But what if you’re not sagging so much as blowing up? Double chins, those unwelcome destroyers of august female dignity, also come with advancing years as we naturally gain weight—and our looser skin, weaker muscles, and free-falling fat do their thing. My friend Ann, a 45-year-old publicist in New York, told me that her chin made her look “like a giant baby.” Norman Leaf, a prominent Beverly Hills plastic surgeon, is a fan of treating puffy necks and double chins with SmartLipo, which uses lasers to melt fat and has the welcome side effect of tightening the skin. Ann, who underwent the procedure, noted that “even after I got pregnant and gained tons of weight, it held.” For those without the Cabbage Patch Kid look but some loose fat around the neck, conventional liposuction, too, can wipe out the drop zone. None other than Susan Sarandon, that paragon of graceful maturity, eschewer of Botox and facelifts, recently admitted to having it done.
Plastic surgeon David Rosenberg, one of Manhattan’s acknowledged kings of the natural-looking lift, was one of the few doctors I spoke to who felt surgery was premature during one’s early 40s. “I’d be much more likely to send you to a good dermatologist for a few more years,” he told me. This may sound like good news, but I’ve always been suspicious of dermatological fixes, which are expensive when compared with the results—and usually require the kind of maintenance I don’t have the time or the patience to undertake. Besides, drooping muscles are a big part of the problem here, so what can surface work really do?
It turns out dermatologists do have some interesting alternatives. London-based Jean-Louis Sebagh is a proponent of preventively injecting necks with Botox. “If you start when you’re around 30, you’ll keep the neck and jowl muscles from sagging at all, and you can put off a facelift until you’re 50,” he said. “I’ve done it to myself for 15 years.” Botox can also soften the dreaded V-shaped platysma cords, which are, after all, just contracting muscles. But, Sebagh warns, “if you ignore your neck, as so many women do, and then suddenly pay attention when you’re 48, Botox is not going to help you.” For double chins, a biopharmaceutical company called Kythera is close to releasing an injectable that uses a synthesized form of human bile to dissolve the middle-age dewlap.
I’m not a fan of shooting foreign substances into my body on a regular basis, so these two wouldn’t be for me anyway. Nor would the fillers that are said to tighten the jawline in order to pull up some of the neck sag. But if something is harvested from my own body, I’m all for it. While I was in Los Angeles—that Wild West of self-improvement technology—I paid a visit to Nathan Newman, the Beverly Hills dermatologist who created the Stem Cell Lift. The treatment is, essentially, grafting—injecting fat from, say, your belly into your face to give it extra volume—with the sci-fi twist of adding a dose of your own stem cells into the syringe. Human fat already contains adult stem cells, but, Newman claimed, the extra amount (which he separates from the fat via centrifuge and then adds into what he’s injecting) makes the skin glow more, enhances collagen growth for dewy plumpness, and produces longer-lasting results than a traditional fat transfer. He said that boosting temples, cheeks, and the hollows below the mouth could lift mini-jowls and tighten up the drop zone. Not surprisingly, the use of stem cells has caused some controversy in the world of aesthetic medicine. Last year, the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery put out a joint statement against the marketing of stem cell procedures until more studies can be done. In any case, I wasn’t looking to change the contours of my entire face—just to take care of the area right below it. Moving right along.