Saturday, January 4th, 2020
A majority of adults have excess fat under the chin in the upper neck even if they are thin. This is because, although we normally lose weight in our faces as we age, we tend to gain fat in the upper neck area. Fortunately, removal of this, restoring the neck and jaw to a more ideal contour, is easily done in the office in several ways. Here, we will discuss these methods and what you need to know to make an informed choice.
Removal of under chin fat has been a part of face and neck lifts since the procedures were developed. For many years, there was no other reasonable option to treat the problem. However, today, we have other methods that are simpler and with faster recovery.
Perhaps the best known method is removal of the fat with liposuction, vacuum removal of the fat using small hollow tubes. We do the procedure in the office under local anesthesia. Unlike liposuction of large areas such as the hips, abdomen or thighs, getting the neck numb is easy and almost painless. Most people do not even need any sedation and, at the end of the procedure, even remark at how easy it was. The advantage of liposuction is that it is a one time procedure and exactly controllable to achieve your desired result. Recovery is also quite rapid.
Although Zerona, and other modalities like CoolSculpting, are designed for larger areas, you can use them for smaller areas, especially if you are also treating other areas. This would not, however, be our first choice.
A number of years ago Allergan developed Kybella, basically a normal bile acid that dissolves fat when injected into it. This works quite well, but is significantly more painful and takes longer to recover than liposuction and takes 2-3 sessions spaced 6-8 weeks apart rather than being a one time procedure. For those reasons, as most plastic surgeons, we have abandoned Kybella, leaving it for those physicians not proficient in liposuction.
All the above methods rely on the skin contracting after removal of the fat to give you a flat, smooth under chin area. If, however, you are over 35, this may not happen as well as desired, though the result may still be a great improvement. If this is not enough, a surgical neck lift may be needed. Frequently, these can also be done under local anesthesia in the office.