I am only 26. Is this a double chin or sagging skin after weight loss? (Photo)

Question

At a normal BMI now but have always had this persistent double chin even as a child. My jawline is good but disappears if I look down. There is also a heaviness to my lower face (jowls) which I don’t like. Am I candidate for submental & neck lipo or should I invest in getting a platysmaplasty or some type of lift? What about parotid/submandibular gland Botox? I don’t want to get buccal fat removal or jaw Botox because it can age you and worsen jowls/lower face droopiness. Thank you.

Lucian Ion, FRCS · Answer

Thank you for your inquiry and for sharing your photographs.

The images suggest predominantly digastric muscle fullness and a small amount of central fatty tissue under the chin, situated deep in the platysma. This would not be influenced by the Botox treatment to the submandibular glands, which appear relatively small. The parotid glands are not oversized, and the fullness that you see laterally when you bring the chin down is purely due to the superficial soft tissue layer.

In the submental region, the volume that you see on neck flexion is an increased projection of the floor of the mouth, pushing the digastric muscles and central fatty tissue down. You can also note that there is a slight increase in the prominence around the submandibular glands, but it is not very visible.

Liposuction under the chin has relatively little to offer in your situation. A small amount of liposuction along the jawline can be carried out and produces a sharper appearance along the area as the skin elasticity will work with the liposuction. If you want to address the volume of the digastric muscles and deeper seated central fatty tissue, an anterior neck lift procedure can potentially help. It does, however, a 3 cm incision and therefore a scar under the chin for access.

The lower face / neck contours are relatively good, so no intervention is also a sensible alternative.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing the details and the photo — it really helps to understand what’s going on. From your description, it sounds like you have a combination of factors contributing to the lower face appearance:

Persistent submental fullness (“double chin”) – since you’ve noticed it even as a child, there’s likely a component of genetics and fat distribution under the chin.

Mild lower face heaviness or jowling – this can become more noticeable after weight loss, even if your skin still has good elasticity.

Given your age (26) and the fact that your jawline is good when looking straight ahead, you likely still have relatively good skin elasticity. This is important because it affects how well the skin will retract after any procedure.

Options to consider:

Submental and neck liposuction: This can be very effective for reducing a localized fat deposit under the chin. Since your skin is still fairly young and elastic, you may get a nice contour without needing a more invasive lift.

Platysmaplasty / surgical neck lift: Usually reserved for more advanced sagging, significant jowls, or older patients where skin and muscle laxity is more pronounced. At 26, it may be over-treatment unless your skin shows very little recoil.

Botox in parotid/submandibular areas: This is generally more for shaping the lower face in certain contexts (like masseter reduction or subtle contouring), but it won’t significantly address a double chin or jowl heaviness.

You are right to avoid buccal fat removal or jawline Botox if your concern is jowl formation and lower face droop — those procedures can accentuate sagging if done prematurely.

Overall, submental/neck liposuction is likely the most targeted, effective option for someone your age with good skin elasticity. Surgical lifts or platysmaplasty are usually not needed at this stage unless there is more pronounced laxity.

If you want, I can break down what recovery and expected results look like for submental liposuction specifically, so you know exactly what to expect.

Raffy Karamanoukian, MD, FACS · Answer

Ultherapy is a non-invasive procedure that lifts the neck, chin and brow, and improves lines and wrinkles on the upper chest. As we age, collagen breaks down, resulting in loss of skin strength and elasticity. For tissue tightening, Ultherapy is ideal for the lower face and neck and we often combine it with CO2 laser or Morpheus8 to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Eric M. Joseph, MD · Answer

Buccal fat removal does not appear to be the correct option for you. The most common cause of your double chin would be a bit of congenital excess fat underneath your chin. Well performed liposuction may help to improve the appearance of your jawline. I hope this helps. Sincerely, Dr Joseph

Reza Nassab, FRCS (Plast) · Answer

You are young and there is some mild amount of fullness under the chin. This is more likely to be fat rather than the platysma which is an issue in older patients. The liposuction helps reduce the fat. There are some other treatments such as the Facetite that also help achieve some skin tightening.

Mats Hagstrom, MD (license on probation) · Answer

Your chin and neck look perfect and I see absolutely no indication for surgical intervention.I think surgery can only leave you disappointed at this point.Best,Mats Hagstrom MD

I am only 26. Is this a double chin or sagging skin after weight loss? (Photo)

Answers (6)

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