Thursday, August 13, 2015

Chin up!

"There’s not a damn thing you can do about your neck,” lamented the late great Nora Ephron.
by Delia von Neuschatz

When the late, great Nora Ephron wrote I Feel Bad About My Neck, she echoed a sentiment shared by countless others. And no doubt, her dismay at the paucity of fixes likewise elicited nods of sympathy: “You can put makeup on your face and concealer under your eyes and dye on your hair, you can shoot collagen and Botox and Restylane into your wrinkles and creases, but short of surgery, there’s not a damn thing you can do about your neck,” she laments in her book. Until now that is – at least for double chins aka “fat necks” in Ms. Ephron’s parlance.
The packaging might seem underwhelming (after all, it's intended for licensed health care professionals, not consumers), but the results are anything but.
Kybella, a new injectable which received FDA approval this past spring, melts away “submental fullness” i.e. the fat under the chin. Made up of a synthetic form of deoxycholic acid, a naturally occurring molecule in the body that aids with the breakdown and absorption of fat, it permanently dissolves fat cells, no scalpel necessary.

Your double chin will never return even if you gain weight. Despite the recent FDA approval, however, this is no Johnny-come-lately to the beauty party. “Kybella has been under development for more than 9 years, and has been the subject of over 20 clinical studies involving more than 2,600 patients,” reveals New York City plastic surgeon Steven Pearlman, one of only a handful of doctors trained and authorized by the makers, Kythera Pharmaceuticals, to administer the injections. “They wanted a long history before it went to the FDA.”
Dr. Steven Pearlman: “Kybella is effective, predictable, repeatable and safe.”
Although it’s an in-office procedure which requires no anesthesia, Kybella is not an instant panacea. While the fat begins to dissolve within 10–15 minutes of injection, a series of 2–4 treatments spaced 4–6 weeks apart is required in order to achieve the desired results. Sessions last 20-30 minutes and patients can expect to experience bruising and swelling that can last up to a week. Temporary numbness can also occur. Costs range between $1,200 - $2,000 per session.
The fat is mapped out and then injected by a plastic surgeon or dermatologist in 10-20 locations. Kybella causes fat cells to burst, releasing their fatty contents into the surrounding area. The fat is then naturally flushed out through the body.
Kybella BEFORE AND AFTER. These photos are effective if not appealing.
“People are so happy with it,” says dermatologist Doris Day, another physician authorized to administer the injections. “But, it’s never a one-trick pony. The most important thing is assessment – having someone analyze and see what you need in order to continue to age as successfully and gracefully as possible.” To that end, “with the right combination of Kybella, Ulthera [an ultrasound treatment] and fillers, you will look like you’ve had a facelift,” proclaims Dr. Day, who is currently training other physicians to administer the drug.
Dr. Doris Day: “Fat under the chin is not always associated with excess weight. It can also be genetic.”
Despite the excitement over Kybella, however, it’s important to note that not everyone is a good candidate for the procedure. Plastic surgeon, David Shafer points out that “liposuction is a better option for patients with a large amount of fat and for patients who just want one treatment.” And ultimately, as Dr. Shafer points out, liposuction and Kybella end up costing about the same: “Liposuction may cost more up front but over the course of several treatments of Kybella it may add up to the same or more than chin/neck liposuction would have cost.” A surgical procedure such as a neck lift would also be required for patients with excess skin or sub-muscular (as supposed to sub-cutaneous) fat or an enlarged thyroid or lymph nodes according to Dr. Shafer.

So, what about using Kybella on other parts of the body? “Clinical trials for elsewhere on the body are ongoing,” says Dr. Pearlman. Currently, the FDA has approved its use only for under the chin. Still, prognosis for the popularity for Kybella is so bright that Allergan, makers of Botox, is in the process of buying the California-based Kythera for $2.1 billion in an all-cash deal. Waiting lists at British clinics are already filling up in anticipation of the drug being licensed in the UK.
Not ready for injections or putting a scalpel to your chin? Chin up because there are things you can do at home to improve the appearance of your neck. “The skin on the neck is thin, dry and more sensitive than that on the face. It is in need of a rich moisturizer for sensitive skin. Those that contain mostly natural ingredients and high concentrations of peptides are preferable,” says beauty expert Alyssa Barrie, founder of online retailer Travel Beauty and curator of the NYSD Beauty Shop. She recommends the following creams:
Sapelo Skin Care Rejuvenating Cream Key ingredients include a high concentration of five peptides. The most notable, acetyl tetrapeptide-17 colloidal platinum, is one of the newest and most active cell-signaling peptides available. Studies of this peptide have shown improvement in skin elasticity by 47%, hydration by 33% and wrinkle reduction by 61%. Cosmetics 27 Baume 27 This powerful tissue repairing formula contains 27 ingredients that restructure, regenerate, stimulate, protect, nourish, moisturize and soothe skin.
BEAUTY TIP: Contrary to popular belief, lotion should be applied to the neck from the top down. The fibers of neck muscles run downward and connect to the muscles in the chest. Massaging moisturizer with a downward motion strengthens these muscles and connections. It also promotes lymphatic drainage which activates body fluid circulation and stimulates the immune system.