Patients, practitioners and pharmaceutical companies shaping the future of medical aesthetics
For this type of patient treatment options can include fat dissolving treatment /fat freezing. Carboxy therapy can provide both small reduction in volume as well as skin tightening, energy-based devices such as HUFU and radiofrequency can help with reduction in fat and tightening the skin. A very effective treatment to reduce double chin appearance can be dermal fillers*. In the hands of experienced and artistic medical aesthetics practitioners they really can achieve a significant reduction. With developments in technologies, we now have products with an excellent safety profile, such as MaiLi, which allows practitioners to deliver beautiful, long-lasting results with no or just minimal downtime*. Before treatment, it is paramount to perform a full facial assessment to understand the prospective patient’s injection anatomy, age related changes in anatomy, facial proportions, beautification of the face and product characteristics. Our approach will be completely different if we are to treat a genetic problem or treat age related changes. If the double chin is caused mainly by genetic problems, we can treat just the lower third of the face (mainly focussing on the chin area) by creating length and projection. Whereas if the cause is induced by ageing than we must take a full-face approach and treat the upper and mid third of the face, before treating the lower third, including chin. The age of the patient and clinical presentation usually determines the required volume of product. These three cases are illustrative examples of: • Early age-related changes (pic1 ). Total volume 4ml: 3 MaiLi Extreme and 1 MaiLi Volume. Chin was treated with 2 ml Extreme. • Genetically induced and early age- related problems (pic2). Total volume 7ml: 4 Ml of MaiLi Extreme used to treat the jaw and chin areas. • Complex and quite challenging case where we see a combination of a genetically small chin, combined with establish signs of ageing (pic 3). Total volume 14 ml treatment was performed in two stages. Total
volume used in chin session 1 was 4ml Maili Extreme. Session 2 Maili Extreme 3 ml was used in chin area. The chin has a number of different anatomical subunits: • Labio-mental angle (treatment of this area reduces appearance of mental chris and opens labio mental angle, elongates the chin) • Apex of the chin (elongates the chin and can play a role in slimming the face, giving the face a more v shape) • Anterior pogonion (gives anterior projection to the chin and reduces hyperactivity of mentalis muscle) • Menton (gives anterior rotation as well as tightening submental area, reducing the double chin appearance) • Lateral chin/prejowls sulcus (reduce appearance of double chin and improves definition of jaw line) Usually, all anatomical subunit areas require treatment to achieve balanced and long-lasting results. The typical volume of product to achieve improvements or structure to the chin varies from patient to patient and can range from 2 to 4 mls. In more difficult cases the volume can be doubled, but this needs to be done over multiple sessions. Often the chin and lower third of the face are more sensitive and the patient can be quite aware and sensitive to the filler in the chin area. Therefore, using product which has low G and high E prime is optimal to ensure good tissue integration and patient comfort. That is why my preferred product of choice is MaiLi Extreme for chin treatments. There is so much educational information available to the patients and they often come to the clinic well informed about different treatment options. As a result, it is important to conduct a thorough consultation; providing patients with an understanding of the problem as well as detailed advice about the best treatment solutions. It is also very important to take into consideration patients’ expectations and lifestyles when creating a treatment plan. The patient is often quite surprised by what can be achieved these days without surgery and with minimal downtime.
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BEFORE/AFTER 1 MONTH 4ml total (3ml Extreme, 1ml Volume)
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Dr Olha Vorodukhina
Explore the evolution of medical aesthetics and the role of dermal fillers like MaiLi in treating double chins, as we delve into the latest nonsurgical advancements.
BEFORE/AFTER 1 MONTH 6.7ml total (3.7ml Extreme, 2ml Volume, 1ml Precise)
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PHOTO: ELISA PHOTOGRAPHY, UNSPLASH
W orking in medical aesthetic industry for the last 10 years, I can see how fast and dramatically this industry has changed and grown. Medical aesthetics practice has undergone a dramatic change in the last 3-4 years, as technology has improved which makes our treatments very safe and we see the introduction of new high- quality products like MaiLi that provide patient with natural long- lasting results 1 . Customer behaviour has changed too. I meet more patients who are looking at preventative treatments. Generation millennials want to address problems before they become more noticeable or severe. This generation also often influences their parents to have treatments and take better care of themselves. As a result, we see how more and more patients choosing a non-surgical route over surgical procedures and results of nonsurgical treatments, when they planned and performed correctly, can be sometimes comparable with surgical results * . In this article I will explore and showcase role of dermal fillers in treatments of double chins.
A double chin is a loss of definition of the jawbone and accumulation of fatty tissues in submetal area. It affects both male and female. According to Google 70% of Americans have double chin 2 . While a survey conducted by PR newswire survey reported respondents alter their behaviour to address their double chin 3 . The report cited: • 35% shy away from photos • 35% avoid video chats and conference calls • 29% of men have grown a beard to hide the area under their chin (younger men were more likely to do this than their older peers) Upon evaluation of photographs of individuals with varying levels of submental fullness 78% of respondents admitted they are more likely to notice a double chin on a woman than a man. THERE ARE THREE MAIN CAUSES OF DOUBLE CHIN: • Obesity and excess weight • Genetics associated with bone deficiency in mandible and over projection in maxilla. Typically, these patients will be presented
with dental class II occlusion (overjet or overbite) • Age related changes such as
BEFORE/AFTER 1 MONTH 15.4ml over 2 sessions (4ml Volume, 11ml Extreme, 1ml Define)
weakening of retaining ligaments and displacement of superficial fat compartments If the patient has excessive weight, it will be wise to give them advice on healthy lifestyle and weight management or refer them to appropriate colleagues such as their GP, nutritionist, or fitness coach. Cosmetic interventions will most likely not be effective or ethical in those patients. Genetic problems such as lack of bony projection and class II malocclusion can be successfully treated by a multidisciplinary team: Dentist/Orthodontist to correct the dental occlusion, Max Fax surgeon to perform surgical repositioning of the jaw relationship, Plastic Surgeon to perform a chin implant treatment and Medical Aesthetics Professional to achieve aesthetic improvements with minimal intervention. Age related adiposity of fat in submental area is often result of both the accumulation of undesirable fat and fat displacement. Often it can be exacerbated by loose skin (skin laxity).
The double chin is one of those areas that patients do not expect to go away or reduce after filler placement. I often compare it with a non-surgical rhinoplasty; people don’t know that significant improvements to the appearance in these areas can be achieved without surgery. In fact, we often combine treatment of the chin, lips and nose to improve the patient’s profile (profiloplasty). I am a big advocate of preventative medicine, and in this case, I would say pre-ageing medical aesthetics. I advise addressing the problem before it becomes moderate or severe. The greatest advantage of doing so is that at this stage there are minimal treatment needs and a minimal amount of product is needed to achieve great long-lasting results and happy patients who trust you to guide them on their beautiful, positive and healthy ageing journey.
Actual patient, individual results may vary. 1) Data on file 2) Google 3) https://www.prnewswire.com/news-releases/new-survey-reveals-impact-of-double-chin-on-self-perception-and- behavior-300422717.html *The information of this article has been prepared by healthcare professionals. Any opinions, views, advice provided are those of the healthcare professionals. Sinclair does not provide any warranty and does not accept any liability for the opinions, views or advice expressed.
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