By Colette House

You work out. You eat right. And those problem “fat” areas remain.

After years of successfully freezing and killing fat cells in the abdomen, love-handles, and thighs dermatologists and plastic surgeons are ready to rid patients of that stubborn double chin.

Zeltiq’s CoolMini, a new application for their CoolSculpting machine, recently received FDA approval to tackle fat removal from underneath the chin. This is the second device approved to reduce “submental fat,” the textbook description for the fat that causes a double chin.

Kybella, a deoxycholic acid injection administered by a doctor, was the first treatment to receive FDA approval in April for the removal of submental fat.

“It’s exciting. Just one year ago the only option was neck liposuction,” Dr. Vic Narurkar, chairman of dermatology at the California Pacific Medical Center in San Francisco. Patients are increasingly asking for surgically non-invasive alternative fat removal procedures, Narurkar said.

With the development of Kybella and the CoolMini, Narurkar said he can help his patients meet their goals. He said he is is optimistic about the results both treatments can yield.

Kybella is injected into the patient after the trouble spot, or “pinchable fat” has been marked underneath the chin. During a 20-minute procedure, Kybella permanently kills off the submental fat cells in the marked area. Patients see results after receiving two to four treatments, spaced one month apart, according to Narurkar. In some patients Narurkar said he can see results after a single treatment.

Narurkar said that in addition to permanently removing fat from under the chin, clinical trials have shown skin-tightening effects around the treated area. He said the main drawback to the procedure is swelling that can last several days and that the swelling size depends on dosage amount and how much fat needs to be eliminated.

Narurkar said he suggests using the CoolMini for patients who want to avoid the side effects of swelling. CoolMini is a new applicator for CoolSculpting, a treatment machine that freezes fat cells. Fat cells  are more sensitive to changes in temperature than other cells of the body and the CoolMini freezes them in the area under the chin. During the hour-long treatment the fat cells are frozen and killed, thereby eliminating fat cells from regenerating in the treated area.

“It literally looks like you have a red stick of butter hidden under your skin,” said Narurkar of the 30 to 40 seconds the frozen fat is visible after the treatment. Then he massages it in and the swelling disappears with the fat.

Patients being treated with the CoolMini receive a series of treatments spaced six to eight weeks apart. Dr. Narurkar said clinically significant results can be measured after just two treatments.

Dermatologists have been using CoolSculpting since it first appeared on the market in the early 2000s.

Dermatologists like Dr. Amy Derick use CoolSculpting in private practice for patients looking to reduce muffin tops and other stubborn areas.

“There are visible results after the first treatment,” said Derick, a clinical dermatology instructor at Northwestern University’s Feinberg School of Medicine.

Derick is excited about treatment options for those eager to eliminate their double chins and regain the sharp demarcation between face and neck they had in their youth.

“Having a defined jaw is a sign of youth,” said Dr. Derick, who has seen a huge market for chin reductions recently.

Both Narurkar and Derick noted that even the fittest people sometimes develop double chins. Narurkar said developing fat in this area is largely due to genetics.

“When you look at it, we all have more fat than we think we do,” said Narurkar.

Narurkar cautioned that these non-invasive fat reduction machines are not meant to replace exercise and a proper diet and are more suited for those that are relatively fit and are looking for body contouring and sculpting.

“These are meant for people in good shape and to use on stubborn (fat) areas that you can’t lose,” said Dr. Narurkar, whose most common clients include new moms looking to loose a “baby bump” and men looking to lose love handles.

Both Kybella and CoolMini target small areas of fat. Those looking to target specific areas noninvasively might be better off utilizing one of these treatments as opposed to liposuction, which is meant to treat larger areas such as both contouring of the jaw line and the area under the chin. Cost of treatment varies across the country. In the Chicago area patients can expect to pay between $700-1400 per cycle of treatment depending on the applicator being used.