Double Chin Treatments

Double Chin Treatments At A Glance

  • Best Results2-3 treatments
  • Treatment Recovery1-7 days
  • Procedure Time20-60 minutes
  • Skin SpecialistNurse, Davin Lim
  • Duration of ResultsMany years to permanent
  • AnaestheticAs required
  • Back to Work1-5 days
  • Cost$$-$$$

Double Chin Treatments

Double Chin Treatments or submental fat is due to genetics, weight gain & age. Though the problem is easy to visualise, the optimal treatment may be complex. My algorithm encompasses non-surgical procedures including fat dissolving injections, dermal fillers, HIFU energy devices, RF skin tightening, Coolsculpting as well as surgical techniques such as liposuction.

FactsFacts on Double Chin Treatments

  • This is a common presenting concern
  • Excess fat accumulates with age & weight gain
  • There is often a genetic contribution
  • Skin laxity contributes to the under chin bulge
  • Coolsculpting Mini is the least invasive treatment
  • Coolsculpting requires several applications over months
  • My preferred option is liposuction as results are better & more predictable
  • I also use RF or radiofrequency energy to tighten & define the neck area
  • Downtime & discomfort are minimal with most treatments
  • Finding the optimal treatment for this complex problem is the first step

What causes a Double Chin?

The three main factors are age, genetics & diet. 

Age. As you start to age, your metabolism slows down. Fat- adipose tissue accumulates in different areas throughout the life cycle. Submental fullness or double chins/chin fat starts to accumulate in the late 20s & peaks in the 40s. Loss of collagen compounds this problem. This results in skin laxity. Hence with double chins it is both accumulation of fat & skin laxity.  

Genetics. If you have the genetic tendency to have more fat cells in the chin area, chances are you will get a double chin as you age. Other factors that come into play include chin projection & jawline definition, as both tie in with the under-chin area. Underdevelopment of these structures can accentuate the appearance of double chins.

Diet: Over time fat accumulates in this area, partly due to a change in metabolism. Losing weight may help reduce the appearance of double chins.

What effective methods are there to reduce double chins?

How does fat dissolving injections work?

Fat dissolving injections or deoxycholic acid is a naturally occurring bile acid produced by the body to metabolise fat. This chemical can be injected in double chins to reduce fat.

The advantage of injections include; minimally invasive procedure (injections), relatively easy to perform. The cost can be spit up over a series of injections.

The disadvantages of injections are significant. This is my least favourite method for the following reasons.

  • Significant pain during the procedure (this can be alleviated by numbing injections)
  • Significant swelling & bruising that last 5 to 8 days (this is universal)
  • Fat dissolving is delayed & not predictable in the outcome
  • 2-4 sessions are required
  • Skin tightening is not predictable
  • Facial nerve injury in 4.9% of cases

*It is not that I do not perform this procedure, as I use deoxycholic acid for melting fat elsewhere. My main argument is that there are far better, more predictable & cost effective procedures as listed below. The biggest disadvantage of this procedure is the total or cumulative  downtime, one week recovery multiplied by three equals three weeks of swelling. 

How does Coolsculpting work?

Coolsculpting Mini works by a process called cryolipolysis, namely fat freezing. When fat cells are exposed to very cold temperatures, they undergo apoptosis or cell destruction.

The advantage of Coolsculpting is that this procedure is non-invasive with a relatively quick recovery time (swelling 2 to 3 days). Once fat is destroyed the cells are gone forever.  Most patients require 2 to 3 sessions for optimal outcomes.

The disadvantage of Coolsculpting is that effective cryolipolysis relies on –

  • A good application seal of the device.
  • A suitable ‘pinch’ of fat (as opposed to skin laxity)
  • Applicators to be placed accurately on the treated areas (depends on the shape of the double chin / excess fat)
  • Immune system to remove the destroyed fat cells after the treatment

*After liposuction, Coolsculpting Mini is my preferred treatment as downtime is minimal compared to Kybella or Belkyra.

Davin’s Viewpoint: Double Chins & how to treat

There are many ways to address submental fullness, from Belkyra/Kybella fat dissolving injections, Coolsculpting Mini, heating devices like Ultraformer III, off label microneedling RF, Vaser liposuction, RF tightening devices like Facetite as well as surgical options including liposuction. 

Here are the facts: the most predictable, cost effective & probably the best solution is with liposuction. Here is why-

  1. Predictability: Liposuction relies on the surgeon physically removing excess fat & fat cells. Non-surgical treatments including Ultraformer III, fat dissolving injections & cryolipolysis (fat freezing) rely on your immune system to destroy & carry fat away. This is unpredictable.
  2. Downtime. Recovery from liposuction is really quick. A neck support brace is worn for 24 hours post procedure, then only at night for one week. Swelling goes down within 48 hours after liposuction. Conducted on a Friday or Saturday am, you can go back to work on a Monday. For fat dissolving injections, expect swelling to last one week. Multiply this by 2 to 3 and you have up to 3 weeks downtime.
  3. Adjunctive skin tightening: Remembering the two most important causes of double chins are skin laxity & accumulation of adipose tissue/fat. During liposuction I also employ techniques to tighten skin. The results? More predictable results & jawline definition. Most of my cases I combine laser, HIFU & or RF devices to produce skin tightening.
  4. Cost effective. By the time you add up the cost of fat dissolving injections & cycles of Coolsculpting, liposuction is a cost effective alternative.

Of course you may not be suitable for surgery, or have a personal wish not to have liposuction. In this case my advice is to consider cryolipolysis with Coolsculpting Mini. This treatment takes 40 to 80 minutes, depending on the location of fat & extent of treatment. I do believe that cold therapy is more effective than heat therapy. We currently run 2 fat freezing devices including Coolsculpting & Cooltech. 

Other options include fat dissolving injections (I hardly use this, purely based upon the downtime to the patient), as well as heating – microfocused ultrasound with Ultraformer III. The latter I use more often as a tightening device, at the same time as liposuction.

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