Double Chins 101: Treatments and Removal of Neck Fat
Known formally as submental fat, the appearance of a double chin is a common condition. It can form when there is an excess layer of fat that collects below your chin or when skin laxity leads to loose skin. While it often occurs when you gain extra weight, double chins are more than a weight issue, and simply losing weight will not necessarily make your double chin go away. Things such as aging and genetics factor in as well.
Double chins have been bothering people for centuries. Once thought to be reserved for those dealing with weight gain/loss, obesity, or underlying medical issues, newer research proves that everyone is susceptible to developing a double chin, which refers to an excess layer of fat under the lower jaw. There are times when extra pockets of fat or medical problems are the root cause, of course, but this unflattering concern can plague just about everyone. Even at a healthy weight, smaller, fit individuals can experience a double chin. Despite the root cause of your double chin, it can still be a concerning and embarrassing issue because of the way it distorts your facial profile and effects your level of self-esteem.
Terminology and Definitions
Submental fat: the pocket of fat underneath the chin that is commonly referred to as a double chin
Tumescent fluid: anesthetic fluid comprised of epinephrine and lidocaine that is injected into fat tissues before liposuction; makes the area more firm and swollen to aid in more productive liposuction sessions Epinephrine also known as adrenaline, is used to constrict blood vessels to reduce bleeding during liposuction procedures Lidocaine: an anesthetic that stops the pain in the injection area
Reasons and Causes
A double chin can appear for several reasons, typically due to weight gain, skin laxity, genetics, or normal aging. In less frequent instances, a double chin may even point to a medical concern or may be the result of experiencing side effects of medication. If you experience concerns related to your thyroid, kidneys, cortisol levels (such as with Cushing’s Syndrome) or something similar, speak with your provider to rule out larger issues that could be contributing to your double chin.
Some people are predisposed to submental fullness, which simply means that they are prone to developing a double chin. However, predisposition doesn’t equal destiny. Your genetics certainly play a significant role in what happens within your body, but personal choices can sometimes trump those genetic predispositions. Your diet, the level of activity in your daily routine, and the way you care for your health all factor into the way your body functions. For a simple example, if you are predisposed to handle stress poorly, you may also be predisposed to carrying higher levels of cortisol in your body. Knowing that to be true, you can choose to implement stress-relievers into your routine (mediation, yoga, journaling, gym time, walking, etc.) to alleviate some of that stress and lower your cortisol levels. The same is true in many areas of life, and even your double chin can be impacted by those daily choices. If diet and lifestyle changes show little or no improvement, however, you have several choices available to you that can help relieve you of this concern.
Along the same lines as genetics, the way you age has a lot to do with whether or not you develop a double chin. Consciously aging can be a helpful approach, and certainly contributes to your overall well-being, but even with the best regimen, you will still experience skin laxity as part of the natural aging process. This means that your skin will lose tautness as you age. This is seen in the way the loose skin begins to sag and cause the look of a drooping, heavier chin. Depending on your genetics, face shape, and the way you carry fat, you may not be completely immune to developing a double chin. Being mindful of maintaining proper posture, consuming a healthy diet, and implementing neck exercises as you age may help alleviate the extremity of your double chin.
That being said, there are many ways to treat a double chin and restore a balance to your facial shape. The options span a wide range – from lifestyle choices to surgeries. Read on to discover which options will best suit your needs.
Double Chin Reduction & Treatment: Kybella, Surgery, Exercises, & More
Kybella® Kybella® is an FDA approved prescription medication that works to dissolve unwanted pockets of fat to reduce your double chin and refine your neck contours. It is an injectable medication that is currently only indicated for use underneath the chin, however, some people have found Kybella® injections successful in reducing fat in areas such as the stomach, the hard-to-get-rid-of back rolls, and the tricky areas above the knees and elbows. You will likely need multiple Kybella® injections, but its fat-dissolving results are permanent, and the injections themselves require only a 15-20 minute time commitment.
CoolSculpting® CoolSculpting® is a well-known, non-surgical method of targeting unwanted pockets of fat in your body. This method freezes fat in areas such as underneath the chin to give your facial profile an enhanced, more appealing silhouette. This method is back by scientific studies that found a way to non-invasively target and remove fat cells in your body. Once your CoolSculpting® treatments are complete, targeted frozen fat cells die off, and are removed through your body’s natural elimination process.
Liposuction Submental liposuction This refers to a technique in which excess fat is surgically removed from the targeted area. This form of plastic surgery has gained increasing visibility over the last 20 years and has quickly become one of the cosmetic industry’s most commonly performed surgeries, especially in the United States. Patients who have used this method for removing their double chins have reported seeing a big impact in their facial proportions. There are different types of liposuction methods that can be utilized for chin reduction, but the main goal of this plastic surgery is to reduce the amount of subcutaneous fat in a given area. When performed on the neck, liposuction will reduce the appearance of your double chin; however, according to clinical trials sponsored by Northwestern University, it may even provide you with the bonus of reducing complications related to chin size, such as sleep apnea.
Tumescent Liposuction A form of liposuction that utilizes a crystalloid fluid called Klein’s solution. Klein’s solution contains low doses of lidocaine (an anesthetic that stops the pain in the injection area) and epinephrine (a form of adrenaline used to constrict blood vessels to prevent bleeding). After the solution is injected, fat is suctioned out of the neck area. The injection of the fluid before tumescent liposuction causes the area to become more firm and swollen, making the liposuction procedure easier to perform.
Laser/Radiofrequency-Assisted Liposuction Laser assisted liposuction removes unwanted body fat while slightly tightening the skin to improve body contours. Whereas skin retraction after liposuction was once unpredictable, this method assists with skin elasticity improvement while creating a better liposuction experience. Laser technology melts adipose tissue for a faster, easier, less aggressive procedure, possibly resulting in shorter recovery time.
Radiofrequency assisted liposuction (RFAL) RAFL also removes unwanted body fat while tightening the skin and improving body contours. Systems of RFAL such as Bodytite™ and Necktite™ are reported to improve skin elasticity up to 30-40%. RFAL heats the fat tissue to be removed which makes for easier extraction. The treatment area is screen monitored through a heat map that actively tracks the area to allow for increased precision while preventing damage to nearby areas.
Mesotherapy Mesotherapy is a nonsurgical alternative to reducing unwanted fatty deposits that relies on individualized injections comprised of different variations of vitamins, vasodilators, nonsteroidal anti-inflammatory medications, enzymes, nutrients, antibiotics, and hormones. “Individualized” means that they are not yet standardized, and injections will vary from provider to provider based on patient needs. Mesotherapy has yet to be thoroughly tested, and although Europe has practiced mesotherapy for decades, it remains a controversial procedure in the United States that has yet to meet FDA approval due to limited scientific studies. For your safety, the American Society for Plastic Surgeons advises extreme caution while mesotherapy continues to be evaluated.
Non-Invasive Fat Reduction/Skin Tightening (Radiofrequency or Laser Energy) This method is useful for those with only minimal double chin conditions, especially those cases where the double chin is directly related to the aging process. This technique allows cosmetic surgeons to target the deep layers of skin with heat energy to encourage the production of collagen and elastin. New collagen and elastin provide your skin with youthful advantages such as tighter skin, an evener skin tone, and more pleasing skin texture. The FDA has approved several techniques for fat reduction and skin tightening, including ultrasound, radiofrequency, and IPL/Radiofrequency combination.
- Ultrasound – A familiar technology to most, the ultrasound method helps to firm the skin through ultrasound waves that penetrate the skin’s surface when applied through a handheld ultrasonic device. Ultherapy is the most common brand for treating areas of the face and neck.
- Radiofrequency – This technique targets the skin’s epidermal layer and is generally considered safe for all skin types. The most common brand names of radiofrequency are THERMI RF, Exilis, and Thermage.
- IPL/RF Combination – This method combines the use of Intense Pulsed Light (IPL) with radiofrequency (RF). IPL has been shown to make RF energy work more effectively, and the two together allows the treatment to heat deeper layers of your skin. You may need more than one treatment, depending on your initial needs. The most familiar treatments for this technique include Refirme™ and VelaShape™ .
Cervicoplasty This method targets the excess skin of your double chin while leaving the underlying muscles completely intact. This allows for a more defined facial profile as it addresses issues such as skin laxity of the neck. This procedure uses a combination of lidocaine and epinephrine to anesthetize the area and retain your comfort through the treatment.
Although the above methods provide the most permanent and visible results, you may also find that there are home remedies that can help reduce the appearance of your double chin. They may also work to enhance your surgical or non-surgical results from one of the treatments previously mentioned. Keep in mind, though, those home remedies have not been approved by the FDA and there is little or no scientific evidence to support their validity.
One of the most effective things to do for your body and overall health is to consider diet and lifestyle habits. Maintaining an active lifestyle and enjoying a balanced diet, full of fruits, vegetables, lean proteins, and healthy fats helps both the internal and the external self. Diet and lifestyle habits directly correspond to your quality of life, affecting both your physical, emotional and mental well-being. As a bonus, you might see a pleasing reduction in the appearance of your double chin.
To target your double chin specifically, consider implementing the following simple exercises into your daily routine (always warm up by gently revolving and stretching the neck to prevent injury):
- While tilting your head upwards to look at the ceiling, push your chin out until you feel a stretch in your neck, hold for a few seconds, and returning to a normal gaze looking straight ahead. Maintain a relaxed posture. Repeat several times.
- Repeat the same exercise as above, but add the extra effect of pushing the tongue against the roof of your mouth while doing so, and returning to a neutral position afterwards. You can also add a tongue stretch, where you stick your tongue out towards the ceiling as well.
- Use ball exercises, where you hold a ball under your neck and against your chest, moving the ball around to strengthen your neck muscles. A small inch ball, such as a tennis ball, is all you need to perform this exercise.
- Participate in some form of aerobic activity daily (walking, running, spinning, etc.)
- Consider ending your day with a short yoga session to relieve stress and prepare your body for a restful night of sleep
- Chewing gum may also encourage tautness in the neck as it works the neck and chin muscles underneath the layer of stubborn fat. This may improve skin elasticity.
There are several options available that span from home remedies to surgical corrections. Since the chin plays a critical role in the profile of your face, it would be well worth your time to consider these methods of correction. Others have found that treating their double chin increases their self-confidence, and it could very well do the same for you. Talk to your provider who could recommend treatment methods or who could refer you to trusted plastic or cosmetic surgeons in your local area. It will be worth the time involved.
List of Sources
Clinical Trials West, Dennis. “Neck Liposuction with Tumescent Anesthesia for the Treatment of Obstructive Sleep Apnea – A Pilot Study.” ClinicalTrials.gov. U.S. National Library of Medicine, Bethesda, MD. June 2012.
- Laser/Radiofrequency-Assisted Liposuction Keramidas, Evangelos and Stavroula Rodopoulou. “Radiofrequency-Assisted Liposuction for Neck and Lower Face Adipodermal Remodeling and Contouring” Plastic and Reconstructive Surgery Global Open vol. 4,8 e850. U.S. National Library of Medicine, Bethesda, MD. 24 August 2016.
- Lidocaine “Lidocaine: Compound Summary for CID 3676.” PubChem. Open Chemistry Database. National Center for Biotechnology Information, Bethesda, MD.
- Mesotherapy El-Domyati, Moetaz et al. “Efficacy of Mesotherapy in Facial Rejuvenation: A Histological and Immunohistochemical Evaluation” International Journal of Dermatology vol. 51,8 (2012): 913-9. U.S. National Library of Medicine, Bethesda, MD.
Non-Invasive Fat Reduction/Skin Tightening (Radiofrequency or Laser Energy) “Skin Tightening.” American Board of Cosmetic Surgery. The American Board of Cosmetic Surgery Procedure Learning Center.
- Submental Fat Compartment Hatef, Daniel A et al. “The submental fat compartment of the neck” Seminars in plastic surgery vol. 23,4 (2009): 288-91.
- Submental liposuction Kovacs, B. et al. “Submental Liposuction in Maxillo-Facial Surgery.” National Center for Biotechnology Information. U.S. National Library of Medicine, Bethesda, MD. March 1992.
- Tumescent Liposuction Venkataram, Jayashree. “Tumescent liposuction: a review” Journal of cutaneous and aesthetic surgery vol. 1,2 (2008): 49-57. U.S. National Library of Medicine, Bethesda, MD.