Considering all options for double chin/jawline/jowls - advice? (photos)

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

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. 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 morpheus8 or PiXel8 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.

Thanks for your question. There are several very effective treatment options for treating neck skin laxity. In non-surgical aesthetics, skin tightening is going to be "all about heat delivery". This is because the microinjury of heat is needed to stimulate collagen and elastin production in the skin, which happens during the healing response to the treatment. Results from any of these procedures are not instant but rather develop gradually over the course of 3 to 6 months. You would want to select a procedure that will simultaneously tighten skin and destroy or remove (liposuction) the fat, such as:
1. Morpheus8- utilizing RF energy delivered at the tips of micropins. With this approach you get the collagen stimulation of the heat PLUS the collagen stimulation of the microneedling, so you can potentially get more result per session, but at the expense of 'some downtime'- puffiness, faint redness for a day or two, potential bruising. The needles can also be set deeper in certain regions so that they will destroy unwanted fat cells- such as in the jowls and the “double chin” zone. Most will need 3 sessions- can be spaced 4 or more weeks apart. ‘Full Face and Neck’ is the ideal approach. Numbing for this procedure is primarily topical but nerve blocks (injection numbing) is very helpful also.
3. FaceTite- this procedure involves placement of a probe just under the skin to achieve full thickness heating. The probe is introduced through some simple needle pokes- considered ‘minimally invasive’. Most require a single session. Results typically last 5 years. Numbing for this procedure requires lidocaine injection.
4. EmbraceRF- this is a combination procedure pairing Morpheus8 externally with the FaceTite procedure. Ideal for the more advanced skin laxity, for skin laxity that is accompanied by surface wrinkles or crepiness, and/or when there is unwanted fat to be destroyed. If the fat collection is substantial, this can be combined with targeted liposuction. Numbing for this procedure requires lidocaine injection. Based on your images my recommendation would be to do the EmbraceRF procedure combined with targeted liposuction.
I hope that helps!

From the submitted photos it appears from the degree of skin laxity present that you would have the best result from a surgical neck lift. You could consider a minimally invasive procedure such as FaceTite which uses RF technology to melt fat and tighten skin, but due to the degree of skin laxity the better choice is the surgical lift.

Your best results will be with the facelift. However, you would get good results with liposuction and minimally invasive skin tightening with radiofrequency, like ThermiTight, done at the same time. Excess fat is removed with liposuction and the radiofrequency tightens the skin. Both are done through 3 small incisions.

Dear PM,
With newer technologies coming out, we are finding better less invasive ways to treat the neck/ jowels and jawline.
Under local numbing technics liposculpting with Vaser and skin tightening with Renuvion jplasma a beautiful neck jawline jowel Rejuvenation can be had.
Best. DrBrecht
Seattle, Wa