50 in Chicago! Need to tighten beginning of turkey neck. Need to define jawline (slight double chin) that never was.

Small double chin. Decent elasticity. Kybella, CoolSculpt, Trusculpt, lipo? What is the best procedure? I've been reading about Ulthera &Thermage & getting very mixed reviews. Need something with proven results performed by a Chicago Plastic Surgeon. I realize that dermatologists, PA's, certified estheticians, & nurses are well trained and often do procedures more than surgeons but it's for my preference.

Doctor Answers 12

Neck Tightening Kybella

Kybella can result in 10-15% reduction of fat similar to Coolshape. Younger patients usually don't need skin tightening after fat reduction as the skin shrinks enough on its own.
Liposuction typically reduces 50% of fat in one session. RF treatments like Velashape and Thermitight plus Deoxycholic Acid the active ingredient of Kybella can result in somewhat more than 15% reduction in the amount of double chin fat with three to five sessions. Most non-invasive treatments are not proven to be safe nor FDA approved for treatment of the jawline/jowls. 
Radiofrequency treatments like Thermage produce quite temporary results requiring periodic repeat treatments.  Ultherapy usually does not work.
The most dramatic results in the neck are achieved with a laser/liposuction with Precision tx or Smartlipo; results noticeable at ten days.
Patients should do the math (all these treatments cost nearly the same) and go for what is in their best interest and most reliable. No treatments are guaranteed; legitimate physicians should not promise results. Each option has the possiblity of side effects.
Please use this information when consulting in person with an experienced Board Certified Plastic Surgeon. They will be most capable of advising what is best for you.

New York Plastic Surgeon
4.4 out of 5 stars 18 reviews

Neck rejuvenation and best procedures NYC

I have found that a combination of Botox, Thermage, and Kybella injections can beautifully re-contour the neck and get rid of your "turkey neck".  It is best to consult a board certified dermatologist who is an expert in these cosmetic procedures for a consultation.  Best, Dr. Green

Kybella and other neck rejuvenation options

Thanks for sharing. Current neck rejuvenation treatments:
  1. Surgical Neck lift* with a lower facelift would be the gold standard and get you the best results
  2. Surgical Neck lift* would be the next best procedure
  3. Neck liposuction and or laser lipolysis if only fat removal is required, typically in a younger patient
  4. Ultherapy is an FDA approved non invasive tightening using ultrasound technology
  5. Kybella is a new FDA approved injection that melts fat under the chin
  6. Botox to platysma muscle bands to decrease their activity
*It is important the a Neck lift involves some liposuction and importantly a platysmaplasty which is a procedure that tightens the underlying loose neck muscles.

Talk to several board certified surgeons experienced in face and neck lifting.  Without photos, recommendations can not be made specifically for you but based on your age range I would say a surgical procedure would likely give you higher satisfaction. 

Raymond E. Lee, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 71 reviews

Cosmetic procedures to improve the "double chin"

The two procedures I recommend most for patients who desire a more svelte jawline are CoolSculpting mini or Kybella.  In order to determine which procedure would benefit you most, an in-person consultation would be required.  I recommend you find a Cosmetic Dermatologist in your area to discuss all the options and determine which would be best for you.

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


Thank you for your question, LexiR. Kybella is the best injectible option for the jawline because it is the only FDA-approved out of the bunch and continues to defeat the bunch in all clinical studies. Please consult with a board certified facial plastic surgeon and make sure that your board certified facial plastic surgeon has experience performing it in Chicago.

Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 93 reviews

Double Chin Treatment / Laxity-- SmartLipo/VASER/ThermiRF, Botox, Venus Legacy, Kybella, CoolMini

I find that VASER / Thermi combination does best for this area. I suggest posting pictures so we can give you a good idea of what is best.  Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews


Thank you for your question. Unfortunately there are no pictures. 

a trampoline lift would give you the best result. Another name for this is the no scar neck lift. This procedure involves suctioning the submental neck and then via needle punctures a suture is weaved below the skin and above the muscle defining your jawline. 

The second best treatment would be liposuction. 

The advantages to both of these procedures includes defining the jawline. 

Kybella is is used to treat the CENTRAL submental fat. It doesn't treat along the jawline. 

Joshua Halpern, MD, PA
Tampa Plastic Surgeon
4.8 out of 5 stars 54 reviews

Seek out a body contouring expert for options under the chin

Now that there are many new options for non-invasive body contouring, it is more important than ever to see an experienced body contouring expert.  These injections should not be one by aestheticians and nurses or even most physicians.  As far as which is best, it is difficult to say with a picture or a live consultation.  In general, Kybella works best in patients with a small amount of fat and a small amount of laxity.  Coolsculpting works best in patients with slightly more fat and less laxity.   In patients with more laxity or more fat, surgical options such as neck lifts or liposuction may be needed.

Kyle Coleman, MD
New Orleans Dermatologic Surgeon
5.0 out of 5 stars 7 reviews

Kybella or coolsclupting

Thanks for the question.  hard to answer this without examining you or seeing some photos.  Typically, if you have a lot of extra fat in the neck, cool sculpting may be the way to go to start.  Kybella can also work but is better for smaller pockets of fat.  If you have lots of loose skin then a neck lift may be your only option. 

Good Luck

"The above answer has been given without seeing this patient and cannot be substituted for actual in-person examination and medical advice;  it is only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Treatment for Tightening Jawline and Double-Chin

A physician would first need to determine if yours is an issue of fat, excess skin, or a combination of both, however generally speaking, you may get the most benefit from Kybella or CoolSculpting, followed by Thermage.

If there is fat present, both Kybella and CoolSculpting are excellent options. Choosing one over the other depends on a number of factors, such as the amount of fat, scheduling, and patient preference. CoolSculpting involves attaching a cup-like applicator to the chin area; if there is enough fat to fit in the applicator, I typically recommend CoolSculpting. For patients with smaller pockets of fat, in order to target very specific areas, Kybella can be a better option.

In terms of skin tightening, after over a decade of experience with the technology, I personally prefer Thermage. You may be seeing mixed reviews because some patients were not appropriate candidates for Thermage in the first place, or the proper expectations were not set pre-treatment. The results of Thermage are dependent on the severity of laxity, and state of each patient’s collagen, therefore still having “decent elasticity” will certainly work in your favor in terms of results.

If you are seeking out the care of a Plastic Surgeon, be sure they are board certified, and pay close attention to their experience, and before and after photos. Best of luck!

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.7 out of 5 stars 17 reviews

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.