The Surgeon Minute

Men and the Double Chin

Men and the Double Chin

Dr. Louis Bucky of Philadelphia has noticed a marked increase in the number of men requesting a consultation. The main area of concern? Their necks. “Men are much more sensitive to their necks than they ever used to be,” he says. “Men’s necks age to a much greater degree than their face.” Younger men especially are keenly aware of their double chin.

Until recently, options for correcting submental fat (or fat under the chin) was with a surgical procedure where skin and/or fat is removed. Today, Dr. Bucky has two new non-surgical tools at his disposal that can change a patient’s profile of treatment without surgery.

by Isabel Bolt
and Louis P. Bucky, MD

First, a quick lesson in anatomy and physiology. Did you know the number of fat cells in your body and their distribution are locked in during adolescence? The bad news is that it is impossible to kill or remove these fat cells through diet and exercise–especially in the neck. More bad news if you are 40 or older…metabolic rates peak at age 30 and then decline. This makes it more and more difficult to keep fat under control. Up until now permanent removal could only be accomplished through liposuction.

CoolSculpting–Freeze it

CoolSculpting gives men an alternative for long term control of body contour and was originally introduced to “freeze fat away” in the abs, thighs, hips and love handles. Very recently a special hand piece was introduced called “the cool mini” that can now effectively address smaller, contoured areas like under the chin. Coolsculpting is FDA-cleared for the treatment of visible fat bulges in the submental area, thigh, abdomen, and flank. Millions of CoolSculpting procedures have been performed worldwide, and it is proven to be a safe and effective means of eliminating fat.

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Kybella–Melt it

In April of 2015 another alternative to address the dreaded double chin was born. The FDA approved a new drug called Kybella which dissolves fat without surgery. Our bodies make a substance called deoxycholic acid which absorbs fat. Kybella is comprised of this same, natural element, essentially “amping up” the absorption rate in the areas in which it is introduced, destroying fat cells. Clinical trials have been going on for over 7 years with over 80% of those getting the drug saying they noticed some improvement in their chin fat.

Fair warning, there are needles involved, but icing beforehand removes almost all discomfort. Your practitioner will “map” the area to be injected depending upon your anatomy. 12-20 injections are average and it takes about 15 minutes maximum. The protocol is generally 2-6 total visits, spaced one month apart. Most patients see a noticeable difference in 2-4 visits. There are no bandages and little swelling, so work or play can immediately be resumed.

What CoolSculpting and Kybella Won’t Do

Patients may experience a few degrees of greater tightness in the overall appearance of their neck, but for those with sagging skin, a necklift may be the better solution to eliminate extra skin and smooth the neck. “15 years ago there was only one alternative with a necklift,” says Dr. Bucky, “a big ‘Z’ or ‘X’ scar.” On younger men with thicker, more elastic skin, liposuction was the procedure of choice to sculpt the neck. While necklift techniques have vastly improved with scars hidden behind the ears, most men are still not thrilled about the idea of surgery.

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A Final Point

A treatment labeled “non-invasive” does not translate into “anyone can do it.”  Only board certified plastic surgeons or dermatologists should be considered for either Coolsculpting or Kybella. A poorly trained provider at the least will leave you with little or no CoolSculpting results. In the case of Kybella, an inexperienced injector can create significant nerve damage. Choose your provider carefully. “I think ‘Cool Mini’ to freeze and Kybella to melt fat away may be good for men who are typically very averse to going to the operating room…or suffering longer recoveries,” explains Bucky. “They are willing to have a few procedures with shorter recoveries if it’s not too disruptive.”

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