Dermatologist Dr. Joshua Fox explains the newest treatments for jowls

A double chin is a common complaint among both men and women as they age, even if they’re not overweight, and for many years surgery was the only effective remedy. For many people this is the first area of their body and face which distorts their self image. “Nowadays, several minimally invasive cosmetic treatments are available to target a double chin or jowls without going under the knife,” according to Dr. Joshua Fox, a New York-based dermatologist and medical director and founder of Advanced Dermatology, P.C.


The newest, non-surgical anti-aging procedure is ultherapy, which relies on high powered ultrasound to tighten and lift the skin. In October 2012 the Ulthera system used in ultherapy became the first device to receive FDA clearance to non-invasively lift the skin under the chin and neck.

“Patients with sagging skin under the chin finally have access to a safe, non-surgical treatment that firms and tightens lax skin,” explains Dr. Fox. “This is not a replacement for a surgical neck lift, but in our experience it works far better than previously available techniques without any cutting or downtime.”

The Ulthera system relies on sound waves to target the tissue underneath the skin’s surface. During the procedure, a hand-held device emits an ultrasound to the skin and tissue beneath your skin, which allows doctors to see the area they are treating. The Ulthera device also delivers heat energy at several specific levels of the skin to tighten the affected tissue without leaving any negative effects. The heat energy causes the skin both to contract and stimulate collagen growth, resulting in firmer, younger looking skin.

In clinical studies, researchers have found significant changes in appearance in 90% of patients who underwent the Ultherapy ultrasound treatment. Specifically, patients report that their jaw is better defined, a lessening of the jaw line, “turkey neck” and double chin.

The procedure takes about an hour with little or no down time. “One 60 minute session is usually all that’s needed to see a visible improvement,” says Dr. Fox.


Liposuction to remove excess body fat is one of the most popular cosmetic procedures in the U.S. The procedure, which involves removing fat has primarily been performed on the abdomen, buttocks and thighs for problems like “muffin top” and “saddle bags.”
In recent years, a laser-assisted liposuction method called SmartLipo has made it possible to use the procedure on smaller, delicate areas like the chin and neck. SmartLipo works by using a calibrated laser to destroy fat deposits through the top layers of a patient’s skin. The laser ruptures fat cells, and the surgeon removes the resulting liquid through a tiny incision in the skin.

“SmartLipo requires a very small incision, and it’s a less invasive procedure so there are fewer risks than traditional liposuction,” explains Dr. Fox. “In general, patients see faster results, experience fewer complications and a quicker recovery time than regular anesthesia.” In addition, SmartLipo patients need only a local anesthetic for this procedure.

Pixel CO2 laser

Various type of lasers (Light Amplification by the Stimulated Emission of Radiation), which focus a powerful beam of light to a specific area, are widely used in cosmetic practices for everything from hair removal to age spots. The Pixel CO2 laser is an updated CO2 laser used to target specific problems including lessening the jowls and improving the angle of the jaw. It can also smooth fine lines, lessens the appearance of acne scars and improves skin tone, to name a few of its popular uses.

Pixel is less aggressive than traditional CO2 lasers and results in much less patient down-time than earlier versions, according to Dr. Fox. In addition, it does not have the high risk of discoloration, long healing times and prolonged redness of the skin.

“The Pixel laser can take years off your face, restoring a more youthful appearance,” says Dr. Fox. “The surface of the skin is revitalized and restored, revealing a new layer underneath while stimulating skin renewal for a softer, smoother appearance. It dramatically lessens jowls and double chins”

According to the American Society of Plastic Surgeons (ASPS), 13.8 million cosmetic procedures (both surgical and minimally-invasive) were performed in the United States in 2011, a 5% increase since 2010. Doctors performed nearly 12.2 million minimally invasive procedures in 2011. Dr. Fox encourages patients to talk with their dermatologists to determine the best plan for addressing their specific cosmetic concerns.

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