Pamela Kulback, MD

Hello, I agree with the plastic surgeon that your fullness is most likely not due to an overdeveloped muscle but an in-office evaluation is the best way to determine this. If the prominence under your chin is due to fatty tissue, there are many types of treatments that can address this. One of the newer radiofrequency devices such as the MiniFX which reduces adipose tissue and tightens skin at the same time might be a good option for you. Another solution would be Kybella injections in that area. Liposuction in combination with a radiofrequency skin tightening device would be another treatment option. If there is some confusion on examination about the type of tissue under your chin, MRI is excellent at distinguishing tissue as either fat or muscle. 

Good Luck

Pamela Kulback M.D.

Thank you for the question as it is a common problem in the aging process.. There are many causes for this problem which include bone loss, fat pad loss in the face and loss of collagen. If the folds are significantly deep, trying to treat them with filler may not be enough. An additional treatment with more lasting effects, up to 2 years, is a PDO thread lift to pull back the skin, tighten the skin and stimulate new collagen production. The combination of filler and PDO threads can result in a more lasting and more complete treatment.

Dr. Pamela Kulback

Thank you for your question. I think many people wonder what type of treatments can be used to treat signs of aging in the neck. Platysmal bands (long cords on neck) can be successfully treated with Botox. For laxity under the chin, PDO threads work great and is a fast and safe treatment. Also, skin tightening treatments like Forma (radiofrequency thermal treatment) or Fractora  (radiofrequency microneedling) are possible treatments that work well. All three of these treatments stimulate natural collagen production and improve skin elasticity with more lasting results. For linear lines ( necklace lines) on the neck, PDO threads can be used and filler added if needed.There are many treatment options that can give you great results.These are a few of possible solutions. Good luck.

Pamela Kulback M.D.

You are a beautiful young women with lovely skin. When you lose that much weight it very much impacts your facial appearance. You have lost weight in your face and now are adjusting to your new facial dimensions. Your face is naturally not as full as it used to be. I would wait another year to adjust to your looks after weight loss and then if you are still bothered by your appearance consult an aesthetic expert to evaluate your face with you.

Hello, PRP with microneedling ( Vampire Facial) is an excellent treatment to improve skin health and treat scars. It takes time and may not completely resolve your scars. It will improve your large pores. The advantage is no downtime,unlike a CO2 laser. I would recommend treating your skin condition with radiofrequency microneedling ( Fractora) which has a more intense microneedling effect and results similar to CO2 laser, again without the down time. I would also use  PDO threads in the ice pick scar areas of your cheek ,which will give you lasting results, with filler to complete the treatment if not totally resolved with the threads and Fractora.

Pamela Kulback MD