What procedure can I do for jowls, and loose neck skin after Kybella? (Photo)

Question

I am 49 years old, I have jowls and loose neck skin after Kybella. I have done thread lift, fillers, micro-needle with PRP, botox. What can I do short of a facelift? Ultherapy? Fraxel? Thank you.

Jason Emer, MD · Answer

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with VASER Liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime.
Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

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

Sabrina Fabi, MD · Answer

I appreciate the fact that you included a photo with your inquiry and I see the skin laxity you are referring to in your question. This looseness can be treated through non-surgical methods like Ultherapy or ThermiTight, which work deep into the dermal structure to constrict tissue and firm up the outer dermis from the inside out. Schedule a consultation with a board-certified cosmetic dermatologist who can give you an in-person assessment and a customized treatment plan based on your precise needs and goals.

Laurie A. Casas, MD, FACS · Answer

Thank you for your question.  After Kybella is used to melt the fat under your chin, you can be left with loose skin that needs help tightening to give you a better profile.  Ultherapy can help tighten the skin under your chin and neck.  Results are seen after 2-4 months and are improved when you pre and post treat with Alastin Regenerating Skin Nectar.

Ellen A. Janetzke, MD · Answer

Hello! There are some wonderful non- surgical options out there such as Ultherapy and SkinTyte that some of my patients choose and they see about a 20-25% improvement. If you are open to a minimally invasive procedure, I have had really wonderful success with Renuvion. Its a small incision under the chin so the scar is quite small and hidden and the down time is quite short. There are options out there so please do your research to determine the best choice or you. I suggest meeting with a board certified plastic and reconstructive surgeon to learn all of your options and potential outcomes. Good luck!

John J. Martin, Jr., MD · Answer

When the fat is removed with Kybella, it is tough to predict who will get good skin retraction.  At age 49, it is not unusual to have some laxity.  You can either do a neck or face lift, which will also help with the banding.  There are some other non-surgical options such as Ulthera, or Face Tite which is RF to help tighten the skin.

Deborah Kessler Hudak, MD, MHA · Answer

Without any hesitancy, seeing the photo of your neck, I believe that Ultherapy could offer you the best results.  With it, the Ultherapist can tighten your skin, targeting the deep dermis; also reduce any residual fat, targeting the subcutaneous fat; and tighten the SMAS, to lift the tissue, as this is our target tissue in all facelift and necklift surgeries.  Ultherapy is the ONLY FDA-approved device that can give you a non-surgical facelift / necklift, because of that ability on the SMAS.  
Please recognize that the experience and technology understanding and technical prowess of the Ultherapist will make a huge difference in the result.  (Of course, that is true of many procedures, such as surgery.  This is true of some procedures more than others.)

Sagar Patel, MD · Answer

There are options out there including Ultherapy and other energy based treatments. I would say that though they can work, your result is not likely to be as good as with surgery. At 49, it is rare to offer Kybella given the likelihood that your skin will not tighten back down. I would say that of non-surgical skin tightening the best results I have seen are from Profound RF. Hope that helps. Also Fraxel will not tighten the skin.

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