What is the best option for sagging skin under chin and on lower face? (Photo)

Question

I am starting to notice sagging or fat under my chin and on my lower face and i want to know what the best treatment would be. I would like to have a more contoured lower face . I am 29 years old and I would rather not try Kybella as I have done it once and it did nothing for me .

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

Kian Karimi, MD, FACS · Answer

I understand your concern as this is often a problem area that can be hard to treat with just exercise. I do see room to slim your face and sharpen your neck and jaw region without being too invasive. Given your age and assessing your photo provided I would recommend a combination treatment of Facetite and Morpheus 8, also referred to as Embrace RF. Facetite is minimally invasive and great at addressing some superficial fat while Morpheus 8 provides skin tightening as well as some moderate fat loss. These two treatments together would be excellent in addressing the extra weight to the submentum and jawline, as well as tightening the skin and addressing some of the skin texture. Going forward, I would recommend you to complete multiple in office consultations with board certified experts to discuss your ideal aesthetic goals. This way, they can better assess your face and create an ideal treatment plan for you.

Best of luck,
Kian Karimi MD, FACS

Best of luck, 
Kian Karimi MD, FACS

Jason Emer, MD · Answer

see link.
most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift.  an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done.

For facial slimming a combination of treatments are always needed.  Options include:
1. Buccal fat pad removal to reduce fat on the lower face
2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping.
3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender
4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined

Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma.

See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option.  Best, Dr. Emer.

Cameron Chesnut, MD, FAAD, FACMS · Answer

Options for neck rejuvenation range from surgical to nonsurgical, with many options in between.

At a younger age, often a combination of micro liposculpting and Virtuoso non-surgical skin tightening can give wonderful results.

Cameron Chesnut
RealSelf Hall of Fame

Vasileios Vasilakis, MD, FACS · Answer

Thank you for the question. Based on your photograph, it seems that you have fullness under the chin. You are also young and have good skin tone. I would recommend liposuction of the area to improve the contour and definition. I wish you the best of luck. Vasileios Vasilakis, MD. Fellowship-trained plastic surgeon.

Nelson Lee Novick, MD · Answer

First, let me start by saying that one treatment of Kybella is seldom enough to achieve optimal results. Usually at least three treatment sessions are required. That being said, I do not like Kybella, as people, under the best of circumstances, usually have to suffer a week or more of redness and swelling at the treatment site that often makes them temporarily look worse and more like "turkey neck" than prior to treatment. And given that several treatments like this are typically required, I find it too much to ask of patients, especially when also considering the expense of treatment. I have found that a series of treatments that combines subcision that promotes new collagen production and skin tightening, coupled with an intralesional anti-inflammatory injection that, in proper concentrations, can cause fat shrinkage, can often do the trick, especially in relatively mild cases, such as yours. If necessary, hyaluronidase may be added to promote further tissue shrinkage. (Despite a lot of the controversy around whether the latter really can work on normal tissues, it does, otherwise it would not have originally been used for treating normal tissues prior to injection of anesthetics or antibiotics to promote their better dispersion. Moreover, it is currently being used for helping certain individuals with a connective tissue disorder, known as scleroderma, to help them to open up their mouths. So, yes, hyaluronidase does can work well, if needed, for shrinking the unwanted submental bulging. Make sure that you go to a board certified aesthetic physician. Best of luck.

Kathleen Griffin, MD · Answer

Hi there! RF microneedling at a deeper needle depth can be used to dissolve some fat under the chin. It can also help to stimulate collagen and tighten the skin on the lower face to prevent sagging and loss of volume.

Patrick Flaharty, MD FAACS · Answer

We have had great results with Cool Sculpting under the chin. This often requires two treatments but in most cases will nicely reduce the fat under the chin improving your profile. Consulting with a physician experienced in Cool Sculpting would be a great way to learn more about this procedure and see if you are a candidate. If you are not a candidate for Cool Sculpting (applicator does not fit) then neck liposuction would be your best option. This is surgical but minimally invasive with limited downtime and provides the most accurate and thorough solution. Consulting with a surgeon experienced in neck liposuction would be a great way to learn more about this option.

What is the best option for sagging skin under chin and on lower face? (Photo)

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