Double Chin is Too Firm to Be Fat. How To Create More Definition?

It sounds as if you might need a limited necklift type of procedure which would include a platysmal tightening procedure. The firmness you are talking about could be related to a deeper type of fat called pre-platysmal fat. You might also benefit from a chin implant to strengthen your neck and jaw line if there is a deficiency there. Anyway, it is hard to say for sure without photographs and I would recommend you have a consultation to gather more information.

For a more defined jawline to strengthen your profile (and help prevent the dreaded jawline "jowl" sagging), we use injectable fillers like Revanesse Versa - a filler known to limit swelling and give subtle, soft enhancements - or Radiesse. Using a cannula to limit pain and swelling, we inject on the bone in strategic points to get more lift and shaping, resulting in a more contoured lower face and defined, structured jawline. I would suggest getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

  It is hard to offer advice without seeing photos and I admire the other doctors who have replied for their efforts to help.  Given the platysmal bands, I agree that neck surgery may be beneficial. even if you do not have fat in your neck.

A double chin can be improved with a neck lift or even a chin implant. It depends on your facial features and the quality of your skin. In many cases as it sounds like with you, excess fat it not the problem and other corrective procedures are more often helpful than simple liposuction to the area.

Neck Lift (Cervicoplasty / Platysmaplasty): restoring elegance to the face

Though it is not technically part of the face, a neck with loose, sagging skin can age the face dramatically. A neck lift is a standard part of most facelift surgeries, as the neck skin is mobilized in continuity with the lower face.

Immediately under the skin of the neck is the platysma muscle, which you can easily see in a mirror when you clench your teeth and tighten your jaw. In youth, this paired muscle meets in the midline below the chin. With age, the right and left sides of the platysma often separate, producing vertical 'cords' in the anterior neck. The platysma can be divided anteriorly and tightened during neck lift cosmetic surgery to permanently eliminate these 'cords' and improve the neck contour. One tightened in the midline below the chin, lateral traction on the platysma then creates a 'sling' which elevates the soft tissues below the jawline.

Cervical / submandibular liposuction

Some individuals have 'sagging' necks primarily due to fat accumulation below the jawbone (mandible). In some cases, liposuction alone can significantly improve the neck appearance. Liposuction is also frequently combined with surgical neck rejuvenation, and in selected cases some direct excision of fat (through a hidden incision below the chin) is performed. The reduction of fat in the area below the jawline and in the anterior neck almost always makes the neck appear longer, and makes the patient's profile appear more elegant or refined.