I love that you asked this!  Also, this question is good for this longer format.  But for some of you who have quick questions, you may want to ask them on my Instagram @drbrandith_skin.  It’s faster!

The first thing to do is a self assessment.  You can try just looking in the mirror but you’ll need to turn your head which changes things.  Better is to ask a trusted friend to take some photos with you.  Take them so you can see the whole head and neck from the collar bone up, with 3 different head positions…. full front, about 45 degrees from the side and then 90 degrees (full side view).   You can also try taking them looking up a bit, chin level, and chin down to bring out any folds.  This will give you a good idea of what you might want to improve.  Try to decide is what you’re seeing fat, skin or both.

1.  Coolmini.

Best for fat on the upper neck, especially if more central.  Many people need 2 treatments (same day) to get a good result so that they overlap in the center.  The number of total treatments depends on the amount of fat and its exact location.   Some people don’t have enough fat to fit into the adapter heads.  Causes some skin tightening with it, but that wasn’t in their FDA approval.

2.  Profound – Dermal

Best for loose skin that’s mild to moderate.  Treatments are very customizable for each patient. 1-4 treatments may be needed to see great results, depending on age, bone structure, etc……   It takes 3-9 months to see full results for each treatment, so start early if you have an event. If there is really a lot of loose skin, surgery may still be your best option.

3.  Kybella

Best for smaller fat pads under the chin.  With an expert, it is very customizable.  Causes some skin tightening with it, but they don’t claim that as an FDA indication.  It does cause (often) a 5-14 day “bullfrog” look that can be daunting.

4.  Profound – SQ (Stands for Subcutaneous)

This is a different “head” for this device that goes deeper and is used for fat under the chin, on the body, and sometimes cellulite.  It can be used under the chin with or without the dermal head in number two.  Some uses are FDA off-label.

You’ll need consults obviously with your doctors for all of the above.   Also, some of our patients ask about the vertical bands (platysmal bands) on the neck.  I really have not seen an effective non surgical therapy for these other than Botox/Dysport, which works quite well (FDA off-label).

Hope this helps,

Dr. Brandith

 

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