The Question
The aging process affects different people in different ways. Hormonal changes, environmental and habitual factors gradually change how the body reacts to trauma, weight fluctuations and fat storage, just to name a few. As these changes progress, they can leave a person dissatisfied with their body or specific portions of it. One example of this is the focus of this week’s Ask Dr. Pane segment. The viewer, from Facebook, asks, “What is the best procedure to get rid of a double chin?”
The Case
The viewer provided photographs but did not state her age. From the appearance of the skin, Dr. Pane estimates her somewhere in her early thirties. There is some fullness between the chin and neck area, or what is colloquially known as a double chin. The patient’s skin appears to be in good condition and there are no indications of other difficulties based on the photographs provided. However, photographs are almost never a fully reliable indicator of what a patient sees in the mirror, making in-person clinical evaluation very important before committing to a course of action.
The Answer
In this case, Dr. Pane says the first item to consider is what the actual problem is. While the photographs show fullness, there are several possible causes, each of which requires a different approach. If there is skin overlap, this is a different issue than if there is actual fat in the area.
Another issue is whether the patient wants to undergo surgical or minimally invasive treatment to correct the area in question. While minimally invasive “freezing” and “melting” treatments are available, which work topically to destroy fat cells beneath the skin, and these do have a clinical track record which suggests they work reasonably well, Dr. Pane does not typically use them in his practice, largely because he is not convinced of their efficacy or durability over time. Radio frequency treatment might be an option, but this addresses skin laxity rather than any subdermal fat. Finally, injectables may also be an option. These substances are injected into a specific area to dissolve the fat from within. All of these have their benefits and risks, but Dr. Pane says they all need to be measured against the “gold standard” for this area: submental liposuction.
In this procedure, a small incision is made either under the chin or behind the ears to trace along the sides of the jaws. The subcutaneous fat is then removed using a small cannula. Dr. Pane far prefers this procedure because it offers the most predictable and durable results of all the available options. Although the others can be done, and patients are normally pleased with the results, they do carry risks such as hardness under the chin or infection, which are almost entirely absent with submental liposuction.
If the patient wanted other procedures done, such as a face and neck lift, adding in submental liposuction would be a very simple matter which in most cases would help to amend the area in question without adding substantively to the healing time or risk of complications, which are very low in Dr. Pane’s practice to begin with. This is also a common standalone procedure which, in Dr. Pane’s opinion, offers the patient the best chance for great results with the lowest odds of potential issues.
RealSelf Patient Reviews of Thomas A. Pane, MD
Evaluating a patient based on photographs is a fine way to form an initial impression. However, photographs carry the inherent paradox of concealing as much, or more, than they reveal. Angles, lighting, the type of camera and any number of other factors may alter the appearance of a problem area to make things appear better, or worse, than they actually are. For these reasons, a clinical evaluation where the doctor can see, touch and view the area from multiple angles to check for possible problem points is essential to delivering a professional opinion which will best serve the patient’s needs.
If you have a question concerning any aspect or type of cosmetic surgery treatment, Dr. Pane and the staff of Atlantic Coast Aesthetics are always happy to take time to discuss your needs and interests. Simply follow us on Instagram, Twitter, LinkedIn and Facebook; use our website’s Contact page to send us a message; or call us at (561) 422-4116. Your question might even help us inform and educate others who share your concerns as the focus of an upcoming Ask Dr. Pane segment. Remember, at ACA we believe the only bad question is the one you don’t ask!