What is the best treatment for congenital rolls? Embrace RF with micro lipo? (Photo)

Question

I recently had a consultation with a plastic surgeon that recommended embrace RF and micro lipo. Another surgeon recommended neck lipo. What is the best option here? I'm not overweight but think this is more of a genetic issue

Semih Yildiz, MD, FEPOBRAS · Answer

Your photos suggest a localized submental/upper neck fullness with horizontal neck folds. In a normal-weight patient this is often an anatomic or genetic issue rather than a weight issue, but the best treatment depends on whether the fullness is superficial fat, deep fat, skin laxity, platysma position, or even a naturally lower hyoid/neck structure.

If the main problem is pinchable superficial fat and your skin has good elasticity, traditional neck liposuction alone can give a meaningful improvement. If there is concern that the skin may not retract well, RF-assisted liposuction such as EmbraceRF/FaceTite-type treatment can be a reasonable add-on because it may provide modest skin tightening while the fat is reduced.

The important point is that RF does not completely erase congenital neck folds or change deeper neck anatomy. Likewise, aggressive liposuction alone can sometimes make skin folds look more obvious if the skin is not elastic enough. That is why a careful in-person exam is more important than the device name.

I would ask each surgeon to show you exactly what they believe is causing the rolls: superficial fat, loose skin, platysma, or deep neck anatomy. If they agree it is mostly superficial fat with reasonable skin tone, neck lipo alone may be enough. If skin tightness is borderline, combining conservative micro-lipo with RF tightening may be the safer plan.

Zoran Potparic, MD · Answer

This is very difficult problem to treat. A combination of selective liposuction with small cannula, radio frequency treatment like Renuvion or similar, and injection of deep lines with nano fat grafts seem to be working well in our hands. Good luck.

Robert M. Tornambe, MD · Answer

I appreciate your concerns, however,  micro liposuction of the face and neck regions will contour these areas nicely. It appears that you have good skin quality, so I’m not sure RF micro needling is needed but it certainly can be an option. Consult with a board-certified plastic surgeon in your area to explore the best options. Good luck.

Connie Hiers, MD, FACS · Answer

I think liposuction would be your best choice for now. You are young and should tighten well, but radiofrequency can be added for insurance.

Felix Omar Márquez, MD · Answer

Hi, thanks for your question and pics. Genetic fat deposits are common. You can repair them with neck liposuction. The procedure is minimally invasive and eliminates fat deposits in the neck. Consult a board-certified plastic surgeon in your area for a physical exam. Good luck!

Mats Hagstrom, MD (license on probation) · Answer

The correct treatment for your neck is liposuction. The device used isn’t important, but who you choose as your provider is.
On the first picture the fat in your double chin area looks a little asymmetrical. Have you had previous treatments?
Delivering consistent quality, liposuction, results is much more difficult than most people realize. The number of plastic surgeons have truly mastered. This procedure is going to be in a minority. If this procedure is not done correctly, it can leave disfigurement that is permanent.
I cannot emphasize enough the importance of provider selection. During each in person consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar facial or neck characteristics to your own. An experienced provider should have no difficulty showing you the before and after pictures of at least 50 previous patients. In fact, the highly experienced surgeons should have hundreds or thousands of before and after pictures to choose from. Being shown a handful of pre-selected images, representing the best results of a providers career is insufficient to get a clear understanding of what average results look like or how many of these procedures they’ve actually performed. I cannot stress this enough. There’s no correct number of consultations needed to find the best provider, but considering the devastation of a bad outcome, I would consider scheduling at least five consultations before choosing a provider. 
The line between the skin rolls on your neck is still going to be there. Sometimes that line can be improved with the careful use of fillers.
Don’t get sold on technology or the name of some fancy equipment. Equipment has very little to do with the outcome. Find a plastic surgeon who can deliver consistent quality results. I can approve it with what looks like an endless list of quality before and after pictures.
When, in doubt, slow down and schedule more consultations.
Bing board-certified in plastic surgery with an overall good reputation and years of experience does not mean somebody has mastered any one single procedure especially not Liposuction.
When you’re in the hands of a provider who knows what they’re doing it should be very obvious.
Best,
Mats Hagstrom, MD

What is the best treatment for congenital rolls? Embrace RF with micro lipo? (Photo)

Answers (6)

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