I had Chin Lipo in January 2022, so why do I still have a Double Chin? (Photo)

Question

I’ve had fullness under and around my chin my whole life, even when I’ve been at my thinnest at around 115lbs. I’ve gained weight since quarantine, but still I’m not a big bodied person and my under chin/jawline is my biggest insecurity. I decided to have chin lipo in January of 2022 from a Doctor in Delaware. He claimed he couldn’t take any more fat out bc of causing lines/denting. Is this true? Or is there anything else I can try?? First 2 photos are before lipo, last 2 are from last week.

Anna Chacon, MD, FAAD · Answer

Hi there,

Thank you for sharing your experience. I completely understand how frustrating it can be to undergo a procedure like chin liposuction, and I still feel like your concerns haven't been fully addressed.

Here are a few key things to consider:
1. Some fullness may not be fat-related:
Even after chin liposuction, residual fullness can persist due to:

Skin laxity — especially if the skin didn’t retract well post-lipo.

Subplatysmal fat — deeper fat under the muscle, which liposuction typically can’t address.

Anatomical factors like a naturally recessed chin or a short/hypoplastic jawline can make the area look fuller even if there's minimal fat.

2. The surgeon's comment about avoiding dents or irregularities is valid:
There is a limit to how much fat can be safely removed. Over-aggressive liposuction can result in contour deformities or a “wavy” appearance, so many surgeons will stop before reaching that point.

3. Next steps to improve your results might include:

Kybella (deoxycholic acid) injections: to further dissolve any small pockets of submental fat non-surgically.

Skin tightening treatments like radiofrequency microneedling, Ultherapy, or Morpheus8 if laxity is part of the issue.

Chin/jawline filler: If you have a weak chin or jawline, filler can improve the angle and contour, giving the illusion of a slimmer profile.

Surgical options: In some cases, a chin implant, deep neck lift, or platysmaplasty might be considered for long-term refinement.

Jose Perez-Gurri, MD, FACS · Answer

It is impossible to draw conclusions on your results without the benefit of an exam. An exam will allow the surgeon to palpate and determine how much fate there may be. Good luck, Doc PG

Lucian Ion, FRCS · Answer

Thank you for your inquiry and for sharing your photographs. Conservative management of superficial fatty tissue is a crucial aspect of liposuction under the chin and along the jawline. As your surgeon has advised, aggressive reduction can lead to burns and contour irregularities.

If you wish to evaluate the remaining amount of superficial fatty tissue, this can be assessed through a soft tissue ultrasound examination. It is important to remember that a certain amount of fatty tissue under the skin needs to be preserved to ensure a smooth and natural contour.

The amount of fatty tissue required for a balanced submental contour decreases when the skin is placed under greater tension, which is a component of the neck lift intervention. For the deeper volume situated under the chin, a deep plane approach can effectively address it. This technique accesses the fatty tissue beneath the platysma muscles, as well as the digastric muscles and the lower portion of the submandibular glands. These structures all contribute to the contour issues you are aiming to resolve.

William Portuese, MD · Answer

It's very important to understand that there are two compartments of fat in the neck, and they're located both above and below the platysma muscle in your neck. Liposuction can only accomplish removal of the fat deposits above the muscle. From these photographs, you still have significant fat deposits below the platysma muscle, which is going to require a neck lift procedure in order to remove that compartment of fat surgically. The procedure involves surgical extraction of the fat below the muscle, removing any residual fat above the muscle with liposuction, and then performing a platysma-plasty to significantly improve your jawline, even when you put your chin in a downward fashion. There are three small access incisions placed under the chin and behind your ears, and no skin removal is necessary. This procedure is performed under general anesthesia which takes about an hour and a half.

Darryl J. Blinski, MD · Answer

Based on nicely post of photos, I would recommend revision of complete chin neck, Lipo with ultrasound guided removal and Endo treatment. Best virtual consult fee $10,000-$20,000

Mats Hagstrom, MD (license on probation) · Answer

People who form a double chin don’t have an abnormal fat distribution.
The reason, people form a double chin is because their mandible is small or lacking in projection in relationship to their maxilla.
When the facial skeletal structure doesn’t have a strong foundation to support the soft tissues the soft tissues start to sag.
Everybody who gets chin and neck, Liposuction has an overbite dental occlusion with an insufficiently projecting mandible.
This is almost 100% true.
And profile pictures all of these patients will have an upper lip that has more forward projection than the lower lip, even though the lower lip is larger than the upper lip.
 You can see this clearly on the last picture.
All of that said, you can’t really grow a bigger mandible so most plastic surgeons will apply soft tissue solutions to problem that is inherently based on facial skeletal structure.Delivering consistent quality Liposuction results is far more difficult than most people realize.
The number of plastic surgeons who approach mastery for this kind of work is in reality quite small.
If you simply pick a plastic surgeon because you’re bored certified and has a reason to be good reputation then that chance that this doctor is going to be exceptional at chin and neck, Liposuction is fairly unlikely.
 Exceptional results come from exceptional providers. most providers are simply average and finding exceptional providers usually takes some work.
Certified plastic surgery does not make somebody exceptional at shin and neck Liposuction. 
Even though the primary ideology of your problem is skeletal, there was probably potential for a better outcome in the hands of a more experienced or talented provider.
Finding these exceptional providers is really difficult.
Most plastic surgeons simply aren’t that great at Liposuction, though the great majority think they’re better than they actually are.
There may be a room for improvement with a secondary procedure.
That said secondary liposuction is much more difficult and much more unpredictable than primary Liposuction.
I’m usually very reluctant to do secondary Liposuction because patients are often disappointed that the second procedure didn’t deliver enough results.
 There are other things to take in consideration.
Those who have weight gain may also have increased fat deep to subcutaneous fat layer deep to the platysma muscle.
There’s a lot to consider.
Equality assessment always requires an in person consultation.
Any attempt at imp proving Liposuction results has the potential of making things worse. 
Provider selection is by far the most important variable.
I would not put much credence on providers touting, high technology equipment like facetite or Renuvion has being significantly helpful for your problem.
Best,
Mats Hagstrom MD

I had Chin Lipo in January 2022, so why do I still have a Double Chin? (Photo)

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