Nationally renowned board-certified plastic surgeon, Dr. Rodríguez-Feliz serves local and international clients at his boutique aesthetic practice in Miami, FL. He is one of few surgeons in the United States that after completing his Residency in Plastic and Reconstructive Surgery, pursued further training in Oculoplastic and Aesthetic Surgery under world-renowned plastic surgeon Dr. Mark Codner. Dr. Rodríguez-Feliz chats with Haute Beauty about the latest treatments for skin laxity.
This is a minimally invasive procedure I perform in my office where I combine a three point (multiple-access) neck liposuction and the newest technology available for skin laxity, Renuvion / J-Plasma.
Neck aging has always been one of the main aesthetic concerns for men and women, and it can start showing its signs as early as in their late 20’s / early 30’s. One of the first complains is a double chin. The 2 main components to a double-chin are: excess fat and skin laxity. Presence of excess fat under the chin and jawline, resulting in poor definition of the lower face, jawline, and neck is a common presentation of in those presenting to my office for a comprehensive facial analysis. What a lot of people do not understand is that many times this has nothing to do with weight gain. It can be related to loss of support as the jaw bone continues to resorb and also a genetic predisposition for a particular aging pattern of the neck are. There has been many other non-invasive techniques to address excess fat under the chin such as Coolsculpting or Kybella. From a surgeons perspective, the ability to exactly contour the area to perfection is limited with those other devises. One the other hand, these non-invasive devices do have something in their favor and it is their ability to have an impact in skin tightening of the treated area to some degree. For a lot of patients that absolutely do not want an invasive procedure, this is promising. On the other hand, those that are not concerned about having a minimally-invasive procedure under local anesthesia and twilight sedation, a much more defined and close to perfection result can be achieved combining a multiple-access point liposuction of the neck and Renuvion / J-Plasma, and this is what I call, 3D Neck Liposculpting.
Renuvion / J-Plasma has helped my patients with the skin laxity component which has been one of the most challenging problems to address in plastic surgery. Many times, this is what has prompted a patient to go under the knife and undergo a face neck lift surgery, as there was no other viable way of reliably improving of excess skin in the lower face and neck area.
Now, patients who are not ready to go under the knife and do not have the time for the recovery period that a face/neck lift entails but are looking for some improvement, can be treated with a combination of liposuction and skin tightening with Renuvion / J-Plasma. It has definitely increase the pool of patients that can see an improvement in their neck without the need to have surgery.
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The best candidate is someone with mild to moderate excess fat under the chin and jawline area. In the past, this was limited to younger patients with good skin tone as we had very few options and not as reliable to treat the laxity component in the neck. Now I can treat patients with mild to moderate skin laxity with liposuction and feel comfortable that they will see an improvement once I do a treatment with Renuvion /J-Plasma immediately after I do their liposuction. Those patients with laxity as their only problem, could be treated with Renuvion / J-Plasma as a stand along procedure.
What I like to call our 3D neck liposculpting procedure, is a minimally invasive procedure done under local anesthesia and sedation to improve the lower face, jawline, and neck contour. Three small (3mm) hidden incisions are performed, one under the chin, and one behind each earlobe. First, liposuction is done in those patients with excess fat under the chin. The most important factor to this 3D approach is to address the neck from multiple angles. This is the reason why it is so important to add those extra small incisions behind the earlobes. This is what allows me to get a much better jawline contour.
Once we are done with the liposuction, in those patients with skin laxity, I use do a treatment of Renuvion / J-Plasma through the same small incisions I used for the liposuction. The Renuvion / J-Plasma treatment works as the ionized Helium creates a plasma that heats the fibro-septal collagen network that attaches the skin to the underlying platysma muscle creating immediate skin tightening that continues to improves as time passes.
In general, this is considered a one and done procedure. The removed fat cells will be gone forever, and as long as the patient maintains their weigh, the result will last for a long time. The laxity on the other hand, is something that could progress as the aging process continues its course and patients may benefit from additional treatments in the future.
Recovery time is minimal and very similar to liposuction alone. Some swelling maybe present for 3-5 days. Minimal bruising might be present as we infiltrate the subcutaneous tissue with a tumescent fluid that contains a local anesthesia and a vasoconstricting agent (epinephrine). The patient must wear a neck garment for the first 24 hours at all times, and then at night for 1 week. The skin may feel slightly indurated and will continue to heal over the next 1-2 weeks. There is an initial improvement in skin texture and retraction, but the best results will start to show around 3 months. Skin laxity continues to improve even after 6-9 months.
By Jose Rodríguez-Feliz
January 15, 2020