Davis

There’s a lot of staring into mirrors that takes place around this time of year. Some of it should probably be attributed to cabin fever. But the vast majority, I believe, stems from a deep-down desire, prompted by the start of a new year, to change something about ourselves.

While much of the advice bogging down the internet at the moment about sticking to our resolutions tend to center on short-lived concerns—the five to 10 pounds gained since the end of the summer, the new urge to drink more often after a month of nightly holiday parties—it’s the ones that have plagued us for as long as we can remember that resonate most during those long stare-downs with ourselves. Things like a double chin.

The good news is, if your double chin and neck area is something that’s distracted you, tightening it up is a fairly painless process that can be done in as little as 15 minutes with a board-certified plastic surgeon. Here’s what you need to know about it.

Did someone say no downtime?

Kybella is an injectable that dissolves fat cells permanently. It was approved by the FDA in 2015 for use specifically in the submental region of the body, also known as the space between the chin and the neck. Its key ingredient is deoxycholic acid, which is a synthetic form of bile, the bodily fluid that plays an integral role in our digestion.

When it’s injected, the acid destroys fat cells in the area around the injection so that they can no longer accumulate or store fat.

Anyone over 18 who has a pinchable amount of fat in their submental area is considered a good candidate for Kybella. Effective as it is, the results aren’t immediate. Most require three to four noninvasive treatments, spaced about a month apart. You should, however, begin to notice a difference after the second session.

For a comparison, you’ll see immediate results with chin liposuction once the swelling subsides, after about three days, but it is a minimally-invasive procedure. The fat is suctioned out through a cannula that’s inserted through a small incision in the chin crease.

An overnight success story

Perhaps the best part about Kybella, in case you glossed over it toward the top of this post, is that it permanently removes fat cells. It’s worth noting that the remaining fat cells can expand over time, so it’s important to maintain your results with a healthy diet and a consistent exercise regimen.

But that shouldn’t be a problem now that you’re no longer losing big chunks of time staring into a mirror, trying to wish away that one feature that, in your eyes, has defined so much of your identity for all these years.

I’m continuing a conversation here that I started in my last post: While plastic surgery has always blended technical expertise and artistry, it’s maybe never been more evident than it is at this very moment with all the innovative ways surgeons are delicately sculpting the human face with precisely placed injections. These are a couple more examples for your consideration.

What you’re not seeing

In high school art classes, it’s one of the first lessons they teach us: What’s not there is every bit as essential as what is. It can seem like plastic surgery is constantly focused on creation, even in the cases of liposuction and breast reduction surgery, where we’re removing something, but also creating a new silhouette. However, much of what we’re able to accomplish through injectables involves the engineering of negative space.

To slenderize blocky jaws, for example, we can administer a neurotoxin to the chewing muscles, which tend to turn bulky after years of clenching and chewing. With the right dose, the muscles will shrink slightly, narrowing the lower third of the face into a softer heart shape.

A neurotoxin can also tighten the neckline when it’s administered in a series of small doses under the jawline and across the platysma muscle that runs up and down the neck. It will enable the face to lift upward, to a degree, and any folds in the neck to lie flat.

Aging produces both positive spaces—folds and fullness—and negative ones, like wrinkles, under-eye depressions, and sunken temples. Hyaluronic acids are commonly used to fill the voids, though it still requires a refined technique and wealth of experience because precise placement is crucial. As is using a gel with an appropriate viscosity. The skin under the eyes, in particular, is extremely delicate. If certain hyaluronic acids are injected in the wrong place, the natural contours can be dramatically upset.

A long-term perspective

Miraculous as much of this sounds (and is), there can be such a thing as too much of a good thing. (Though, much more often, it’s a good thing that’s been poorly administered.) In those instances, we can refresh the canvas by dissolving hyaluronic acid with an enzyme called hyaluronidase. (It doesn’t have the same effect on other types of filler, which generally have to degrade on their own or be surgically removed.)

With many of the treatments I’ve highlighted in this post and the last one, it’s important to consider them as part of an ongoing treatment plan that’s been designed by a board-certified plastic surgeon after an extended and thoughtful discussion about your short- and long-term expectations. Without the right guidance, it can be easy to lose perspective and begin adding volume beyond what’s been naturally lost.

Throughout these posts, I’ve emphasized the surgeon’s expertise in knowing where to place these injections and his or her ability to place them. But just as important is their vast knowledge of the human anatomy and the effect these subtle alterations will have, not only over the next several months, but over the course of a lifetime.

Maybe you hold an image in your head of the type of woman (or man) who gets Botox. Amanda Montell did: Ramona Singer, of “The Real Housewives of New York,” “who is known,” Montell writes, “for always having white wine in hand and managing to look more youthful with age.

“I was 16 at the time and watched in pure contempt of Ramona’s superficiality. People who got Botox had their priorities all out of whack, I decided. Couldn’t people just let themselves age gracefully anymore? Shouldn’t the goal be feeling young instead of looking young,” Montell writes in her essay for the beauty site, Byrdie. “Now, looking back, I have to laugh at my young, wrinkle-free self. It’s easy to condemn procedures that eliminate wrinkles when you don’t have any of your own!”

‘How quickly your tune can change’

What she’s trying to say is that her perception changed when her reality changed. At 26, the woman who thought she was nothing like Ramona Singe sought her first preventative Botox treatment.

“Oh, how quickly your tune can change the moment you actually see yourself start to age,” Montell writes.

A photographer friend had taken some shots of Montell. Later, when she saw the prints, all she could see were the vertical lines between her eyebrows, her “angry 11s,” as she refers to them, and other lines across her forehead that she’d never really noticed before.

“It’s not as if the lines were extreme, but they were there, staring back at me, an undeniable physical symbol that one day I wasn’t going to look like—or be—a young person anymore,” Montell writes.

“I couldn’t help but think: If my goal is to feel young, but the way I look doesn’t match that, then one day I’m not going to recognize myself anymore. That’s what bothered me—I wanted my outside to match my inside. And my inside still felt so wrinkle-free.”

Preventative vs. corrective

It’s important to understand that our perceptions of the kind of people who get Botox, or any type of plastic surgery, for that matter, have been shaped by reality TV and pop culture sites, which rarely cast anyone in the best light. “Preventative Botox,” as the treatment’s come to be called, is quickly gaining traction in large part because millennials are dismissing outdated stigmas and becoming well-informed about the aging process and the options for slowing it down.

The benefit of beginning Botox, or any type of botulinum toxin, when fine lines are just beginning to form (preventative), rather than waiting until they become deeply etched (corrective), is that it retrains the muscles responsible for those lines, effectively stopping them in their tracks. And once that happens, even less Botox is needed to maintain the results.

“With all the information laid out in front of me, the taboos and judgements around this one small procedure seemed so senseless,” Montell writes.

As of when she wrote the essay, Montell had undergone two Botox treatments over the previous six months. Already, her “angry 11s” had completely disappeared, and her makeup, she writes, is going on smoother than ever.

The prospective cosmetic surgery patient is much better educated than they were even just a few years ago. They’re entering the initial consultation with a pretty clearly defined idea of the procedure they want and what it’s going to entail.

By that I mean they understand that there’s going to be a certain degree of bruising and swelling. That knowledge, however, doesn’t always soften the shock.

Even in the hands of a skilled, board-certified plastic surgeon, a cosmetic procedure is still a type of trauma from which the body must heal. Your body can’t distinguish between tripping and scraping your knee and a doctor taking a scalpel to your chin. Which is to say the bruising and swelling can be relatively intense in the initial aftermath. But there are a few things you can do to ensure a speedy recovery.

What to expect

Before we get into the recovery, let’s discuss what you can expect to see and feel following your cosmetic procedure. In the first few days following surgery, the bruising will be a dark black, purple, or blue—which can look even more traumatizing when it’s in a highly visible place, like the face. But it should begin to lighten up by the fifth or sixth day and subside completely within two weeks.

The swelling, similarly, is going to be its worst over the first few days after the surgery. It’ll begin to go down after a week, and within two weeks, the swelling should reduce by about 75 percent. Six weeks out, almost all of it should dissipate. Any lingering swelling will go down over the next few months.

Self-care after surgery

Let me preface the tips that follow by saying that the single-most effective thing you can do to ensure a complete recovery is to follow your doctor’s post-care recommendations. That means keeping dressings and compresses on until you’re told to remove them. If you had a procedure performed on your face or neck, you may be told to sleep with your held elevated for the first few weeks. Stop taking any blood-thinning medications or supplements. It also means, above all, being a diligent observer of what you’re seeing and feeling. Redness around the site of the procedure, for example, coupled with pain and fever could be sign of infection, which warrants immediate attention..

Beyond that, simply take care of yourself. Don’t smoke. Avoid alcohol for at least the first few days. Drink lots of water. Stay out of the sun (exposure can deepen the color of bruises). Avoid strenuous activity, including exercise, for the first few weeks after surgery. And get plenty of sleep. Again, your body believes it’s recovering from a trauma, so enable your immune system to work at its full capacity.

When to return to normal activity

You may have a ready-made excuse for avoiding the gym for a while, but you’ll want to get out of bed and at least walk around the house a bit as soon as you feel up to it. It’s essential to promote healthy circulation and discourage the development of clots.

If the bruising makes you self-conscious, you should be able to mask it with makeup after a few days, but clear it with your doctor first. And steer clear of open wounds and stitches.