in each treatment session, with a series of 2 to 4 sessions scheduled about a month apart. The swelling that follows can last for more than a week and is severe enough prompt patients to compare themselves to bullfrogs. The CoolMini, meanwhile, is non-invasive but often requires more than a single treatment to get the desired results, which, at best, reduce about 20% to 30% of the targeted fat. Compared with plastic surgery, the non-surgical methods generally produce subtle results that can take weeks and months to appear.
Liposuction of the neck, on the other hand, typically takes about 20 minutes, doesn’t require a general anesthetic, and uses a technique that’s been around for decades and is considered very safe. It can also be combined with other procedures to not only reduce fat but create a more prominent chin and minimize the signs of aging. Lastly, neck liposuction has one period of recovery, whereas the non-surgical treatments have a recovery period after every treatment.
“Plastic surgery for a double chin or submental fullness produces a more significant and long-lasting improvement, often with minimal downtime,” says a blog post on the website of board-certified facial plastic surgeon Dr. Houtan Chaboki, a facelift specialist in Washington, D.C. “Plastic surgery may reduce neck fat, tighten neck muscle, lift sagging skin, or augment a weak chin.”
Ultimately the best approach depends on the patient. Whether a patient elects liposuction or a non-surgical alternative, the best results for treating submental fat occur with younger patients whose skin retains most of its natural elasticity. Removing fat when there is excess, lax skin can actually look worse.
Most importantly, anyone considering these options should consult with a plastic surgeon who performs these various procedures. He or she can complete a comprehensive evaluation and help determine the most appropriate procedure for you.