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High-efficiency Combination Treatment of Submental Neck Fullness.
Plast Reconstr Surg Glob Open. 2019 Jul; 7(7):e2306.PR

Abstract

Fat accumulation, skin laxity, and muscle contraction cause aging cervical fullness. Combining botulinum toxin to treat muscle contraction, and technique-oriented microfocused ultrasound for skin laxity, can improve cervical fullness without requiring lipolysis. Gel-assisted depth adjustment (GADA) is a depth-targeting, image-guided approach using an appropriate gel volume to precisely heat tissue layers during real-time visualization.

Methods

A 41-year-old woman presented with moderate submental neck fullness and saggy cheeks. An appropriate gel volume was applied as determined by the targeted tissue layer's distance from the skin. The submental and submandibular areas received 112 lines of 0.9 J/cm2 microfocused ultrasound with visualization (MFU-V) from a 4.5-mm transducer and 0.3 J/cm2 from a 3-mm transducer to treat the SMAS and dermosubcutis, respectively. For concomitant jowling, these transducers delivered 111 MFU-V lines to the lower cheek. Six units of incobotulinumtoxinA was injected in 1 point at the mandible to modulate hyperactive mentalis muscles. The platysma received 10U of incobotulinumtoxinA per cheek, whereas downturned mouth corners received 4U of incobotulinumtoxinA.

Results

One-month posttreatment, submentum improvements included changes of the vertical pogonion position, more mandible angularity, and a straighter mandibular line. Anterior chin projection was more pronounced and the pogonion had more inferior displacement, creating a younger appearance in the chin-neck complex. Patients followed-up for 3 months also demonstrated these changes.

Conclusions

Delivering MFU-V using the GADA technique effectively tightens submental and submandibular soft tissues. When combined with incobotulinumtoxinA, muscles in the chin and perioral area are relaxed. Thus, GADA yields significant clinical improvement and patient satisfaction.

Authors+Show Affiliations

Haute Beauté Skin Clinic and The Bundles Skin Clinic, Taipei, Taiwan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31942341

Citation

Cheng, Carl K L.. "High-efficiency Combination Treatment of Submental Neck Fullness." Plastic and Reconstructive Surgery. Global Open, vol. 7, no. 7, 2019, pp. e2306.
Cheng CKL. High-efficiency Combination Treatment of Submental Neck Fullness. Plast Reconstr Surg Glob Open. 2019;7(7):e2306.
Cheng, C. K. L. (2019). High-efficiency Combination Treatment of Submental Neck Fullness. Plastic and Reconstructive Surgery. Global Open, 7(7), e2306. https://doi.org/10.1097/GOX.0000000000002306
Cheng CKL. High-efficiency Combination Treatment of Submental Neck Fullness. Plast Reconstr Surg Glob Open. 2019;7(7):e2306. PubMed PMID: 31942341.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High-efficiency Combination Treatment of Submental Neck Fullness. A1 - Cheng,Carl K L, Y1 - 2019/07/25/ PY - 2019/01/20/received PY - 2019/04/26/accepted PY - 2020/1/17/entrez PY - 2020/1/17/pubmed PY - 2020/1/17/medline SP - e2306 EP - e2306 JF - Plastic and reconstructive surgery. Global open JO - Plast Reconstr Surg Glob Open VL - 7 IS - 7 N2 - : Fat accumulation, skin laxity, and muscle contraction cause aging cervical fullness. Combining botulinum toxin to treat muscle contraction, and technique-oriented microfocused ultrasound for skin laxity, can improve cervical fullness without requiring lipolysis. Gel-assisted depth adjustment (GADA) is a depth-targeting, image-guided approach using an appropriate gel volume to precisely heat tissue layers during real-time visualization. Methods: A 41-year-old woman presented with moderate submental neck fullness and saggy cheeks. An appropriate gel volume was applied as determined by the targeted tissue layer's distance from the skin. The submental and submandibular areas received 112 lines of 0.9 J/cm2 microfocused ultrasound with visualization (MFU-V) from a 4.5-mm transducer and 0.3 J/cm2 from a 3-mm transducer to treat the SMAS and dermosubcutis, respectively. For concomitant jowling, these transducers delivered 111 MFU-V lines to the lower cheek. Six units of incobotulinumtoxinA was injected in 1 point at the mandible to modulate hyperactive mentalis muscles. The platysma received 10U of incobotulinumtoxinA per cheek, whereas downturned mouth corners received 4U of incobotulinumtoxinA. Results: One-month posttreatment, submentum improvements included changes of the vertical pogonion position, more mandible angularity, and a straighter mandibular line. Anterior chin projection was more pronounced and the pogonion had more inferior displacement, creating a younger appearance in the chin-neck complex. Patients followed-up for 3 months also demonstrated these changes. Conclusions: Delivering MFU-V using the GADA technique effectively tightens submental and submandibular soft tissues. When combined with incobotulinumtoxinA, muscles in the chin and perioral area are relaxed. Thus, GADA yields significant clinical improvement and patient satisfaction. SN - 2169-7574 UR - https://www.unboundmedicine.com/medline/citation/31942341/High-efficiency_Combination_Treatment_of_Submental_Neck_Fullness L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=31942341.ui DB - PRIME DP - Unbound Medicine ER -
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