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Ask Dr. Barber

baberpicQ.  I want to know if there is anything non-surgical that can be done to get rid of fat in my upper, outer, and inner thighs.  I am 39 and exercise but cannot seem to make any progress on my thighs.  I do not want to have surgery but would be willing to consider other alternatives.  

A. You did not provide any information on your weight and height, but assuming that you are close to your ideal body weight, you may be a candidate for Coolsculpting® of your inner and outer thighs.  Zeltiq (the company that makes the Coolsculpting device) has recently introduced a new fat freezing applicator that may help with the outer thigh, which is an area that previously has not been amenable to Coolsculpting.  I have not seen the new applicator as it has just been announced, but we are excited that there is now a non-surgical option for the outer thigh region.

Coolsculpting® is a patented process developed by a Harvard University researcher that uses cold temperatures to freeze fat cells.  When the fat cells freeze, they will die and then be eliminated by the body.  The Coolsculpting process will take anywhere from one to three treatments per site, depending on how much fat you wish to be removed, and each treatment takes one hour.  Most people get the results they are looking for with two treatments per site.  Each treatment will reduce the fat in the specific treatment area by about 22% to 25%.  Treatments are usually scheduled about one month apart to give an opportunity for some of the fat that has been frozen to clear.  There can be mild discomfort in some people but not enough to require pain medication or anesthesia.  There is no down time, so you can expect to return to work or your normal activities immediately.

Q. I recently had a consultation with a plastic surgeon in the Triad area about my neck.  I am interested in doing just a neck lift but I was told that it is better to do both a face and a neck lift together.  I am not bothered by my face and only want the “turkey gobbler” fixed.  This surgeon would not operate on just my neck.  Why? 

 

A. I cannot speak for the surgeon with whom you consulted, so I may not be able to answer your question with total accuracy; however I can make some general statements about the topic that you have raised.  I am consulted almost weekly from patients, both men and women, who ask to have their neck lifted and not their face.  Lifting the neck alone really does not work very well for a couple of reasons.  First, the face and the neck age as a unit, meaning they age together.  To lift only the face or only the neck, will leave you with a bit of “rejuvenation mismatch”.  Meaning for example, a lifted, tighter and more defined neck, with a loose and saggy cheek just is not very aesthetically pleasing.  It may not look like you need a cheek lift, until you lift only the neck, then suddenly the cheek and the neck do not look like they belong together.  Secondly, and more importantly, it is difficult to lift the neck alone without creating a rather odd look in front of the ears.  What I mean by this is that if the neck skin is lifted and tightened, the pulling effect on the neck will also drag some of the cheek skin closer to the ear, creating a gathering or bunching of the skin in front of the ear.  You can demonstrate this effect on yourself by pulling the neck skin tightly toward the back of the neck and watch the skin in front of the ear being pulled and bunched.  That bunched skin must be removed to prevent a rather strange look of excess skin in front of the ear.  If you are not interested in a full facelift along with the neck lift, you can certainly undergo a neck lift with a mini cheek lift.  Perhaps you can seek a second opinion, however, I do believe that the advice you were given is basically sound.

 

William Byron Barber II, M.D.

has been practicing plastic surgery in Greensboro for 20 years and is certified by the American Board of Plastic Surgery.  He is Chief of Plastic Surgery for Moses Cone Health System, and is an active member of numerous local, regional and national plastic surgery associations.

Visit his website at: www.BarberPlasticSurgery.com or e-mail him at: AskDrBarber@BarberPlasticSurgery.com

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