Jowls and under-chin fat
What are they?
JOWLS
As time passes, fat redistributes on your face an body even if you maintain the same weight and maintain the same body fat percentage.
so fat that once gave you a full youthful cheek might now be giving you a fatty bulge to the side s of your chin - a bulge we call a "jowl".
Pinch the jowl with facial muscles held tight and you'll realise the jowl is composed of fat underlying the skin.
Aside from fat redistribution, the loss of connective tissue support and elasticity under the skin allows this fat to descend. There's often some loose skin overlying the jowl.
UNDER-CHIN FAT
Often described as a "double chin", under-chin fat arises similarly to jowl fat. Whether a patient is generally heavy or not, achieving a reduction in under-chin fat helps the patient *look* less heavy
So jowl fat is generally a problem of age, under chin fat is generally a problem of heaviness, and of course the two often coincide.
How are they managed?
The most time-honoured approach has been *face-lift*, but this approach has its problems. Firstly, simply pulling the fat out of the way only ever helps temporarily. Skin and subcutaneous fat will not remain under tension: loosening follows and the fat returns to where it was. However better it might look when you push your cheeks up in the mirror, a facelift will not reproduce that effect permanently. Further, facelifts permanently rearrange your facial features. Then there's down-time and cost, etc.
Next consideration is *liposuction*, performed alone or in combination with a face-lift. And when the patient is in a hurry and the fat to be removed is substantial, liposuction makes sense. It should be recalled, though, that the larger the quantity of fat being removed the greater the risk of a later irregularity. Liposuction is a surgical procedure and is not without risk, in anyone's hands.
For many years we have offered and performed here at Peach *lipodissolve injections*. This involves injecting a certain substance into the fatty tissue with a view to killing fat cells. And this treatment works, without doubt. It involves needles and injections, but no cutting. It is relatively inexpensive. Patients thereafter experience several days of pain swelling and bruising, and the final outcome becomes apparent over a number of weeks. In general, more than one treatment is required.
Over ten years ago this practice started offering *cryolipolysis* for the removal of unwanted fat. However, the machine delivered mixed results and was essentially unreliable. It then emerged that some patients experience a strange side effect called paradoxical fat hypertrophy, whereby the treated area becomes *worse* not better. Supermodel Linda Evangelista was a famous sufferer of this side effect. We then disposed of that machine.
Today, for non-invasive reduction of jowl fat and under-chin fat, with little in the way of down time or side effect (we've seen none), we first recommend high intensity focussed ultrasound, or HIFU.
HIFU is well tolerated. You can go back to work same day or next day. Best results are seen at six months. We generally recommend an initial course of three treatments, performed monthly for three months.
Every face is different.
Every face requires an individualised plan and approach.