Social media has created a surge in demand for cosmetic treatments as of late. The selfie craze, in particular, has fueled a concentrated interest in reducing the appearance of submental fullness or a “double neck”. About 68% of people including men and women surveyed by the American Society of Dermatologic Surgery in 2014 named excess fat under the chin (double chins) and neck as one of their top concerns. Many people believe a double chin makes them look heavier or older than they actually are, and no clothing or make-up can hide it. The presence of submental fat is influenced by several factors, such as aging, genetics and weight gain. The problem is, this fat is often resistant to diet and exercise alone. Until recently, the only treatment available was surgical liposuction and face-lifts.
While surgical treatment options offer excellent results, many people can’t afford these procedures or aren’t interested in surgery. For the first time, we are able to deliver effective non-surgical methods to treat this troubling area of the body. The two treatment methods described here result in permanent reduction in the number of fat cells in the treated area. Assuming the patient remains stable in weight, they should not have a recurrence of fat in the area.
The ideal patient for these treatments is a person that has excessive fat under the chin that is not associated with a great deal of loose skin. Anecdotally, both methods are associated with a degree of skin tightening but the main purpose of these treatments is to reduce fat. Mild degrees of skin laxity after fat reduction can be improved with nonsurgical treatments such as Ultherapy. Greater amounts of excess skin is best addressed surgically, so non-surgical fat reduction doesn’t make sense for this population of patients.
Coolsculpting® by Zeltiq has an impressive history of growth. Since Zeltiq’s founding in 2005, the company has grown the CoolSculpting brand to become the #1 non-invasive fat reduction procedure with millions of procedures done to date. The company has recently introduced a new applicator for submental fat reduction. Two treatments spaced several months apart are recommended for the best effect. There is often no evidence of treatment the next day, although some swelling or bruising may be evident. Through selective freezing of fat, fat cells are damaged and will be removed naturally by the body over time. The result is visible fat reduction in the treatment area seen as soon a 1 month after treatment and maximally at 3 months. Treatments sessions last one hour, although an upgrade to the present system will see the treatment times being reduced in the near future.
Belkyra™, recently approved by Health Canada is also known as Kybella in the United States where it is FDA approved. Belkyra™ is an injectable drug made of deoxycholic acid, a naturally occurring molecule the body produces to absorb fat. Typically, two to four treatments are done at 6-8 weekly intervals to achieve fat reduction in the submental area. When injected into fat, it causes immediate destruction of the fat cell membranes resulting in cellular death. At this time, the medication is approved for injection of fat only directly under the chin and not into the lateral aspects under the jaw. The most common side effects include swelling that usually lasts several days and some pain on the day of injection. Numbness, redness, tingling or itchiness, and a sensation of warmth or hardness are other common side effects. A treatment session typically takes 15 minutes to perform.