Treatments for early jowls and double chin? (Photo)

Question

I'm 40 and just starting to get the dreaded jowls - they're hereditary, my grandmother looked just the same. I've always had a double chin too, though I'm not overweight. What treatments could I look at? I've read about Coolsculpting and jawline fillers - also Kybella, though that sounds a bit scary! Thanks for any advice :)

Phillip Chang, MD · Answer

Hi delirium80

Coolsculpting is the number one non-surgical alternative to liposuction for removing unwanted fat.  You can treat most areas of the body including your neck, arms, abdomen, flanks, and thighs. For more information about this procedure, please visit our website.

Dean P. Kane, MD, FACS · Answer

Dear delirium80,  
Thanks for sharing your photos! They are helpful and illustrate the mild skin laxity most of us experience at 40.

The beginnings of facial skin laxity start at 30 years old when collagen skin repair diminishes and passive skin aging relaxes downward. The web of fibrous compartments in and under the skin loses stretches, separates, loses fat and elongates forming 5 growing “waves” of skin at points of attachment, developing:
•	hooding along the eyes,
•	lower eyelid / cheek junction or tear trough / nasojugal fold
•	nasolabial fold,
•	lateral mouth commissure and marionette folds,
•	jowls and neck.
Without the opportunity for an in-person consultation, I would recommend that you:
1.	Consult with a talented, Board Certified Plastic Surgeon and his team regarding non-surgical and minimally invasive options. These may include:
2.	CoolSculpting along the jawline and under the chin.
3.	A Zein Obagi, MD, ZO Skin Health retinoid program and peels for skin tightening
4.	Sculptra is a minimally invasive injection series of bio-stimulatory filler for face and neck skin tightening
5.	Minimally invasive lipocontouring of the submalar jowl, jawline and under chin with or without ThermiTite skin tightening
6.	Minimally invasive jowl lifting options such as Silhouette or EuroThread suspension sutures     
I hope this is helpful. Stay well.
All the best!

Teresa Mann, MD · Answer

In my opinion, you are a good candidate for either CoolSculpting or Kybella for the double chin issue. Both are FDA approved to help reduce moderate to severe fat under the chin, also known as submental fat. Both of these procedures work well though one involves cryolipolysis (freezing the fat) and the other is performed by multiple small injections of deoxycholic acid (Kybella) into the treatment area. Individuals who do not like needles prefer CoolSculpting. Either technique is safe, dependable, and similar in cost. Your submental fat pad is relatively small and you may only need one treatment with either of these techniques. Larger fat pads often require a series of 2-3 treatments. 
For the jowl area, your best results would be a combination using a dermal filler along the jawline in what we refer to as the "pre-jowl sulcus" and the use of Kybella injected into the small fat pad of the jowl itself. Again, both dermal fillers and Kybella are safe and produce good results in individuals such as yourself.

Solomon Facial Plastic - Thornhill · Answer

Hi there,
In terms of your double chin, the gold standard treatment would be neck liposuction if the issue is fat under the skin, otherwise, a neck lift or face lift would be the best way to address skin laxity. The surgical approach would also address the jowls. If you want to address the jowls non surgically, the best way is to add filler to the chin and on underside of the chin in front of the marionette lines to give you lower face more structure. Jowls are almost always related to loss of volume in the cheeks, I would also like to ensure that your mid and lateral cheeks are adequately volumized, this can often help to mitigate the jowls.

Treatments for early jowls and double chin? (Photo)

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Answer: Jowls and double chin

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Treatments for early jowls and double chin? (Photo)

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Answer: Jowls and double chin

Answer: Jowls and double chin

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