Double chin liposuction removes the fat built up under the chin with a fine cannula, through incisions a few millimetres long. It brings back the angle between the chin and the neck, which is what defines a profile.
A double chin is not always fat. It can be, and then this procedure resolves it very well. But it can also be down to skin that has lost its elasticity, to separation of the neck muscles — the vertical bands that show when you speak — to a chin with little projection, or to a dropped submandibular gland. Each of those causes has its own treatment, and none of them is fixed with a cannula.
Hence the consultation consists above all of telling them apart. Liposuction on a neck whose skin no longer pulls back leaves a slack result, sometimes worse than the starting point: the filling is taken out and the cover remains. When that is the case, the correct indication is a different operation, not this one.
It usually helps when there is
- Fat localised under the chin, with good-quality skin that pulls back.
- Stable weight, with no significant excess weight.
- A double chin that will not shift despite being slim: that is the one that responds best.
- A profile with a poorly defined neck-chin angle because of fatty volume.
- Young or middle age, with elasticity preserved.
Worth discussing first if
- Markedly lax skin: the problem is the skin, not the fat.
- Visible vertical muscle bands in the neck, which call for a different surgical step.
- A chin with little projection, which may be creating the apparent double chin.
- Excess or unstable weight.
- A dropped submandibular gland, which liposuction does not correct.
None of these rules the procedure out on its own; all of them change the conversation.
On its own, or combined
In many necks fat is only part of the problem, and what works is combining.
Liposuction alone
The option with the shortest recovery, indicated when the skin is good and only fat is in excess. Two or three incisions of a few millimetres, hidden under the chin and behind the ears.
With platysmaplasty
Joining the neck muscles along the midline is added, for the vertical bands. It needs a somewhat larger incision under the chin.
With chin surgery
When the double chin is largely a problem of chin projection, bringing it forward a few millimetres improves the angle more than removing fat does.
Leave a layer, do not empty
The work is done with fine cannulas in an even plane, always leaving a layer of fat under the skin. Emptying the area down to the muscle produces adhesions and irregularities that in the neck show under any side light, and that are very hard to correct.
The other criterion is about limits: how far the removal extends along the edge of the jaw and down into the neck is defined, so that no step is left. And it is checked with the person sitting up, not only lying down, because the neck changes shape with position.
What the process is like
From the first consultation to discharge, with the usual timings for this procedure.
Consultation
Where the double chin comes from is established: the fat is pinched, the skin's recoil assessed, you are asked to clench your teeth to see the muscle bands, and the projection of the chin is measured.
Before surgery
Laboratory tests and anaesthetic assessment. Stopping smoking and any medication that encourages bleeding. The informed consent is signed.
Surgery
As a day case. Infiltration, liposuction with a fine cannula and checking of the contour. A chin strap is fitted at the end.
Follow-up
Reviews at one week, one month and three months. Massage or drainage if indicated.
Week by week
The chin strap is the instruction that most determines the result and the hardest one to keep to.
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Days 1 to 5
Chin strap almost all day, swelling and sometimes bruising under the chin. Moderate discomfort.
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Days 6 to 14
Strap mainly at night. Social life from the first week onwards, with the area still somewhat swollen.
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Weeks 3 to 8
The contour starts to show. There may be areas that feel firm — fibrosis — which are worked on with massage and settle.
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Months 3 to 6
Final result, once the skin has finished pulling back. That is the real timescale for this area, and it is why judging at one month is a bad idea.
Risks, and what is not promised
The usual risks of liposuction — bleeding, haematoma, infection, contour irregularities, fibrosis, asymmetry — and those specific to this area: temporary altered sensation and, infrequently, injury to the marginal branch of the facial nerve, which produces an asymmetrical smile. It usually recovers, and in isolated cases it does not.
An insufficient result is the most frequent eventuality, and almost always for the same reason: the skin did not pull back as much as hoped. That is what is assessed before surgery and what you are warned about when the outlook is not good.
No particular angle is promised. These risks are reduced by a sound indication and a correct technique. They are not eliminated. The ones that apply to your case are explained to you in the consultation and are set down in writing in the informed consent.
The information on this page is for guidance and does not replace an in-person medical consultation. Medical practice is an obligation of means, not of result.
The questions we are asked most about double chin liposuction
It depends on the elasticity of your skin, and that is exactly what is assessed in the consultation. With good-quality skin, the recoil closes the space and the neck ends up defined.
When the skin no longer pulls back, removing the fat leaves the cover empty. In those cases this surgery is not indicated on its own: what is called for is one that also removes skin.
The fat cells removed do not come back, but the ones left can increase in size if you put on weight, and the skin goes on ageing.
At a stable weight, the result holds well for years.
There are injectable lipolysis treatments and cooling or radiofrequency devices that reduce some volume in small double chins, over several sessions and with more modest results.
They are a reasonable alternative in mild cases. With a double chin of real volume, the difference from surgery is large.
The first five days almost all day, and then mainly at night until you complete around three or four weeks, depending on how your reviews go.
It is uncomfortable and it is the instruction most often abandoned, but it is the one that most influences how the contour turns out.
Question not answered here? There are more answers in the frequently asked questions.
