HIFU or High Intensity Focused Ultrasound is also known as Microfocused Ultrasound. The two stand out devices are Ultherapy & Ultraformer III. I use the former for lower face lifting, whilst the later can be used for double chin reduction. It works by delivering energy below the surface of the skin, into the fatty tissue damaging the fat (off label).

On label treatments contract the collagen under the chin & neck area. This provides skin tightening. In most cases one treatment is required. I often combine this with liposuction to achieve better results.

I totally get non-surgical treatments as these are less invasive & less scary (hence why I offer half a dozen alternatives to treat double chins). The flipside is that I prefer liposuction for the following reasons-

Predictable outcomes: Other treatments rely on your immune system to remove fat. Liposuction relies on me to physically remove fat. I trust my skill sets more than your immune system. On average I remove between 20 ml to 140 ml of fat from the under chin area.

Only one session needed: 95% of patients require only one liposuction procedure. This compares favourably with Belkyra (2-4 sessions), & Coolsculpting (2-3 sessions).

Fast recovery times: Believe it or not, the recovery is over 8 times quicker than fat dissolving injections. After liposuction, you are in a neck support brace for 24 hours. There after it is worn at night for another week. Swelling goes down within 36 hours post surgery. Bruising takes a little longer.

No pain: Seriously, this treatment is painless (unlike fat dissolving injections). I perform this procedure under mild sedation. The entire procedure is well tolerated.

Skin tightening: Liposuction can provide skin tightening via controlled dermal remodelling. In some cases I use RF during the procedure, in other cases I use HIFU. These procedures act synergistically with liposuction to contract collagen in the neck & under chin area.

More cost effective: It is not uncommon liposuction patients to have trialled (and failed) all non-surgical modalities. By the time one adds up treatments & time taken off work, liposuction is still one of the most cost effective & clinically effective treatments for double chins.

Yes. Threads have a somewhat predictable outcome if used correctly. Namely in patients with little sun damage & mild to moderate laxity. I use both monofilament PDO MINT threads as well as suspension threads. I also combine threads with devices like HIFU, RF, & other skin tightening methods.

The downside of thread lifting is the limited duration of efficacy, they typically last 3 to 6 months. A one year duration is exceptionally good, rather than the rule.

RF microneedling can tighten loose skin under the neck. The best system is Morpheus8 as it is the only system that has a penetration depth of 7 mm.

RF devices are best combined with other modalities including collagen stimulating fillers, threads, & lasers.

The device of choice is NuEra, Tempsure or Pelleve as I have stopped performing  Thermage a year ago. Here is my reasoning-

• RF delivers heat. This contracts collagen & provides skin tightening
• Heat can be delivered slowly with multiple sessions – Pelleve or Tempsure
• Heat can be delivered fast in one session- Thermage
• Slow heating gives more predictable results, namely Tempsure or Pelleve
• Slow heating is more cost effective
• If I require fast high power heating, I do it with ultrasound guidance, namely Ultraformer III or with Ultherapy

*The main reason I do not recommend Thermage is the fact that like all other skin tightening devices, patient selection is critical. The cost to the patient for a single treatment (which has a true efficacy rate of around 20%) is enormous. In truth, Tempsure has a similar efficacy however it is much more cost effective (and comfortable) for the patient. If I require significant tightening in the correct skin type (thick dermis, little or no sun damage), I prefer HIFU devices such as Ultherapy.

The majority of results are long lasting. The most predictable results are with liposuction as I am physically removing between 20 to 100 ml of fat from the area. This means fat cells are physically extricated. The remaining fat cells do not multiply, so by definition the results are permanent.

The caveat is that the remaining fat cells (approximately 10% of adipose tissue), may increase in size with lifestyle changes. Hence if you gain weight (fat), these cells may increase in size, but not number. Keep your lifestyle healthy, & this is not a problem.

What is a problem is getting older. This I have no miracle fix for. Remember the second aspect of treating the submental area is skin & tissue laxity. Over time tissue will loosen. The speed of loosening & collagen breakdown is determined by your genetics (I don’t control this) and your lifestyle choices (smoking, UV, increases collagen breakdown).

Another important fact to grasp is with bone resorption with age. 2 key elements to consider are chin projection & jawline definition. Reduction in bone mass will result in loss of traction of the skin for the under chin area. Solution? Dermal fillers. If you are opposed to dermal fillers, consider seeing a maxillofacial surgeon for implants.

This is an easy concept to understand. Having a small or recessed chin & poor jawline definition results in a poor support for the underlying chin area.  If you provide traction & support in these areas you ‘stretch out’ the skin overlying the double chin. Think of it as countertraction when you support a tent.

By building up a recessed chin you place traction in an anterior or forward vector. This stretches your under-chin skin forward. By supporting & contouring your jawline area, it provides lateral support to stretch skin sideways (on both sides).

I use dermal fillers to recreate contours & re-volumize. In some patients this may be enough to reduce the look of submental fullness without actually removing the fat.

You can potentially reduce your double chin by losing weight. More importantly, to maintain the effects after liposuction & other fat removing methods, keeping a healthy BMI will ensure that fat cells do not increase in volume.

Sun protection is especially important in Brisbane & the Coast as UV damages collagen. This results in skin laxity of the face & neck, accentuating the bulge of double chins. Simple sunscreen coupled with skincare vitamins will prevent further damage.

The cost depends on the extent of your double chin & the complexity of treatments. Surgical options such as liposuction are usually more cost effective because it requires only one treatment. Results are predictable. Non-invasive treatments typically require 2-4 sessions. To see what treatment options are available, book for a FREE* consultation with my nurses & clinical team.

As a guide:

Fat dissolving injections: $990 to $1300 per application (2-3 required)

Fat freezing: $750 to $1500 (depending on number of cycles & applicators)

Dermal fillers: $750 to $1290 per ml (nurse vs myself)

Ultraformer III & Ultherapy: $ 700 to $1990 (depends on the extent)

Thread Lifts: $990 to $2990 (depending on number of threads)

Liposuction: $3990 to $5990 (depending whether I use skin tightening as well)

RF Tightening: $790 to $990

RF Microneedling: $990 to $1990