Cosmetic Plastic Surgery Articles

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.