There are many techniques to maintain a youthful neck depending on the issues involved, genetics and external factors like sun exposure and smoking. Early on simple treatment like neurotoxins or microneedling can help minimize the appearance of fine lines and wrinkles. Additionally, there are many laser and light devices which help to control or reverse photodamage, spots and stains on then skin. As time continues and the skin begins to loosen, minimally invasive procedures with radiofrequency like Thermi Tight, Thermage etc can help with tightening. Ultimately, when there is excess fat accumulation or very lose skin, the gold standard treatment is a necklift or a facelift. In this case, excess fat, tightening of the muscles and removal of excess skin can be accomplished at the same time. Sometimes if the person is young and has good skin elasticity but has accumulation of fat, treatments like a submental liposuction or Kybella can be used. Although Kybella is effective at reducing fat deposits, it does NOT tighten the skin so one must be careful to diagnose then patient properly.

Answered by Dr. GalloMay 21, 2020

Kybella

Q Could Kybella on abdomen give me results and get rid of stubborn fat? (Photo)

Kybella is an excellent lipolytic agent, ie. it destroys fat cells but it does not tighten the overlying skin. The advantages are that it is an easy to perform in office procedure done with local anesthesia, with minimal downtime and recovery. It does cause significant swelling which resolves in 6-8 weeks. Depending on how much is the fat deposit, it may require 3-4 treatments separated by 6-8 weeks. Usually there can be a mild amount of bruising. Remember, that this is an FDA approved treatment for submental fat; using it in the abdomen is an off label treatment and it should be discussed with your physician. Kybella works best where there are small discrete collections of fat. It does not replace liposuction, weight management or large amount of fat nor cellulite. It is more suited to small pockets left after a liposuction or a small discrete area that is naturally occuring.

Answered by Dr. GalloMarch 31, 2020

Kybella

Q Can I use Xeomin or Botox in conjunction with Kybella?

Yes, using a combination of injectables is often indicated to treat different areas of the face. In your case, using Kybella to reduce submental fat while using an injectable to manage unwanted lines is appropriate. However, if you are looking to address marionette lines, you will likely not use Botox. Botox is a neurotoxin that limits muscle activation, reducing chin and brow wrinkles. To address marionette lines, you will benefit from a dermal filler to “fill in” the lines and create a smoother and softer appearance.

Answered by Dr. GalloJanuary 4, 2017

Lip Fillers

Q Am I a good candidate for lip filler/injections? (photo)

You have a beautiful mouth shape and a full bottom lip. If you are unhappy with the size of your top lip, then you may consider a lip filler injection. You should consult a skilled facial plastic surgeon, who has extensive experience with injectables. Using a hyaluronic based lip injectable can create fullness into the top lip and better define the shape of the upper lip. It is important that you do not over inject the top lip, as you want to maintain the natural shape and proportion of your mouth. Lip injections last 4-6 months, so it is not a permanent procedure. You may choose to start with a mild enhancement to see if a fuller top lip satisfies your desired look. You can always ask for a more noticeable enhancement the next time.

Answered by Dr. GalloOctober 27, 2016

Laser Resurfacing

Q Laser Resurfacing or Pinch Excision for Loose Skin on Eyelids?

As always, each case is individual and the treatment plan should be customized for each patient after careful evaluation and discussion with your surgeon. In general, laser resurfacing ( I prefer fractional lasers such as the Active and Deep F/X) is used to smooth out wrinkled skin. The CO2 fractional lasers have the advantage of creating more collagenesis because of the thermal (heat) component of the laser. Of course, it is limited because the surgeon is not removing skin or muscle. A transconjunctival lower lid blepharoplasty plus a laser is a great option for rejuvenating that area. Conversely, if there is a significant muscle roll, laxity of the lower lid tendon, or a lot of redundant skin, then an external incisional blepharoplasty is indicated in order to access these structures to tighten and/or remove them. Thank you.

Answered by Dr. GalloJuly 28, 2009