32 yrs old looking for prevention. Any suggestions?

I'm height/weight proportionate (21 BMI) & would like a more defined jawline. But my main concern is prevention. I've seen the hereditory droop that happens in 2 generations of women in my family. It creates very noticeable wrinkles and pretty unsightly folds. So far I've researched kybella, cool sculpting mini, Venus freeze(would rather something more permanent), Buccal fat removal, or lipo. Are there any options I haven't heard of? Which is recommended?

Doctor Answers 13

Defined Jawline and Prevention

The best way to prevent and tighten the jaw line at your age would be Thermage.  Thermage with the new CPT tip and radiofrequency technology will produce new collagen and tighten this delicate area which is the first signs of aging.  Please consult an expert.  Best, Dr. Green

Neck prevention

Thanks for the question.  It would really help to see some profile pictures to see exactly how your neck line appears.  Treatments like Kybella are better for patients that have healthy elastic skin that can contract and tighten to help define the neck line.  If a patient already has noticeable wrinkles and folds in their neck skin, then Kybella, or liposuction for that matter, are not likely going to help and might even make the problem worse.  In my opinion, once you have hanging loose skin, the best options for correction are going to be surgical.  
There are several good products on the market currently for people in your age group: Kybella, Coolsculpting, and traditional liposuction.  Schedule a consultation with a board certified plastic surgeon to see which might be best for you.  Best of luck!

Kybella vs Coolmini vs Liposuction

Fantastic question! Good to know all of your options.
There are multiple factors that go into answering this question...
If there is a lot of fat, liposuction is your best bet. This can be done in-office under local anesthesia.
If surgery is not something you are comfortable with, Coolsculpting would be your best bet financially... as long as the Coolsculpting applicator fits and you are okay with more time to see full results (than liposuction). If your jaw is too small or the amount of fat too little, the CoolMini may not fit.
Lastly, if you have a small amount of fat and the CoolMini applicator doesn't fit your face, I would go with Kybella. There is a significant recovery period with Kybella and the product is not cheap. That is why I reserve it for people with a small amount of submental fat.
All three will give you some skin tightening.
My best,
Dr. Nazarian
@drsheilanazarian on Instagram

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 44 reviews

Prophylactic Kybella

Neither Kybella, Cool Sculpting, Thermitight, nor surgery is indicated for prophylaxis of fat accumulation that "might" occur as we age. Familial traits tend to run in families but so do bad habits. Maintenance of good nutrition, normal BMI, healthy exercise routines, and no smoking go a long way to maintaining one's youthful appearance.

Jaw line options

Thank you for your question and for sharing your concerns with us. As a trainer for Kybella, I spend a lot of time teaching the safe and effective practice of administering Kybella, and assessing patients to help determine if they would be a candidate. As a plastic surgeon, I can also offer different options such as a neck lift and/or liposuction as well as many other non-surgical procedures that can affect the neck such as the Coolsculpting mini, Ulthera and Profound. As with any procedure, the experience and technique is the most important determinant of a good and safe outcome.  I would recommend visiting with a plastic surgeon who also has a great deal of experience with non-surgical options so you can determine which option(s) are the best for you.

Improving Droopy Neck

While eating healthy, sunscreen, moisturizers, certain vitamins, maintaining a healthy weight all play a part in preventing droopy skin it will happen eventually. If you are looking at a minimally invasive procedure to help the droopy skin under the neck I would consider ThermiTight RF. This is a procedure that uses a small canula smaller than a pencil under the surface of the skin to heat the tissue with radio frequency. When the tissue is heated with radio frequency it causes tightening and collagen regrowth.

Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 102 reviews

Preventative Measures for Facial Aging

Preventative measures can be different than treatments, invasive or non-invasive. For a young and normal face to age without the genetically prone pattern of soft tissue descent, maintenance of health and skin care is vital. Fat removal or alteration may actually accelerate this process, so all "treatments" may not be preventative. Soft tissue support, including implants, volumetric fillers and biostimulators like Sculptra or Radiesse may be beneficial at supporting the soft tissue of the lower face and can give definition. Good skin care with possible collagen promotion with fractionated laser and/microneedling may also be beneficial. Good health with weight management, sun screen and smoking cessation are all proven in facial aging prevention.

Andrew P. Trussler, MD
Austin Plastic Surgeon
4.9 out of 5 stars 24 reviews

Kybella not a good option for prevention of submental fat accumulation

Kybella is great for treating submental fat, but it would not be useful as a preventative measure.  Similarly, CoolSculpting is something that can treat fat that already exists, but wouldn't prevent it from developing. Same goes for liposuction.  In my opinion, there aren't any good medical procedures available today to prevent fat from accumulating beneath your chin.  Good diet, exercise, and maintaining a health BMI will be your best bet.

Jill C. Fichtel, MD
Columbus Dermatologic Surgeon
5.0 out of 5 stars 16 reviews

Improving your neckline

A consultation would be extremely useful to determine the most appropriate treatment for you.  All the procedures you listed can give great results in the properly selected patient. Kybella works very well and is the only FDA approved injectable to treat the double chin. It does require 2-3 treatment sessions spaced 4 weeks apart to get maximal results. It all depends on how much submental fat is present because this will determine the number of recommended treatments.

Michael T. Somenek, MD
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Looking to Prevent a Double Chin

Thank you for your question.  While Kybella is a great option to treat a double chin, it does not prevent it.  Aside from the obvious preventative measures, such as staying fit and taking care of your skin (wearing sunblock), you could choose to have some tightening treatments.  There are many radiofrequency-based devices which help to tighten nicely.  When used in the early phases of skin laxity, they can help to slow the progression of, or sometimes even prevent skin laxity.  Unfortunately, there is nothing we can do to change genetics, so this will always be working against you if this problem runs in your family.  

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.