Double chin after liposuction - what other procedures would make improvements? (Photos)

Question

I am looking for options to resolve a double chin even after liposuction. I had chin liposuction over 4 years ago and I am still unhappy with my jawline and double chin. I am about 10 pounds lighter than when I had the procedure. Both pictures are recent.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing this—this is actually something I see fairly often. Chin liposuction can be very effective, but it doesn’t always fully address all the factors that contribute to fullness under the chin or a less defined jawline, especially over time.

Since you’ve already had liposuction and are now even lighter than before, the persistent fullness is usually due to a mix of factors rather than just fat alone. Common contributors include residual fat, skin laxity, muscle banding, and even the natural shape or position of the chin and jaw.

Here are the most useful options depending on what’s driving your concern:

1. Skin tightening treatments (non-surgical)
If the main issue is mild to moderate skin laxity after fat removal, treatments like radiofrequency tightening (e.g., RF microneedling) or ultrasound-based devices (like Ultherapy-type treatments) can help contract and firm the tissue. These don’t remove fat, but they can improve definition by tightening loose skin.

2. Injectable treatments for contouring
In select cases, deoxycholic acid injections (fat-dissolving injections) can still help small remaining fat pockets, even after liposuction. Results are gradual and require a series of treatments, but they can refine contour irregularities.

3. Chin and jawline filler (structural balancing)
Sometimes the issue isn’t just under-chin fullness, but also a weak chin projection or jawline definition. Strategic use of dermal fillers in the chin or jawline can improve balance and create the visual effect of a sharper profile, even without further fat removal.

4. Submental muscle treatment (if platysma bands are contributing)
If there is visible banding or neck muscle pull, neuromodulators (like Botox-type injections) can soften the platysma activity and improve neck contour in certain patients.

5. Surgical revision options
If there is significant residual fat, skin redundancy, or structural laxity, a neck lift (lower facelift/platysmaplasty) is sometimes the most definitive option after prior liposuction. This addresses both skin tightening and deeper structural support, which liposuction alone cannot fix.

In your situation—given prior liposuction and weight loss—the most important step is identifying whether the concern is primarily skin laxity, residual fat, or structural anatomy. That distinction determines whether a non-surgical tightening approach or a surgical revision would give the most noticeable improvement.

Often, the best results come from a combination approach rather than a single procedure, tailored to what’s actually driving the contour underneath the chin.

Daniel Barrett, MD · Answer

Dear Adventurous61600,

it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Carl Truesdale, MD · Answer

A persistent or recurrent double chin after liposuction is one of the most common reasons patients seek second opinions, and the underlying cause is usually one of three things.
First and most common: skin envelope didn't retract. Liposuction removes fat but doesn't tighten skin. If your skin elasticity was already compromised (age, weight history, sun exposure), removing the fat leaves a loose envelope that hangs as the new double chin appearance. Adding more lipo makes this worse, not better. Solution is a neck lift to remove the redundant skin and reposition the platysma.
Second: subplatysmal fat that wasn't addressed. Standard liposuction removes the fat above the platysma muscle. There's another layer of fat below the platysma that requires open dissection to remove. If this layer is the source of fullness, additional liposuction won't help. Solution is a neck lift with subplatysmal fat reduction.
Third: platysmal banding that became more visible after the overlying fat was removed. Solution is a platysmaplasty (corset technique through a small chin incision) or full neck lift.
What I'd avoid: a second round of liposuction in the same area if the first didn't give the result you wanted. The diagnosis is almost certainly something liposuction can't fix.
Best move: consult with a facelift/neck lift surgeon who can examine you in person. The pinch test and palpation of the platysma give a much clearer picture than photos. Ask specifically about subplatysmal anatomy and whether your platysmal bands need addressing. These are technical details a good surgeon will discuss openly.

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment, we need quality pictures.
Please send us complete sets of before and after pictures from your previous procedure.
If you don’t have before and after pictures from your Liposuction procedure, then ask your provider to send the pictures they took.
You can also look how plastic surgeons take before and after pictures to get an idea of what we need.
Best,
Mats Hagstrom MD

Double chin after liposuction - what other procedures would make improvements? (Photos)

Answers (4)

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