31 years old - Do I qualify for Kybella or (laser) liposuction? (Photos)

Question

I'm a 31 year old caucasian male. For as long as I remember I have had somewhat of a double chin, even when I was a few pounds lighter than nowadays. It's a stubborn fat deposit. I have somewhat of a recessed chin/jaw which results in an even faster fat accumulation under my chin. However, I'm not ready yet for a sliding genioplasty, as the recession is rather mild. Woud I - based on these pictures - qualify for a Kybella or (laser) lipo? Or do I really need chin surgery?

Jason Emer, MD · Answer

"For a double chin, InMode FaceTite with VASERlipo would give you the best result.

With significant neck sagging you would need a facelift / neck lift with muscle tightening (platysmaplasty). At the same time, I would recommend lasers (Fraxel, CO2, Halo, or Erbium) and microneedling RF (Fractora, Morpheus8, PiXel8, Intensif) to improve the crepey skin and wrinkles. Overall, the neck can be treated with a combination approach:

1. Microneedling and laser treatments for texture
2. Botox, Dysport, Xeomin or Jeuveau to help platysmal bands
3. Intensif, Fractora, PiXel8, or Morpheus8 microneedling RF for crepey skin and lifting
4. Injectable fillers like Belotero, Restylane Silk, Versa, and Juvederm Volbella to improve lines and folds
5. Face/neck lifting if sagging is prominent or premature, with or without platysmaplasty (muscle tightening)
6. Renuvion (J-Plasma), ThermiRF, and InMode FaceTite/AccuTite for internal tightening
7. Ultherapy and Thermage for external tightening
8. Regular Venus Legacy, Exilis Ultra, or InMode Forma treatments with facials to maintain tightness
9. PDO NovaThreads or Silhouette InstaLift cone threads for lifting and long-term collagen production

See an expert for a formal evaluation and to develop a personalized treatment plan based on your individual situation and goals. Best, Dr. Emer"

Daniel Barrett, MD · Answer

Dear VincentG,
Kybella typically takes 3 to 5 treatments to work. This is why I've stopped carrying Kybella in my office. I recommend neck liposuction more often then any injectable procedure for the neck now. It provides superior results gives me more control over the area than any injectable. It also costs about the same as what you paid for your first kybella session. The liposuction can be done under local while awake in the office and recovery is about the same as kybella.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Mats Hagstrom, MD (license on probation) · Answer

Your mandible is recessed and slightly undersized while at the same time your chin projects and has a pointed shape. This makes any type of chin augmentation tricky because it will excessively project your chin causing a deep labiomental fold and if overdone eventually a witches chin appearance.
The technically correct procedure would be a jar advancement moving not just the tip of your mandible but the whole mandible itself.
I too would be reluctant to have that procedure but in terms of understanding the primary problem that is the crux of it.
If the primary problem is based on skeletal structure in addressing soft tissues is only going to give you a partial improvement.
Liposuction can give impressive results if done correctly especially on young people who have a substantial amount of fat to remove.
Still, it’s important to understand that you’re fat distribution is normal and is not the primary cause of the double chin or lack of jawline definition.
Personally I would avoid Kybella because it is inferior, unpredictable and requires multiple treatments with undesirable excessive swelling after each treatment. well done Liposuction is the gold standard and the way to go.
It’s a fairly straightforward procedure but I am found of pointing out that delivering consistent quality liposuction results is more difficult than most people believe so choosing the right provider is pretty important.
Do that by having multiple in person consultations with local board-certified plastic surgeons. During the consultation ask each provider to show their entire collection of chin and neck liposuction results. Simply being shown a handful of sample pictures which most likely represent the best results of each provider‘s career is insufficient to get a clear understanding of what average results look like in the hands of each provider. For that reason you should ask providers to open up their portfolio and show you all or at least as many as they’re willing to in regards to before and after pictures. I asked to provide her to show as many pictures of male patients or patients with similar fascial characteristics to you.
You may also want to ask them to give you examples of excellent outcomes, average outcomes unless then outcomes.
Chin and neck liposuction it’s a pretty common procedure. An experienced provider should have no difficulty showing you at least 30 sets of before and after pictures. Highly experienced surgeons will have hundreds or potentially even thousands of before and after pictures for this common procedure.
It’s important to discuss exactly what areas will be treated in regards to the extent of Liposuction so you have an idea of what to expect. You can ask the surgeon to describe on before and after pictures exactly where the transition zone is between treated and entreated areas.
Finally I recommend reading all reviews on various physician review websites avoiding providers with any significant number of justified negative reviews.
The absence of justified negative reviews is more important and more telling than having an abundance of positive reviews.
Continue having consultations until you feel quite certain you found a Doctor Who can do the job correctly for you.
Liposuction is kind of a one time deal. If not done correctly it is extremely difficult to correct or improve on the outcome.
The type of equipment used is pretty irrelevant. what matters is the skill and experience of the provider. Find the right plastic surgeon and everything falls into place.
Don’t go to med spas and have a nurse inject you with Kybella. 
Best,
Mats Hagstrom MD

31 years old - Do I qualify for Kybella or (laser) liposuction? (Photos)

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31 years old - Do I qualify for Kybella or (laser) liposuction? (Photos)

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