Dr Gilles Korb
Erasing a double chin is a frequent request in my practice.
This anomaly often combines excess fat under the chin with distended skin. During a recent aesthetic medicine congress in France, a seminar was held about the different medical treatments at our disposal, other than surgical liposuction.
Combining several techniques
Fractional radiofrequency: A smooth wand or one with microneedles delivers high-frequency waves through the skin. These waves make the dermis retract (tightening effect) and compact the subjacent fatty tissue. For an effective tightening effect, we need to treat both the area under the chin and the sides of the neck at the same time. Several sessions, spaced 2 to 4 weeks apart, are scheduled.
Focused ultrasounds (HIFU): When focused on the skin, these heat up the dermis and fatty tissue. The skin is tightened and the adipose tissue becomes thinner. Fairly pain-free and requiring no downtime, this treatment yields results after a few months.
Tensor threads: Resorbable, barbed threads are inserted under local anaesthetic. They are inserted with blunt-tipped cannulas, which are less painful and less aggressive than needles, which can cause haematoma. They only help with skin sagging, or to reshape the angle of the neck. Two to four barbed threads are usually enough, along with coiled threads to smooth the skin thanks to their “spring” effect. 1 or 2 sessions are carried out, spaced a month apart. The effects are immediate but are optimised after a month. These threads are resorbed in 12 to 15 months, depending on their composition, and so the procedure must be repeated.
“Cold” lasers: These have just arrived on the market. The procedure involves applying laser diodes to the skin. These diodes have a specific wavelength which empties the adipocytes of their fat. The session, which is pain-free, lasts 30 minutes and should be repeated twice a week for 2 to 4 weeks or more, depending on the case. The fat must then be eliminated through physical exercise on the same day. Risk-free and with no side effects, this highly promising technique will probably be developed further in the future.
Cryolipolysis: This destroys the adipocytes with cold. It is recommended for young patients who have only small fat stores. The handpiece is placed onto the skin and delivers a temperature of -7° for one hour. It may cause a bit of temporary bruising. The results are visible after 3 months on average.
Biomimetic peptides: These are small proteins that destroy the fat inside the adipocytes. They are indicated for middle-aged adults. The injections are carried out using a meso-therapy gun. Plan for a minimum of 3 sessions, followed by massages of the treatment area. You must be patient: results are unpredictable and are only noticeable after 3 to 6 months. They can be enhanced by taking food supplements.
Deoxycholate: This molecule melts away fat but cannot help with distended skin. The protocol includes 3 sessions of subcutaneous injections and involves a painful, local inflam-matory reaction. Its use is currently prohibited in France.
Dr Gilles Korb: Surgeon of the face and neck in Nantes, specialising in aesthetic surgery and aesthetic medicine for the face and neck. Member of the French Society of Plastic and Cosmetic Surgery of the Face and Neck, member of the World Society of Anti-Aging Medicine (WOSAAM).