Micro-needling of the skin is one of the fastest growing procedures in the aesthetic marketplace.  This device works by stimulating the regeneration of the skin which effectively improves the tone and texture, and can also tighten the skin.  

In my evaluation of these devices, the Rejuvapen System is one of the best devices on the market for micro-needling.  Their needles and power levels have proven safe and effective.

One other important aspect of micro-needling is the combination of this treatment with topical application of growth factors.  We love combining growth factor treatments with micro-needling, both topically and injected. We have seen very good results with the combined treatment.  

Schedule a consultation with our Medical Aesthetician Desirée Watton and see why so many of our patients feel that she's the best around! Office number 941-355-FACE (3223)

 

 

Q: I have had 2 consultations and I was told 2 different things. I don't like the puffy dark bags or the wrinkles under my eyes. Or would Ultherapy help? Please any suggestions. 

From Realself member stst630 (https://www.realself.com/question/buffalo-mn-good-candidate-blepharoplasty#1806051)


 

 Answer: In my opinion, based on the photos, your problem is a lack of volume at the lower eyelid/cheek junction.

It appears that you have a combination of findings, a flattened lower lid/cheek complex and descent of the cheek fat. As the fat of the cheek descends it can leave the bony rim of the eye socket more apparent through the relatively thin skin of the lower eyelid, and cause deflation and abnormal shadowing that makes you appear older or tired. In most this occurs with age but it can be genetic (the so-called "negative vector" cheek).

Additionally the thin skin of the lower lid is somewhat translucent to the muscle underneath it, and that's why it appears like dark circles (imagine placing a wet paper towel on a raw steak -- you'd be able to see the darkness of the muscle through the thin paper towel).

Injectable dermal fillers are expensive and temporary but safe. In the lower lid the procedure is technician-dependent so find someone reputable. You can try this approach to see how you like the result, but repeated injections would have to be performed every 9-24 months thereafter so you may wish to consider a technique that lasts longer.

You could consider autologous fat transfer to the problem area. Fat transfer is safe and can be performed under local anesthesia with oral sedation. My chief concern would be potential irregularities of the contour of the skin afterward, and a potential temporary result.

In my opinion the best solution to give you a lasting result is surgery. Through an incision just below the eyelashes, the fat of the upper cheek may be mobilized and sutured into a higher position to add volume to the lower eyelid and help the dark circles fade. Though it should not be considered a permanent solution, this approach should give you a durable improvement over 15 years or more (before you start to see the same issues appear again). You can see photos of patients who had this procedure on the website.

Malar (cheek) implants can be considered as well.

Lastly, I have not been impressed with the results from Ulthera in this region.

Best wishes!

 

From Realself.com:

"Dr Wright is extremely professional and knowledgeable. I always disliked my thin upper lip and wrinkles between my eyebrows. After a thorough consultation, Dr Wright used juvederm and Botox to correct my concerns. Dr Wright is a perfectionist. I couldn't be happier with my results and highly recommend him to others!"

Before & After photos of typical results:

See the full testimonial at (https://www.realself.com/review/sarasota-fl-juvederm-botox)

The double-chinned have new nonsurgical options thanks to Kybella, the first FDA-approved injectable that specifically targets fat in the neck!

Dr. Harry Wright is among the premier cosmetic surgeons in South Florida to offer this innovative treatment.


 

Men in suits are lining up to have their double chins removed by Lindsay Putnam, in the New York Post

Some people inherit their father’s baby blues, or their mother’s blond hair.

What did Kristian inherit from his parents? A double chin.

“I’m the youngest of four children, and there’s a hereditary gene of having, what I like to call, no neck,” explains the 34-year-old actor from Chelsea, who asked that his last name not be used for professional reasons.

“I’m very self-conscious about [my double chin]. I think it’s a lot harder for guys. Everybody makes jokes that I have no neck, no chin. My sister Becky really comes down on me about it,” laments Kristian, who took notice of his unsightly facial feature when he started college. “I’m 6-foot-2 and 175 pounds, I run and work out every day, I eat right — but it won’t give me the results I want.

“I just don’t like it. I don’t like looking like a turkey.

After 16 years of hating his meaty mandible, Kristian finally decided to do something about it. Three weeks ago, he got his first treatment of Kybella, a newly available, injectable drug backed by the FDA that claims to melt fat underneath the chin.

And he’s hardly the first guy to seek out the instant chin-fixer.

“Forty percent of my [Kybella] patients are men. On some days, it’s even more men than women,” says Dr. Sachin Shridharani, an Upper East Side-based plastic surgeon who has treated 30 patients, including Kristian, with Kybella since its June 15 release. Typically, male patients make up less than 10 percent of his practice.

The majority of Shridharani’s male patients are corporate men sick of being choked by their ties. Shridharani was the first, and until recently the only, plastic surgeon in NYC approved to use Kybella.

“Either you wear a looser-fitting shirt with a collar that doesn’t close against the skin to make it more convenient, which looks sloppy, or you have people adjusting their neck, putting a finger between their collar and skin all day because it’s uncomfortable,” he says. “I have a lot of individuals coming in saying, ‘I need to feel more comfortable in clothes. I can’t wear certain types of clothes without it looking weird.’ ”

Kybella, which was created by Kythera Biopharmaceuticals Inc., was approved by the FDA in an overwhelming 17-0 vote in April. The drug is made from deoxycholic acid, a chemical produced in the body to help absorb fats. When injected into the fat below the chin, known as submental fat, it destroys fat cells, which are reabsorbed by the body. Patients can receive up to 50 injections in a single session, with as many as six sessions total, coming at least one month apart. The average treatment lasts 30 minutes for the first appointment, and 15 to 20 minutes for each subsequent one.

Kybella patient #2  Photo: Dr. Shridharani and Kythera Pharmaceuticals
Kybella patient #2  Photo: Dr. Shridharani and Kythera Pharmaceuticals

 

 

 

 

 

 

 

 

 

 

“The medication is approved for mild to moderate [double chins],” Dr. Shridharani adds. “Most patients will need two to four treatments, but a severe, full neck could take up to six treatments.”

Treatments cost between $800 and $1,800 a pop, depending on how much medication is needed. The larger a patient’s double chin, the more appointments are required to fix it.

Kristian first heard about Kybella years ago, when it was still in its testing phase.

“I didn’t want to be put out and go under the knife — it scares me,” he says of his decision not to get liposuction. “I actually got it done the day I went in for the consultation.”

Dr. Shridharani, who sees between 10 and 20 new patients a week who are interested in the treatment, says 98 percent of those who were qualified ultimately opted to undergo the procedure.

Reasons for deeming a patient unsuitable for Kybella include risk factors such as smoking, steroid use, diabetes and poor skin quality, as they contribute to bad wound healing and recovery.

Of course, men aren’t the only ones seeking slimmer chins. Women are lining up at Dr. Shridharani’s door in such high numbers that he’s had to expand the hours of his practice by three hours a day so he can fit them all in.

“I think so much of it has to do with photographs and selfies,” he explains. “The number one thing I’m hearing is, ‘I saw a photo of myself, look at how I look, look at my jawline, look at my double chin.’ It’s not just what people are seeing in the mirror, it’s what they see [on Instagram].”

Roxanna, also a patient of Dr. Shridharani’s, got her first injection of Kybella three weeks ago — perfect timing, considering she’s preparing to tie the knot at Lake Como in Lombardy, Italy, later this month.

“That’s the reason I did this. I’ve noticed I like my pictures from the front and less from the side, because of the bump underneath my chin,” says the 32-year-old physician from Tribeca, who will don a Reem Acra gown for her big day. (Roxanna also requested not to use her last name for professional reasons.)

The procedure, she says, was painless. “He numbed my chin with ice and then injected lidocaine, and then did the [Kybella] injections. Your chin feels a little weird for a couple days, like jelly.”

But unlike liposuction, there’s less bruising and down time — in fact, Roxanna went straight to a dress fitting following the procedure.

“It’s swollen for a few days, but it doesn’t impede your living or working, you don’t look weird, and you can still go out.”

She’s noticed improvements already, and is planning a second appointment when she returns from her wedding. And she might even bring a guest along with her.

“[My mother] wants to do it the next time she’s in New York. She has a bump too. [I used to think] I would get a neck lift eventually, because I can see my mother and how similar we look.”

Kristian was equally thrilled with his results.

“I feel more confident. People notice it and think that I’m just losing weight. It can change your life.”

He was so impressed with Dr. Shridharani’s work, in fact, that during a recent check-up, he opted to get Botox in his forehead as well, to fill out a deep crease.

He’s planning to receive between two and four treatments of Kybella before his chin recedes to a more photogenic appearance. He has no regrets about his decision.

“I don’t have some obsession of looking like plastic, it has nothing to do with that,” Kristian says in defense. “When some people say, ‘Hey, I’m gonna get my nose done,’ someone will say, ‘But I love your big nose!’

“No one ever says, ‘I love your fat chin!’ ”

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