Double win

Dr Judy Todd tells us how she combined minimally invasive liposuction with RF microneedling for ultimate results with little downtime

DR JUDY TODD

Dr Judy Todd runs Synergy Clinic in Glasgow. She graduated from the University of Glasgow Faculty of Medicine in 1995 and started her career in aesthetic medicine in 2005. She is also a consultant anaesthetist with the NHS and a Fellow of the Royal College of Anaesthetists. Follow her on Instagram: @dr_judy_todd

CONSULTATION

My patient was 45-year-old Lauren Simon, who appears on reality TV show The Real Housewives of Cheshire. She came to me wanting to rejuvenate her appearance following her divorce, specifically concerned with redefining her jawline, reducing submental fat under the chin and generally improving her skin texture.

From my initial consultation I could see that Lauren was a good candidate for FaceTite. She had moderate amounts of loose skin and excess fat on the face and neck. The deposits of fat were located under the jawline, which gave her a double chin, and there was a moderate degree of skin laxity. Due to her olive skin, she didn’t suffer from fine lines but there were enlarged pores and a pronounced nasolabial fold, both of which could be significantly improved with Morpheus8 radiofrequency microneedling and FaceTite non-surgical advanced contouring, both treatments from InMode. For the loose skin and excess fat, we opted for a combined treatment of FaceTite and NeckTite. This combined therapy of the three procedures is known as Refine RF in the US.

FaceTite is a minimally invasive advanced contouring system that uses a cannula inserted below the skin to “burn away” fatty tissue, employing a directional radiofrequency thermal field which reduces fat coagulation and provides tissue remodelling. There is a dual-temperature system which provides greater safety and control, focusing the energy concentration in the treatment zone. NeckTite works in a similar way but focuses on the fatty tissue under the jawline and chin. The system automatically shuts off when it reaches a maximum temperature and issues an alert noise to the aesthetician, and there is also a guide on the exterior which shows the exact position of the cannula tip.

All treatments were to be conducted at the clinic on the same day, with the total treatment time projected at just a little over two hours.

Left: before, 

Right: three months after treatment

TREATMENT PLAN

Lauren was given tumescent anaesthesia under the jawline and around the cheeks to prepare her for the NeckTite and FaceTite procedures. This also provided hydrodissection for the cannula to navigate through the subcutaneous fat layer. The treatment is minimally invasive and is, in my opinion, the next best alternative to facelifts without the invasive surgery. First, I performed NeckTite to the fatty tissue under the jawline and chin. Then, moving onto FaceTite, the cannula went in close to the ear and was then moved across towards the nose within the fat layer above the SMAS. Between four and five movements were applied in a fan-like shape so that the whole of the cheek area was covered, and this was repeated on both sides of the face. Total treatment time was around an hour including the anaesthesia. At all times Lauren was conscious and comfortable; she was aware of the procedure but not in any pain. Approximately 15-20ml of fatty tissue was extracted from the jawline and cheeks with some gentle liposuction. Aspirating some of this reduces downtime and postoperative swelling.

The Morpheus8 treatment followed immediately afterwards. The tumescent anaesthesia provided adequate pain relief in the lower face, but Lauren’s upper face was prepped with an anaesthetic cream an hour prior to treatment. The treatment itself lasted around 45 minutes with the microneedling conducted at two depths, at 0.4mm for fat contraction and at 0.2mm for skin rejuvenation and contraction of pores. For me, one of the great advantages of the Morpheus8 treatment is that I can provide skin tightening right into the delicate eye area, and Lauren had the treatment on the lower lids and to reduce crow’s feet at the sides of her eyes.

RESULTS

After the treatment, Lauren was given a compression bandage for her face which she was told to wear for the next few days. She was concerned how long the downtime would be as she leads a very active social life, but it was only a little over 24 hours in her case; she had the treatment on Friday afternoon and was able to enjoy a Sunday lunch out with friends the same weekend.

Lauren is thrilled with the results of her treatment; her jawline is much more pronounced, her skin texture and pores are hugely improved, and the double chin has been almost entirely irradicated. The time for the results of the procedures to fully develop was just under three months. There is some initial swelling from FaceTite post-procedure, but this goes down quickly and then the contraction takes a couple of months to finish. The treatments have given Lauren so much more confidence to get back out again socially after a difficult divorce and have truly given her a new lease of life. She is so grateful for everything we’ve done for her.