I'm 40 and I have always hated my chubby cheeks, now turning into jowls. Is Hifu a good option? I've seen some horror stories.

Question

I've always looked really young for my age. I have no wrinkles, but my chubby cheeks are sliding down and I have a bit of a double chin. This combination has weakened my jawline. (I'm avg weight.) I've seen great "After" results from Hifu, but there are a few horror stories, about nerve damage and muscle damage, floating around, mostly to do with Ulthera. I'm considering Ulfit. I know it's a similar treatment with similar risks. Is there a way or ways to minimise the risk of nerve damage?

Jason Emer, MD · Answer

most of my younger patients do buccal fat pad reduction, facetite/liposuction of the neck, and fillers to chin/cheeks/jawline/temples,  to give them a more chiseled face.  see my IG and links. at home derma-rolling should be started to Improve texture and tone and tightening along jawline (see link where we have a recommended daily skincare and weekly MTS + anteageMD derma-rolling protocol).

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

most of my younger patients consider...
5. deep microneelding RF like morpheus every 2-3 months forever to further improvement tightening
6. early face/neck lift if you want a really tight contour and the most extreme improvement in jawline and neck shaping
7. threads, PDO or Instalift, after neck surgery/facetite to further improve the outcomes and give them long term collagen production and shaping
8. Thermage (radio frequency heating) and Ultherapy (ultrasound muscle tightening) yearly to prevent sagging in the future

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

Riaz Agha, MBBS, DPhil(Oxon), FRCS(Plast) · Answer

Difficult to be more precise without photos. However, I have seen patients who stated they tried HIFU and it didn't work for them. So patient selection may be key. Speak to an expert in HIFU who has done lots of these to know what's possible. 
Other options include buccal fat pad removal or a facelift depending on what the exact issues are that concern you, your goals and expectations.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Facial liposuction targets the face, head, and neck, including the jowls. The Gold Standard for superior liposuction results requires use of the advanced technology of ultrasound assisted VASER liposuction. As an official trainer of VASER liposuction, I perform full body liposuction cases every week. VASER liposuction has been the only modality that has consistently resulted in outstanding liposuction outcomes. VASER liposuction ensures a smooth contour regardless of degree of excess fat by virtue of being able to remove any and all remaining fat comprehensively and uniformly. If skin redundancy is observed, Renuvion technology can be simultaneously applied to tighten your skin to optimize your overall contour outcome. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.

Respectfully,
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Mats Hagstrom, MD (license on probation) · Answer

Your first step should always be to have a proper assessment. There’s a saying in medicine that “the Doctor Who treats himself has a fool for a patient”.  I’m not sure what the saying would be for a patient who treats them self rather than getting the advice of a physician.

I suggest having several in person consultations with local senior board-certified plastic surgeons who specialize in facial aesthetics.

Get an understanding of what the underlying problem is. You may think it’s skin laxity but it could be many other things.

The biggest problems with the modalities you’ve listed is that they have a propensity to shrink subcutaneous fat creating premature aging.

Fat is more sensitive than skin and the fat cells will be damaged before the skin cells do.

It may be that a facelift is a much better procedure for you and that ultrasound or radiofrequency treatment may not at all Deliver what you had hoped for.

If you consult with plastic surgeons who offered these treatments as well as charcoal treatments then you’ll have a less biased opinion then if you go to providers who only offer one or the other.

My best guess is that you will not be happy with the outcome of the treatment options you have chosen.  Most likely the change will be a very Underwhelming, subtle and seem like a waste of money.

I could certainly be wrong and I don’t have a strong belief either way.

Without posting pictures we can’t make any type of assessment.

I just know with 40-year-olds who start complaining about facial aging what they typically need and don’t need.

Best,

Mats Hagstrom MD

Manuel Belen, MD - Account Suspended · Answer

Hello,
Thank you for sharing the information, it is a pleasure for me to answer your question.
It is difficult to evaluate the options without seeing photos,
Yes, you can do the procedures perfectly, if your state of health allows it.
Definitely the most appropriate is to start (tummy tuck, liposuction and BBL can also be included), you are a candidate perfect, for the procedure, with this you can eliminate all localized fat and flaccidity, you will get the best results and have a defined appearance according to your body. everything depends on your BMI, if it is within the normal range, above 35 it can generate risks.
It is advisable to consult with a certified plastic surgeon, for a good evaluation, to provide you with all the information you need to know about the appropriate recommendations, so that you can achieve the desired goals in your body.

I hope this answer will help you,
My best wishes for you...

I'm 40 and I have always hated my chubby cheeks, now turning into jowls. Is Hifu a good option? I've seen some horror stories.

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