How to Get Rid of Double Chin

At your age, double chin does not refer to excess skin, loose skin, "turkey wattle," or premature aging. Genetics plays a large role in where and how much fat is deposited in certain areas of the body, and whether or not it is "diet and exercise-resistant."

The fat beneath the chin that gives one a "double chin" is more accurately termed submental fat. There is both superficial or subcutaneous fat (beneath the skin but above the platysma muscle), and deeper fat beneath the platysma, which is the flat, sheet-like muscle along the front surface of the neck. This muscle often causes neck "bands" as we age, and the anatomy of the submental platysma is variable.

Why this is important is that a "double chin" may have some or all of these anatomic factors, and "liposuction under the chin" may not even address the real issue(s) that give you the appearance that you wish to improve.

I have performed thousands of liposuction procedures and taught liposuction for over two decades, so I have extensive experience with this in the neck area. I tell you this because over the years I have found that liposuction alone can give suboptimal results, including lumps, irregularities, and just inadequate improvement. Liposuction cannot be used safely for the sub-platysmal fat, so if this the predominant cause of the neck fullness, this will go unimproved. Another reason for "suboptimal" outcome!

As a solution for these procedural inadequacies I have found that treating the submental area in the same way I treat the neck when I do facelift surgery gives me consistently better results. In other words, with a 2cm submental incision as I do with my facelifts, I can thoroughly and evenly excise the subcutaneous fat under direct vision, carefully cauterize all bleeders, and also take out fat beneath the platysma if necessary or desirable for better results.  I can also suture the front edges of the platysma if necessary (platysmaplasty) to diminish the neck bands, which further smooths and tightens the neck and under-the-chin areas. This takes about 45 minutes (under general anesthesia or IV sedation), and gives my patients a much better result than I previously ever achieved with liposuction (even ultrasonic or smartlipo) alone. The cost is similar, and I have happier patients with better results and fewer re-do surgeries. (The slightly longer scar is just as imperceptible as a shorter scar in the same location--I use only under-the-skin dissolving sutures, and most heal this area beautifully!)

If needed, an anatomic chin implant can be placed via this same incision, tightening and restoring the jawline and filling in the pre-jowl area in patients that would benefit from this. This adds about 30 minutes to the procedure and does not lengthen the recovery, but can significantly enhance the results in appropriate patients!

Liposuction is technically pretty easy, and it's often what patients ask for, but in my humble opinion, it is not really the best, and this area of the body is critical to our appearance and youthfulness. Consider this option and ask your surgeon if he or she is comfortable with this approach. Best wishes! Dr. Tholen

For submental fat that is resistant to healthy diet and exercise, there are alternatives that can significantly improve the neck and chin appearance. To create a beautiful silhouette, I recommend neck liposuction, the gold standard of fat removal. This is accomplished with a procedure that removes the unwanted fat with a tiny cannula, which allows for the most control, and leaving behind a beautifully sculpted neck.  There are also nonsurgical methods available to help.

This fat is genetic, persistent and difficult to get rid of without directly taking it out. The good part of that is that it can be used to augment other areas of the face. This will then have a higher likelihood of living in that location. A couple other things that come into play the position of certain bones and muscles. Particularly the hyoid bone has implications about how much the neck can be improved. You would need an examination by a surgeon with a facial analysis for that. Also the platysma muscle has implications in neck definition and some times a platysmaplasty can help with that. I recommend seeing a surgeon who does a lot of neck lipo and sculpting to get an idea of what can be obtained.Hope this helps.Best of luck,DrC