2015 was a breakthrough year for new chin treatments. Probably the most talked about is KYBELLA® which I have written about before when it was known as ATX-101. The second new chin treatment is the COOLMINI™ applicator for the CoolSculpting system. These 2 treatments, in addition to Ulthera, are great solutions for the troublesome fat under the chin (double chin or turkey neck).
I first learned about Kybella at a research meeting years ago. It is deoxycholic acid that has been around for years. In the past, some physicians had attempted mesotherapy with deoxycholic acid as one component. They would inject a variety of compounds approved by the FDA for other uses into areas of fat in an attempt to reduce these areas of fat. This off label use of these drugs did not have scientific proof. Now, the FDA has reviewed several Kybella research trials and approved it for reduction of fat under the chin. The main advantage is that we can now reduce fat without having to go to the operating room. It is a short in office procedure, and involves several injections of the medication in the area under the chin. The needle is the same size used for Botox injections. There will be some swelling for about 7-10 days, followed by gradual reduction of the fat. After about 6 weeks we reassess the area and can treat again to get further reduction if needed. The cost of Kybella depends on the amount of the medication used and can range anywhere from $600 to $1600 for each treatment. Because Kybella actually destroys fat cells, the effects of the treatments are permanent. If the 7 to 10 days of swelling is a problem for you, then you should consider the new Cool Mini applicator.
The Cool Mini applicator is the newest addition to the CoolSculpting treatment toolbox. When I first offered CoolSculpting 6 years ago, one of the main areas that I wanted to treat was the chin. Because of the vacuum system used, the applicators could not be used under the chin. The challenge was to cool without sucking up vital nerves and arteries into the applicator. The engineers at Zeltiq were able to overcome these challenges, and now have an FDA approved applicator for treating the under chin. Treatment involves applying some gel to the chin and placing the applicator on the chin for 1 hour. After the hour, all you need to do is massage the area. Usually there is no swelling, only a slight numbness. The hardest part about this treatment is keeping still for 1 hour. Pricing can range from $995 to $1495 for each treatment depending on how large the treated area is. There may be more than one treatment needed if the area is thick.
While both of these treatments are FDA approved for fat reduction, they also tighten the skin a small amount. The part I am most excited about is using them in combination with the Ulthera to tighten the skin. In select cases, I think we can get a completely non-surgical neck lift by reducing fat and tightening the skin. There will still be a few patients that have too much extra skin or deep fat. They will need a surgical neck lift, but that is why you need to see a Board Certified Plastic Surgeon. When you see someone who can offer both surgical and non-surgical treatment options, you get the best treatment possible for you.
Unfortunately, there will be many poorly trained people trying to treat these problem areas. Not everyone injecting Kybella or performing CoolSculpting is a physician. I was appalled by the lack of basic anatomy knowledge by some of the non plastic surgeons in the Kybella training program. I can not stress enough how important it is to see a physician who operates on the neck. Someone who understands the anatomy and the relationships of tissues in the neck is far better qualified to take care of you and your neck. Before you go in for a consultation, make sure your physician is a Board Certified Plastic Surgeon and has privileges to perform neck lift surgery at a local hospital or accredited surgical center.
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