Which procedure would help minimize the appearance of small double chin and lines? 37 y/o (photos)

Question

Hi, I'm not sure what I'd need but I seem to have a small double chin which connects into my face lines and divides the front of my face from the back. Almost into two faces. What type of procedure would you recommend? I'm 37 years old.

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

"I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments.

1) Skincare with products and microneedling/PRP
2) PDT Light Therapy a few times per month with growth factors
3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year
4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill
5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting
6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest

Best, Dr. Emer."

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photographs.

In my opinion, the most reliable approach would be a deep plane neck lift, potentially associated with a lower facelift.

Depending on the contour of the neck in neutral position, deep plane facelift may also be adequate but your photographs do not allow comprehensive evaluation.

Nonsurgical tightening techniques may offer some benefits but would come short of the degree of correction that I believe you are contemplating.

Daniel Barrett, MD · Answer

Dear spongecake
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

William Portuese, MD · Answer

Much more information as needed, such as a full set of facial, Chin and neck photographs to make a determination about how best to proceed. A mini facelift would be required for extra skin removal, a neck lift would be performed for fat removal in that area, and a chin implant is used for the recessive chin profile

Mats Hagstrom, MD (license on probation) · Answer

Your pictures are in sufficient to make a quality facial assessment.
Look at how plastic surgeons take facial before and after pictures to get an idea. We need to see the entire face shown from the front and from the side(think mug shots)
Pictures should also I’ll be taken without facial expression.
Dynamic lines are based on contraction from facial of muscles expression and are not easy to treat.
I’m not sure if anyone is even going to be able to find the problem since it is most likely at least in part related to tension created by muscles and facial expression.
It is definitely not a straightforward situation and I don’t think there is easy treatment options. To start with you need an accurate assessment and that is going to require more than what was provided.
I suggest having multiple in person consultations with local plastic surgeons in your community.
Do not schedule any procedure unless someone can clearly explain the ideology or give you a clear assessment with a solid working diagnosis I can show you before and after pictures of previous work similar to what they recommend for you.
Best,
Mats Hagstrom MD

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