These before and after photos show the difference a year can make in a patient who received liposuction and Renuvion of her neck.

1. Can I do anything about the lines around my mouth?

The treatment depends upon how bad the wrinkles are and how much time one has for recovery.

The simplest treatment that can be done at the same time as the consultation would be “fillers” and a very small amount of either Botox or Dysport to weaken the muscles causing the wrinkles. No recovery time is needed. These treatments are reserved for mild-to-moderate wrinkles.

For more advanced “barcode” wrinkles, the best treatment is the Deca laser using the advanced settings. This can virtually eliminate the wrinkles, but there is recovery time needed due to swelling and pinkness.

The pinkness can last for several weeks, but can be covered with makeup after the first week. Sun blocks must be used until the pinkness is gone.

2. What can be done about a double chin?

Double chins can be from excess fat, aging or sun damage to the neck, and in some cases due to lack of prominence of the chin. As expected, the type of treatments needed are based on the underlying problem(s).

If the neck problem is only excess fat, often genetic, the treatment requires liposuction. If it’s expected that liposuction will leave loose skin, then Renuvion done at the same time will tighten the skin.

The Renuvion probe shrinks collagen and skin with instant intense heat, like micro-bolts of lightning. This can be used to tighten skin virtually anywhere.

For severely wrinkled neck skin a proper laser can do an excellent job. This is often combined with the Renuvion. These can be done under local anesthesia as are all of the above-mentioned procedures.

If the patient has microgenia (small chin), correction can be done with long-acting fillers or a chin implant. The benefit is immediate, making the neck-jaw ratio more normal and also tightening the neck. It is often used with other procedures, and can make a dramatic improvement, particularly in one’s profile.

Last, of course, is a face-and-neck lift. When both face and neck sag beyond what can be treated with non- or minimal-surgery techniques, then surgical options are needed for the best result. This requires general anesthesia, and the recovery time can be two to three weeks.

There are different degrees of facelifts, geared toward the individual’s problems, and what they see as their main goals. Since a major part of sagging of the face is from loss of volume, most facelifts do involve some volume enhancer, usually fat grafts (fat transfer) or fillers.

Properly done, facelifts should make the patients look younger and better, but not different (too pulled, or looking “face-lifted”).

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton. fingerandassociates.com