Hi! I’m Dr. Loo Keng Shien.

Here's Episode 35 of the Patient Mailbox series, where we collect handpicked questions submitted by patients suffering from various skin diseases and condition, and personally answer them with our best efforts. I hope to help any one of you who faces challenges from similar situations.

Editor’s Note: Dr. Loo Keng Shien is a Consultant Aesthetic Physician with a special interest in Dermatology and Aesthetic Medicine. She has highly certified qualifications from the American Academy of Aesthetic Medicine, American Academy of Anti-aging Medicine, and in Practical Dermatology from Cardiff University. She currently practices at Peter Ch'ng Clinic Skin & Laser Specialist in Desa Park City.

 

Question:

Hi Dr. Loo,

I’m Ameera.  At 43 years old, I notice that the skin around my neck is not as tight or defined as before. It looks as if there is mild sagging of skin around my jawline, making me look older and chubbier.

I hate this double chin and I would like to get rid of it. Could you share with me the treatment options for double chin that are non-invasive, and with zero downtime? Do advice on its risk, safety, and side effects too. Thank you in advance.

Answer:

Having a double chin is a very common phenomenon. Did you know that an astounding 70% of Americans suffer from double chin? This statistic from the American Society for Dermatologic Surgery reassures that you are not alone.

Before we delve further on the treatment options, let us understand what is double chin.

 

What is double chin?

Double chin refers to the submental fat located just below the chin area. Everybody is born with some submental fat. But having too much fat causes the appearance of jowling.

What causes double chin?

Many factors cause an individual to have a double chin. One of them is weight gain. As you put on weight, the fat you have gained is distributed throughout your body. And the fat that accumulates just below the chin is referred to as a double chin.

Packing on the pounds is not the ultimate cause for a double chin. If you have natural fullness under the chin even with dieting, then the condition is said to be genetically induced.

Aging is another factor that causes double chin. As we age, our skin becomes less elastic, resulting in the appearance of a saggy jawline.

 

Can double chin be treated without undergoing surgery?

Should you dread going under the knife, here’s the good news. There are several ways to get rid of a double chin without surgery.

CoolSculpting or cryolipolysis is an FDA-approved procedure that freezes excess fat located below the chin. CoolScupting works by destroying the fat at very low temperatures between -5c to -10c. Over time, your body will process the fat and expel the dead fat cells out of the body.

For a tight jawline, it is best to treat the skin under the chin with skin tightening procedures using radiofrequency laser or ultrasound device, after CoolScuplting.

Another treatment option that delivers satisfactory results is Ultherapy.

How does Ultherapy work in treating double chin?

Ultherapy is an FDA-approved high-intensity focal ultrasound (HIFU) treatment. Ultherapy uses micro-focused ultrasound energy to provide direct visualization of the skin layers. During Ultherapy treatment, the superficial muscular aponeurotic system (or SMAS) is heated up to 60 – 70 degrees. This alters the natural structure of the skin and stimulates collagen synthesis.

 

Can you share what happens before, during and after the Ultherapy treatment?

We place the utmost care in patient selection to ensure optimal results are delivered. Before the Ultherapy treatment, we will assess the patient’s suitability. During the assessment, we will rule out contraindications suggesting that the patient is not fit for the treatment. For example, patients with open wounds, severe or cystic acne at the treatment site or patients with active implants are deemed not suitable candidates.

After the consultation and diagnosis, we will formulate a customized plan for the patient. If the patient agrees to the recommended plan, we will treat the patient accordingly.

With the patient’s medical consent, a pre-treatment photo is taken. The treatment area will be marked, and a layer of ultrasound gel will be applied to the treatment area.

The advantage of Ultherapy is its direct visualization. This provides the physician with clear navigation and ease of avoiding treating major blood vessels and bone. It also allows us to look at the depth of the treatment area, and treat areas that were previously targeted without reservation.

Generally, an Ultherapy treatment is completed within 30 - 90 minutes.

After the procedure, you can resume your normal activity as there is no downtime. You may experience slight tenderness and swelling, but this should not hinder your daily activities. Any swelling and discomfort will subside in the next 24 hours.

Please make a point not to miss any of the follow-up visits scheduled so that we can monitor your progress.

 

How long do the effects of Ultherapy last?

You will not only see immediate effects after the swelling has subsided. In fact, you can expect to enjoy further improvements between 3 to 6 months. By maintaining a healthy and active lifestyle, the results can be prolonged to last up to a year.

 

Are there any dos and don’ts after Ultherapy treatment?

A lot of patients are concerned if their daily activities will be impacted by Ultherapy treatment. And the answer is no. You can eat whatever you wish, go back to work immediately or resume your workout.

Just remember to keep up with your skin care regime and be vigilant with sun protection.

 

How many Ultherapy treatments do I need to see results?

The number of treatments required depends on how well the patient responds to Ultherapy, and the degree of skin laxity. Typically, most patients will need only one treatment to see significant improvements.

Patients that present with severe laxity can repeat the treatment after 6 months.

For maintenance purposes, we recommend patients to undergo an energy-based tightening laser every month.

To summarize, Ultherapy is known for its highly predictable and consistent results.

 

Which is more effective in treating double chin – Ultherapy or Cool Sculpting?

Comparing Ultherapy against Cool Sculpting is not a like-for-like illustration. Both are different treatments and extreme opposites of one another. Here’s why.

CoolSculpting works by targeting the subcutaneous fat. Fat is frozen, resulting in the death of the fat cell (apoptosis). Thereafter, these dead cells are naturally removed by our bodies.

On the contrary, Ultherapy does not remove fat. What it does is tighten the muscles and underlying skin, giving the jawline a trimmer appearance.

So to say that one treatment modality is more effective than the other can be misleading. With an accurate diagnosis of the underlying problem, the practitioner can then devise the most effective treatment plan to meet the patient’s expectation.

 

What makes a good candidate for Ultherapy?

Individuals that present with mild to moderate laxity can be treated effectively with Ultherapy. For patients that present with severely sagging skin, the excess skin must be excised and hence surgical intervention is required.

As a rule of thumb, most patients below the age of 50 with mild to moderate laxity make good candidates for Ultherapy. Such patients can enjoy good outcomes minus the longer downtimes that come with surgery.

 

Are there any lifestyle tips that will help me get rid of my double chin?

Once you have treated your double chin with Ultherapy, it is important to maintain a healthy weight. Eating moderately, revving your heart rate up with exercise and abstaining from smoking will help to prolong the longevity of your trimmed jawline from Ultherapy.

 

Are there any risks or side effects related to this treatment?

In the hands of a skilled physician, Ultherapy is an extremely safe procedure with no risk. The underlying science behind Ultherapy is its ultrasound technology. And this technology has been used for more than 50 years in various fields of medicine.

Furthermore, Ultherapy is an FDA-approved treatment. To earn this medical recognition, Ultherapy has undergone stringent clinical tests, with treatment safely performed on more than 100,000 patients worldwide.  This is a reassurance that Ultheraphy is a safe treatment.

Essentially, Ultherapy is a medical treatment. With medical treatments, you should only entrust trained aesthetic doctors or dermatologist to perform the treatment on you. Incompetent execution of the medical device often happens under the untrained watch of beauticians who lack the technical expertise. After all, your face is the canvas to your soul. You should walk out of the treatment room feeling upbeat and optimistic, instead of worrying about the outcome.

So if that double chin is still bordering you, feel free to book a one-to-one consultation and diagnosis with Dr. Loo.  A short chat may lift your worries off your shoulders and get you on track to a tight jawline.

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If you’d like to ask more about your skin condition or have a discussion with Dr Loo, call us at +6011-22882299, Whatsapp us, or book an appointment with Dr Loo here!