Getting Rid of that Pesky Double Chin—what is the right treatment for you?

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By now most of us have heard of celebrities and models who have undergone non-surgical skin tightening or fat removal.  The buzz last year about the Baldwin cousins who had a non-surgical treatment for their double chins got me thinking about treatment options for the double chin in 2023.  

As a facial plastic surgeon, I initially was skeptical of any non-surgical treatment that could result in truly noticeable results.  It was the along the lines of thinking ‘if it sounds too good to be true, it probably is’.  A decade ago, this overall was the case.  Devices that claimed to remove a double chin (submental fat) would have unreliable results, so it was hard to counsel patients as to whether or not a treatment was recommended for them.

Surgically, submental liposuction is one of the most straightforward and reliable techniques to remove a double chin (which in medical lingo is called “submental adiposity”).  In this procedure, a small incision is made just under the chin and then the fat that sits under the skin is suctioned and removed.  It is a relatively quick and safe procedure, and results are seen nearly immediately.  One downside to liposuction is that if someone is a bit older and/or has aged skin in the neck (and is not having additional surgery such as a neck lift), that skin may not retract, so they may be left with a bunch of loose skin under the neck—their double chin is still there just without the fat.

Non-surgical treatments to remove submental fat or a double chin are available and are great in that they give people options for treatment that doesn’t involve surgery and also opens the door to remove that pesky double chin for those people who wouldn’t be good candidates for liposuction.  Injections such as Allergan Kybella® (deoxycholic acid) rid the body of fat cells and treatment may take several sessions spaced out every 2 months or so.  Other devices freeze the fat transcutaneously (the device is held on the skin under the chin).   

Fast forward to 2023, and there are newer (and I dare say better) non-surgical devices that can be used to target the stubborn subcutaneous fat in the upper neck, aka a “double chin”.  These devices show reliable and reproducible reduction in subcutaneous fat with the added benefit of improvement in skin tone and tightness.  By and large, these devices fall into two modalities:  radiofrequency (RF) and ultrasound (US).  Within each modality, companies have developed different mechanisms to deliver the energy, and so we have a bunch of devices to choose from, including Candela Profound® RF Microneedling, which is my favorite.  

So, should everyone out there who hates their double chin run to get treatment too?  Maybe, but I’d recommend doing your homework and consulting with a facial plastic surgeon who can listen to your concerns and give recommendations based on your particular situation and goals.  Remember- not every treatment, whether it is surgery, an injection, or a non-surgical device, is right for everyone.  This is why it is super important to consult with a medical professional who is appropriately qualified and also has experience with several of these options so that you get the best results possible with the smallest chance of complications.


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