Which nonsurgical procedure would deliver long lasting / permanent results in the chin? Is chin lipo the only option? (photos)

Question

Hello. I'm 5ft 9 170 lb. I have tried various treatments such as cool mini and morpheus 8. At first it seems to look like good results but then it just comes back over time regardless of weight. I feel like this is a genetic issue rather then lot of fat. I am seeking advice in what would be the best treatment to significantly reduce the double chin permanently. Is chin liposuction the only option. I was also thinking about em sculpt? Prefer best non surgical treatment. Thanks.

Connie Hiers, MD, FACS · Answer

You would do best with liposuction and radiofrequency to tighten the skin. However, nothing is permanent because aging continues.

Joel L. Cohen, MD · Answer

Kybella (has downtime with swelling common for 2 weeks after each session). Evoke (no downtime). I was a site for the clinical trials for both of these modalities, and we use them in combination. Both require a SERIES of sessions. And I tell patients that once they have reached some noticeable improvement, then an Evoke session every 3-4 months makes a lot of sense to try to maintain the results. Plus, it’s important to exercise regularly with high metabolic exercise combinations (like Orange Theory and doing interval stations), eat very healthy as well as get down to and maintain a low BMI.

Mats Hagstrom, MD (license on probation) · Answer

Aesthetic medicine is in many ways not that different than other forms of medical practice.
Patients typically present with a problem or symptoms and the first step is to make an accurate diagnosis.
For medical conditions this can involve ordering tests, doing an examination or radiographic evaluation.
For facial aesthetics typically the assessment or diagnosis is done visually or in combination with an examination.
Once you have a solid understanding of what the problem is you can then select treatment options that address the primary problem. in some cases there are more than one variable that need to be considered and then those cases the problems need to be differentiated into a primary, secondary and possibly tertiary ideologies.
In your case all of this was skipped and you went straight to treatment.
Somehow you or some provider assumed that fat distribution was your diagnosis or ideology of your problem.
The truth is you’re fat distribution is not what’s causing your double chin and your fat distribution is probably very normal.
On top of that you chose treatment options that are not effective at fat production.
This makes me question the providers you chose for your treatments. A competent provider would have understood that fat is not the problem and the treatments offered would not be effective.
To make an assessment for facial aesthetics we first need to start by having quality pictures.
Quality pictures need to include the entire face, be taken without facial expression at straight angles. look at how plastic surgeons take before and after pictures of the face to get an idea.
The camera height needs to be held at the same level as the mid cheek or nose. pictures should be taken by someone else or using the timer on your camera from about 6 feet away. Sideways pictures should be taken without turning the neck.
Keep your head steady like you’re caring a book on top of your head.
During an examination doctors can make the assessment without pictures but if you’re seeking consultation online or through virtual consultations you will need to get better quality pictures.
From the pictures you have included the reason for you having a double chin is purely related to facial bone structure. In particular your mandible is small in relationship to the Maxilla.
When the mandible lacks in projection the underlying platysma muscle drapes the neck and an oblique fashion.
There’s typically also presents with individuals having a overbite dental occlusion, profile pictures will show the upper lip having more forward projection than the lower lip, individuals will have a premature double chin, lack of jawline definition and often formation of premature jowls.
Liposuction may be effective in individuals who have sufficient amounts of fat and good quality skin with strong elasticity. this is typically the case for young chubby people.
To treat the primary problem requires addressing the mandible shape and size.
Some people are willing to undergo the correct procedure and should expect a quality outcome. Others are not and no one has to have cosmetic surgical intervention.
What you should however not expect is a procedure not treating the primary problem to give you a quality outcome.
If the problem is based on bone structure and soft tissue treatments are not going to fix the problem. you may see very subtle slight improvement from soft tissue manipulation but until you address the primary problem the overall appearance will still be the same.
To get an accurate assessment I suggest consulting with oral surgeons or plastic surgeons with cranial facial surgery background.
You can always opt for not having surgery but by understanding what the problem is and understanding all the various treatment options and what they can and cannot accomplish you can then choose in the more educated manner.
Your current approach is a bit like playing the lottery. let’s try this procedure and see if it works.
It completely lacks the fundamental process of how medicine is practice.
It isn’t just medicine it’s practice this way. Car mechanics, plumbers or many other people who fix things have the same formula.
We start by having a clear understanding of what the problem is and then look for solutions.
Understanding facial aesthetics is a complex topic and while soft tissues are important and do contribute to both diagnosis and treatment options is important to recognize when something is primarily based on bone structure and when it is related to soft tissue.
There are a number of different treatment options you could opt for and many of them could give an excellent results.
Treatment options that may be highly effective include job advancement, sliding genioplasty, liposuction especially in combination with mandibular augmentation, A cervicpoplasty (neck lift with the incision made under the chin), a facelift(facelift are really a neck lift but the incisions are placed around the ears or any combination of the above. Fillers and implants can also be used but will not reduce your double chin.
By consulting with providers who can offer the most complex of all the procedures you will have access to all treatment options including lesser ones.
If you choose providers who have a limited armamentarium you are more likely to get misdiagnosed and offered treatments that are less effective. an oral surgeon would not have recommended radio frequency or fat cooling treatments. 
Like I said earlier nobody has to have surgical intervention for aesthetic purposes but it is impatiens favor to have a good understanding of what the problem is including all treatment options so they can make an intelligent decision for themselves.
When it comes to actually choosing procedures I suggest patients spend a significant amount of time and effort in provider selection. The vetting of providers is paramount in maximizing high quality outcomes with high patient satisfaction.
Do that by having multiple in person consultations with providers in your community. In your case I recommend that you consult both with oral surgeons and plastic surgeons. oral surgeons tend to see things more from the facial skeletal perspective what plastic surgeons unless they are specifically trained in craniofacial surgery tend to be more soft tissue oriented.
How many input from both medical specialties will give you potentially conflicting recommendations but also a better understanding of various treatment options.
During each consultation bring pictures of your own facial frontal and profile and use those for comparison when reviewing before and after pictures.
Ask providers to open up their portfolios and show you their entire collection of before and after pictures looking especially for people who have similar facial characteristics to your own.There’s no point of seeing results of people who had a completely different set of problems and who were in a sense and very different candidate for that procedure.
For reference an experienced provider should have no difficulty showing you at least 50 that’s a before and after pictures of commonly performed procedures in that practice.
Ask providers to show you a variety of outcomes including excellent results, average results and less than results. Ask the providers about how often they do revisions and what the revision surgery policy is.
Pay attention to how thorough each provider is in making an assessment, reviewing before and after pictures, reviewing your medical history, reviewing before and after care, discussing complications and answering all your questions.
A detailed comprehensive consultation should probably take about 45 minutes.
Simplistic treatment options are not going to deliver significant or even visible results in your case.
Get yourself better informed and make sure you take an active role in provider selection and vetting of providers.
Recognize that you are hiring the provider and you have a right to have a clear understanding of their scope of practice, skill and experience.
I cannot emphasize enough the importance of finding the right provider for any facial aesthetic procedure.
Find the right plastic surgeon and everything falls into place.
Regardless of what you choose having a clear understanding of the problem and treatment options is always the first two steps.
Good luck,
Mats Hagstrom MD

Which nonsurgical procedure would deliver long lasting / permanent results in the chin? Is chin lipo the only option? (photos)

Answers (3)

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