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As Spring rapidly approaches, so also do reunions, weddings, and all of the photography that go along with these events. But for many people, photos are simply no fun because they simply do not like their facial profile and the seemingly benign act of taking a candid shot can be painfully uncomfortable. As we age and as we gain and lose weight, many of us develop increasing fullness to the neck just beneath the chin. This “waddle”, as many patients refer to it, can become distressing and make us appear older than we really are. And for many people, simply losing weight will not do the trick.
Over the last several years, I have seen a number of patients benefit from a straightforward combination procedure that effectively has taken years off their appearance. This procedure combines ultrasonic VASER liposuction with a chin implant and create dramatic results in less than an hour and with minimal downtime and discomfort.
To better understand why and how this combination is so effective, let’s consider who is a good candidate. First, the ideal candidate is relatively young (under the age of 50) and has a moderate degree of fullness to their submentum (area beneath the chin). This fullness makes the angle between the chin and the neck (“cervicomental angle”) obtuse or more open and creates a more aged appearance overall.
Next, many of these patients have what we refer to as a “recessed” chin. This means that if we drew a line from their top lip to their lower lip and then to their chin, the chin would sit behind this line. When this happens, a recessed chin makes the distance between the angle of their jaw and their chin point look short.
To address these issues, the following steps are performed. First, a very small 1.5-2 mm access incision is made just beneath your chin. Through this incision, a small amount of wetting solution is instilled just beneath the skin. This solution provides numbing relief and also contains epinephrine which not only makes discomfort minimal but dramatically reduces the risk for bruising. The solution is allowed to take effect for about 10 minutes following which ultrasonic energy is applied to the tissues beneath the skin. This energy not only allows for melting of fat but also may have the potential to effectively tighten the neck skin. In addition, the skin is effectively separated from the fat and muscle and a new plane created. Once this is accomplished, gentle suction is then applied and fat is removed. The result? A smoother, more youthful neckline. But wait…there’s more!
Once the central triangle of the upper neck has been addressed, the chin is then readied. To do this, the lower lip is numbed and a small incision made inside the mouth on the lower lip through which the bony chin is reached. Chin sizers are then placed to evaluate an appropriate degree of augmentation. Once an appropriate size has been decided, the tissue pocket is cleansed with antibiotic solution and the permanent implant placed. Tissue layers are then closed over the implant holding it in place and taping is used externally to fix the implant in place. For many patients, a small amount of BOTOX® can be injected a few days prior to surgery to help reduce muscular movement of the chin in the early healing period and potentially allow for more adequate stabilization.
The final step involves placement of a supportive head-wrap which remains in place for 5 days. The wrap applies pressure to the neck and dramatically reduces swelling and bruising and helps the skin better adhere to the underlying tissues. Once removed, a chin strap is then work at night for the next two weeks. During this time, it is recommended to avoid sleeping on pillows and flexing the neck.
And the end result? A more youthful neck and a more structured and well-balanced jawline. While many of these procedures are performed under general anesthesia, they can very easily be performed using light sedation with similar results.
To learn more about this exciting combination approach, please contact us. We look forward to hearing from you.