Double chin: the different solutions to get rid of it

Often seen as an unflattering feature around the neck, a double chin is a frequent source of self-consciousness. This cosmetic concern, caused by a build-up of fat cells between the neck and the tip of the chin, can affect both men and women, and at any age. Fortunately, several solutions exist to get rid of this localised pocket of fat. Here are the different surgical and non-surgical techniques to remove a double chin.

What is a double chin and why does it appear?

We speak of a double chin (or submental ptosis) when an excess of tissue, most often fatty, settles between the chin and the neck and blurs the cervicomental angle that normally gives a clean profile. Far from being limited to people who are overweight, this feature affects a large share of the population: according to a 2017 survey by the American Society for Dermatologic Surgery (ASDS) of 7,322 people, 73% of respondents said they were bothered by fat under the chin and neck — a source of cosmetic dissatisfaction as common as wrinkles around the eyes.

Understanding the origin of a double chin is essential to choosing the right solution, because the treatment differs significantly depending on whether it is caused by fat or by skin laxity.

The main causes of a double chin

A double chin can have several origins, sometimes combined in the same person:

• Heredity: a family predisposition explains why a double chin sometimes appears very early in life, including in slim people. The submental area, little used by the muscles, in fact releases its fat with difficulty.
• Weight gain: the accumulation of fat cells (adipocytes) under the chin is one of the most common causes. Conversely, rapid weight loss can leave behind an excess of slack skin.
• Ageing: with age, the production of collagen and elastin decreases, the skin loses its firmness and the platysma muscle of the neck slackens, accentuating the sagging appearance.
• Hormonal changes: at menopause in particular, hormonal fluctuations can promote a redistribution of fat around the face and neck.
• Poor chin projection: when the bone structure is set back (a receding chin), the neck looks heavier even without any marked excess fat.
• Posture: keeping the head tilted forward for long periods — in front of a screen or a smartphone — barely engages the neck muscles and can accentuate the laxity, including in young people.

Identifying the dominant component (fat, skin laxity or a lack of bony projection) helps guide the patient towards the most suitable treatment, from a simple skincare routine to liposuction of localised fat pockets or to re-tightening the skin.

Removing a double chin with plastic surgery

There are several surgical procedures that can remove a double chin and restore a more refined contour around the neck.

Having submental liposuction

To deal with a double chin, the most sought-after plastic surgery procedure remains submental liposuction. Although it is an invasive method, it nonetheless proves to be the most effective technique. During the surgical procedure, the surgeon removes the fat (adipocytes) under the chin by suctioning it through fine cannulas inserted behind the earlobes and under the chin, after small incisions have been made. Skin smoothing can be carried out at the end of the procedure to eliminate any irregularities. This process redraws the oval shape of the face, harmonises its contours and restores a well-defined cervicomental angle.

Neck liposuction is performed under local or general anaesthesia depending on the type of procedure and the patient’s profile. It usually lasts around thirty minutes and is carried out painlessly for the patient, who can leave the hospital a few hours after the operation. A compression dressing is applied at the end of the procedure and must be worn for 3 days. Bruising and swelling of the neck may be observed for a few weeks, which means the final result is not yet visible; it can be truly appreciated 3 to 6 months after the procedure.

Combining liposuction with re-tightening of the skin

Liposuction of a double chin is intended for people with a particularly visible pocket of fat around the neck. It is sometimes combined with liposuction of the cheeks when the patient has jowls (sagging fat at the cheeks). Liposuction of a double chin also requires good skin quality and, in particular, the ability to retract so that the skin can settle back satisfactorily over the cervical muscles and the floor of the mouth. Otherwise, it is possible to re-tighten the skin of the neck, which can be done:

• scarless thanks to J-Plasma Renuvion technology, which uses radiofrequency combined with helium gas to significantly raise the temperature beneath the skin and produce a mechanical retraction effect on the dermis. This minimally invasive technique is therefore also described as a scarless facelift;
• with a scar, through a cervical lower-face facelift, which is notably required when patients have an overly marked slackening of the neck skin.

Removing a double chin without surgery

For patients who do not wish to undergo a surgical procedure, it is also possible to deal with a double chin through various methods, whether aesthetic medicine or other practical tips.

Turning to aesthetic medicine

Several aesthetic medicine techniques are now available for patients wishing to get rid of neck fat, such as cryolipolysis, radiofrequency, deoxycholic acid injections and the mesolift.

Cryolipolysis: using cold to melt away neck fat

Cryolipolysis is a method of destroying fat cells through the prolonged action of cold. It can target localised bulges through a process of cellular suicide called apoptosis, during which 20 to 40% of the targeted fat cells self-destruct. This is referred to as cell lysis of the adipocytes.

During this procedure, the plastic surgeon lowers the temperature of the fat cells over a defined area using a special device (CoolSculpting® or CoolTech®, in particular) applied directly against the skin on the area to be targeted. The temperature is then lowered to -11 °C. This method can eliminate up to 40% of the fat cells located between the neck and the chin. The procedure is completely painless, requires no anaesthesia and lasts about an hour. A second session may be needed for an optimal result. To see the final results, however, you must wait 6 to 12 weeks for the lymphatic system to drain the destroyed adipocytes.

Using radiofrequency

Deep radiofrequency works like a device placed on the neck that uses electrodes to heat the area where the double chin sits. The repeated electrical stimulations help to melt the fat through a natural reaction of the skin which, by resisting this stimulation, tightens, becomes smooth again and naturally eliminates the adipocytes. It is a completely painless and safe technique, since the temperature at the surface is generally limited to a maximum of 40°. In fact, it is deeper down, in the dermis, that the temperature really rises, reaching up to 65° and melting the fat cells. This method is particularly recommended for slackening of the facial oval with relatively few fat cells; the QUANTUM RF method, which harnesses radiofrequency to firm the skin, is based on this same principle.

Deoxycholic acid injections

Less well known in France, the deoxycholic acid injection is nonetheless the first molecule to have received, in 2016, a European authorisation specifically dedicated to treating submental fat (marketed under the name Belkyra®, or Kybella® in the United States and Canada). This acid reproduces a substance naturally present in the body that takes part in the digestion of fats: once injected under the chin, it destroys the membrane of the targeted adipocytes, which can no longer store fat. The treatment, carried out over several sessions a few weeks apart, is intended for moderate to severe double chins of a fatty nature; it is restricted to physicians and requires a prior assessment, as it does not correct skin laxity.

The mesolift technique

The mesolift technique using mesotherapy is, this time, recommended when the double chin is caused mainly by skin laxity. During the procedure, the practitioner inserts a very fine needle into the area concerned. This is used to inject a cocktail of boosting and revitalising products for the skin, such as hyaluronic acid, antioxidants, vitamins, amino acids, trace elements and minerals. These ingredients then act as an immediate tightener and trigger a process of cell renewal that restores all its tone to the skin of the neck.

The mesolift technique treats skin laxity in a localised way. The patient can see the effects of the treatment relatively quickly, after 10 days. This treatment does not, however, provide a lasting result and must therefore be repeated frequently, with a course of 4 to 6 sessions spaced 15 days apart. When the laxity is more pronounced, placing absorbable thread lifts to re-tighten the facial oval is an alternative for redefining the jawline.

A few tips and treatments to reduce a double chin

When a double chin is linked to ageing or to skin laxity of the face and neck, adopting a skincare routine can help to prevent or partly repair this unsightly concern. These measures remain limited in their effectiveness, however, and do not replace medical treatment once the pocket of fat is established.

Restoring skin tone with facial exercises

Through ageing or following a diet, the muscles of the skin tend to droop and slacken. To help the skin regain its tone, do facial exercises regularly. You can perform these exercises in front of the mirror to better see their effects. Keep your head straight, lower your shoulders and try to stick your tongue out as far as possible. Repeat this about ten times. Then rest your chin on the palms of your hands. Apply several presses for 20 seconds each. Natural techniques generally take longer to take effect. If you choose this alternative, you will therefore need to arm yourself with patience and discipline to obtain visible results.

Using a firming cream and turning to massage

In the cosmetics aisle, there is a variety of slimming and firming creams available in pharmacies that can help reduce a double chin. To aid its penetration and effectiveness, apply it working from the chin towards the chest. If you incorporate it regularly into your beauty routine, morning and evening, you will manage to obtain satisfactory results. Some physiotherapists can prescribe mechanical massages to smooth the neck and redensify the skin.

Having an intra-oral massage

When facial laxity is the cause of the double chin, it is possible to re-tone the skin with an intra-oral massage, which can be performed in certain specialised beauty salons. As part of this procedure, the beautician carries out lymphatic massages all along the jaw, the aim being to eliminate toxins. The practitioner then puts on latex gloves and performs a massage by placing their fingers inside the patient’s mouth, working with movements from top to bottom. This procedure engages the muscles of the cheeks. As a rule, this kind of treatment should be carried out every 15 days for women over 35. For younger patients, one session a month is amply sufficient.

Using tricks to disguise a double chin

To soften the appearance of a double chin, you can « cheat » a little with your haircut. If you are short of inspiration for a cut that can create the illusion, ask your hairdresser’s advice. You can also disguise this imperfection with good make-up. In that case, work with contouring and play with shadows. To do this, use different shades to create an optical effect. Finally, men also have the option of hiding a double chin by growing a beard.