Getting rid of a double chin with submental liposuction

Actual patient of Dr. Devgan, before and after under-the-chin liposuction

Actual patient of Dr. Devgan, before and after under-the-chin liposuction

Actual patient of Dr. Devgan, before and after under-the-chin liposuction

Actual patient of Dr. Devgan, before and after under-the-chin liposuction

Actual patient of Dr. Devgan, before and after under-the-chin liposuction

Many patients complain of focal fat deposition under the chin ("double-chin")-- not only is this area troublesome, but it can also make the face appear chubbier and the whole body appear heavier.

There are two major options for treatment of submental fullness, or under-the-chin fat. 

Submental liposuction

The first option, and what I consider to be the gold standard treatment, is submental liposuction. With this technique, I make a tiny 3 millimeter incision hidden underneath the chin crease and utilize narrow cannulae (sterile surgical instruments like straws) to physically suction out the fat.

The advantages of submental liposuction are that:

• fat removal is permanent
• I am able to focally and selectively reduce fat depositions wherever they are bothering you
• I can slim the entire jawline and angle of the mandible
• downtime is minimal
• the surgery can be done under local anesthesia only (wide awake)
• only one intervention is needed
• patient satisfaction is extremely high

There are essentially no disadvantages of submental liposuction, except for the fact that it does create a tiny scar underneath the chin. Overall, I find this to be the vastly superior approach for under-the-chin fat.

Kybella

A newer technique for getting rid of stubborn fat under the chin/ neck area is an injection called Kybella. This FDA-approved product is made by Allergan, the company that makes Botox and Juvederm. It contains deoxycholic acid, which is an enzyme that dissolves fat permanently. Kybella has gotten a lot of press lately because Khloe Kardashian and her sisters have credited it with helping them with sleeker, thinner necks and chins.

The advantages of Kybella include the fact that:

• it is an injection (and not a surgical procedure)
• there is no downtime
• the procedure is done while you are awake
• there are no scars created

The disadvantages of Kybella include that:

• patients can require 2 to 6 treatments spaced out over the course of year
• each treatment is associated with a moderate degree of swelling
• Kybella is best used right underneath the chin and cannot effectively target the angle of the mandible or further-back areas of the jawline
• it can be painful

For the most beautiful, robust results, I find that submental liposuction is the best approach for the vast majority of patients. However, I have had great success with Kybella as well. To figure out the best approach for your needs, lifestyle, anatomy, and goals for surgery, I would recommend coming into my New York City private practice for a consultation with me.

Recent review by an actual submental liposuction patient of Dr. Devgan

Liquid Facelift

Actual patient of Dr. Devgan, before and after Botox to forehead/ crows feet/ glabella/ DAOs, Juvederm to lips, Voluma to cheekbones.

Actual patient of Dr. Devgan, before and after Botox to forehead/ crows feet/ glabella/ DAOs, Juvederm to lips, Voluma to cheekbones.

Actual patient of Dr. Devgan, before and after Botox to forehead/ crows feet/ glabella/ DAOs, Juvederm to lips, Juvederm to nasolabial folds, Voluma to cheekbones.

The most definitive aesthetic results come from surgical interventions, particularly with facial aesthetics. The power of a modern facelift, necklift, blepharoplasty (eyelift), and fat grafting can truly refine the face in a manner that can last for decades.

However, for those who are not interested in pursuing surgery, options for minimally invasive, non-surgical interventions do exist. These options principally involve a combination of the following:

• Botox (or Dysport, Xeomin, or related neurotoxins) for softening of wrinkles and fine lines, including:
  • forehead
  • glabella
  • crow's feet
  • frowning angle of the mouth
  • "bunny lines" on the sides of the nose
  • platysmal bands in the neck
  • gummy smile
  • slimming the jaw/ masseter muscles
  • sweating (hyperhidrosis) of the palms and armpits
     
• Filler (such as Juvederm, Restylane, Voluma, Belotero, Radiesse, Sculptra, and others) for improving contour and volume of the:
  • temporal hollows
  • cheekbones
  • nasal irregularities ("liquid rhinoplasty")
  • nasolabial folds
  • marionette lines
  • lips

The term "liquid facelift" can refer to any combination of the above procedures, and others, depending on an individual's unique anatomic features and aesthetic concerns. In my practice, I perform a detailed facial analysis and in-person examination of each patient's face prior to offering any formal recommendations about which treatment approaches might be best for him her.

A liquid facelift can last months to years, and while it lacks the longevity of surgical procedures, it offers the benefits of short procedural time, no incisions, no anesthesia, and no downtime. It can be a good temporizing maneuver for those patients who are considering surgery at a future date, or for those who want to get a sense of the best case scenario without surgery.

If you are considering surgical or non-surgical improvements for your face or body and would like to discuss your concerns with me in person, please do not hesitate to reach out to my office. My patient coordinator, Erica, can assist you via phone at 212-452-2400 or email at office@LaraDevganMD.com.

Cheekbone augmentation with injectable filler

Cheekbones are said to account for 70% of facial beauty-- they anchor the face, make the face look thinner and more sculpted, and set the stage for beautiful facial features.

One of my favorite techniques for improving facial balance and beauty is injectable filler to augment the cheekbones. Not only does it improve the sculptural quality of the cheekbones, but it also replaces the volume loss of the midface that starts to occur in our 30s.

This technique takes about 10 minutes, and results last 1-2 years. I typically use Voluma, an FDA-approved filler made by Allergan, to achieve soft, natural looking results, as shown above.

Some of the benefits of cheekbone augmentation include:

• better apparent bone structure of the face
• softening of the nasolabial folds
• improvement of facial volume and softness of the upper cheeks
• reduction of "midface descent" or malar bags/ festoons
• creation of a heart-shaped, youthful face, rather than a square-shaped, older face

For all of my cheekbone augmentation patients, I am precise and meticulous when it comes to their facial features. In my practice, I feel that it is mandatory to:

• carefully analyze facial balance and facial features
• measure anatomic landmarks
• mark with a white pencil the important anatomic areas for concern
• sterilize the skin
• use topical and vibrational pain control
• use microdroplet injection techniques for greater precision
• cleanse and massage the tissue after the procedure
• apply a topical steroid ointment to reduce inflammation

If you are interested in Voluma cheek filler (or cheekbone augmentation), please call 212-452-2400 or email office@LaraDevganMD.com.

Natural looking rhinoplasty

Actual patient of Dr. Devgan, before and 1 week after rhinoplasty.

A beautiful, subtle rhinoplasty changes the character of the nose by a few millimeters, but it can change the character of the face much more significantly.

When I am seeing a rhinoplasty patient in my practice, I take several steps to ensure beautiful results that are harmonious with the patient's overall face. This involves:

1. Detailed physical examination of the components of the external nose: the dorsum, the sidewalls, the tip, the soft triangles, and the nasal alae
2. Assessment of the physical characteristics of the nose: the skin type, sebaceous glands, the skin thickness, and the strength of the cartilages
3. Examination of the inside of the nose, including the septum, turbinates, internal and external nasal valves, and the mucosa
4. An overall facial analysis that takes into account other related facial features, such as the chin, eyes, cheekbones, and mouth
5. A detailed conversation with my patient about his or her goals and expectations for surgery

I take tremendous pride in my work and attention to detail, and these qualities are particularly important with rhinoplasty ("nose job") surgery. To see me as a patient in my New York City practice, please call 212-452-2400 or email office@LaraDevganMD.com.

Breast lift (mastopexy) to correct drooping and asymmetry

Actual patient of Dr. Devgan, before and after breast lift (mastopexy).

Actual patient of Dr. Devgan, before and after breast lift (mastopexy).

Actual patient of Dr. Devgan, before and after breast lift (mastopexy).

Actual patient of Dr. Devgan, before and after breast lift (mastopexy) and implant removal.

Actual patient of Dr. Devgan, before and after scarless internal breast lift (mastopexy) and breast augmentation.

Time, genetics, breastfeeding, and pregnancy can all effect the appearance of the female breasts. Over time, drooping, sagging, and deflation of the upper and medial poles of the breasts can set in and leave a patient with a less-than-desirable aesthetic appearance.

A breast lift (or mastopexy) can be a gratifying operation for restoring a natural, feminine, perky shape to the female breasts. A typical breast lift (even when a minimal amount of tissue is removed) will slightly reduce the size of the breasts. In select patients, a breast reduction can be combined with a breast lift if a patient would like to decrease the overall size of their breasts more significantly.

Types of Breast Lifts & Scars

Circumareolar

A circumareolar breast lift raises the nipple position about 1-2 cm. This lift has the advantage of keeping scars hidden in a donut shape around the areola, but has the disadvantage of only being capable of a modest elevation in breast position.

Lollipop

A lollipop or vertical pattern breast lift raises the nipple position more significantly, but the tradeoff is a slightly longer scar that extends around the areola and down the center of the breast. This is an excellent option for moderate lifts.

Anchor pattern

An anchor pattern breast lift has a circumareolar component, a vertical component, and a small horizontal component hidden underneath the breast. This is the best option for very large breast reductions or very droopy, pendulous breasts.

Scars for all types of breast reductions fade significantly and mature over the course of a year, so that regardless of your scar pattern, you can have an excellent result that is individualized to your concerns and anatomy.

If you would like to see me as a patient interested in breast lift, please call my office at 212-452-2400 or email office@LaraDevganMD.com.