A double chin and neck lines have different causes — submental fat, skin sagging, chin position — so the approach is divided by cause, into liposuction, neck lift and other options.
A double chin and neck lines are not a single problem. In some cases fat has accumulated under the chin; in others the skin and the platysma muscle beneath it have loosened; in others a receding chin makes the jawline look short — and often several causes overlap. Different causes call for different methods. If fat is the cause but only the skin is tightened, or if sagging is the cause but only fat is removed, the expected change does not appear.
That is why Atelier Plastic Surgery starts by establishing the cause, rather than which treatment to do. We pinch under the chin to gauge the thickness of the fat layer, watch how the jawline changes when you raise and lower your head, check whether vertical bands stand out on the neck when you clench your teeth, and look at where the chin sits in profile. Only once this is done is it decided whether liposuction, a neck lift or combined treatments are right.
Dr. Juyoung Go lectured at the 37th Symposium of the Minimally Invasive Plastic Surgery Society (MIPS) on the double chin, neck sagging and submental fat. Because she works with both surgery, such as liposuction and neck lift, and non-surgical treatments, such as CoolSculpting and Ulthera, she can choose the approach that fits the cause without presuming any particular method.
Through a small incision inside the crease under the chin, a fine cannula is inserted to remove fat from under the chin and below the jawline. If the skin has good elasticity, it settles naturally into the space left by the fat and the jawline is revealed. The amount removed is set according to skin elasticity, and avoiding over-removal is a principle.
Through incisions behind the ears and under the chin, the neck skin is lifted, the separated platysma is sutured together at the midline to correct vertical bands, and excess skin is excised and secured. Submental liposuction is performed at the same time if needed. It is often done on the same day as a facelift.
When there is only a small amount of submental fat, CoolSculpting reduces it without an incision; when loss of elasticity is mild, Ulthera or Facela tightens the area under the chin and the neck. When platysmal bands stand out only slightly, botulinum toxin can also be used to reduce the muscle's tension. The details of each treatment are covered on its own page.
When the chin recedes, the boundary between chin and neck blurs and looks like a double chin even without much fat. In this case, chin filler to supplement the length and angle of the jawline can restore the profile's definition without reducing submental fat. It is sometimes performed together with liposuction.
These may vary depending on your condition; we will give you precise details at your consultation.
The method differs completely depending on whether it is fat, sagging or chin position. At consultation we weigh the causes by palpation and profile assessment, and if needed confirm the thickness of the fat layer by ultrasound before making a plan.
Removing more submental fat is not better. Removing fat excessively from skin with reduced elasticity leaves the skin behind, which can sag further and make the area under the chin uneven. We remove only as much as the skin can follow.
Tightening the neck skin alone leaves the platysmal bands in place and the vertical lines reappear. In a neck lift, the separated platysma is sutured to create the floor of the neck before the skin is refined.
A double chin and neck lines are often connected with sagging cheeks and jowls. Correcting the neck alone can leave an awkward transition, so when needed we plan it together with a facelift on the same day. The director performs the surgery and follow-up checks herself.
A compression band is worn under the chin and around the neck. After liposuction you go home the same day; after a neck lift you recover in a private recovery room and are discharged the next day.
Swelling and bruising are at their peak. There may be a tight feeling and numbness under the chin. Wear the compression band as instructed.
After liposuction, you can return to daily life. After a neck lift, some of the sutures are removed and you can begin washing your face.
Suture removal after a neck lift is complete and you return to daily life. Swelling has decreased, but the area under the chin may feel firm; it softens over time.
Swelling subsides and the jawline is revealed. Sensation recovers and the incision lines fade; you visit the clinic for follow-up checks.
The marginal mandibular nerve, which moves the corners of the mouth, runs under the chin and below the jawline, so rarely, irritation or injury to the nerve may cause temporary weakness in the movement of a mouth corner or asymmetry. Most cases recover, but recovery is slow in some. Other possible complications include hematoma, infection, seroma, skin contour irregularities and unevenness, hollowing under the chin or skin sagging from over-aspiration, reduced sensation under the chin and in the neck, scarring and hypertrophic scars at the incision sites, asymmetry, the submandibular gland (salivary gland under the jaw) becoming more noticeable as fat decreases, scars behind the ears and changes to the hairline after a neck lift, skin necrosis (higher risk in smokers), anesthesia-related risks, and the possibility of revision surgery if the result is unsatisfactory. Smoking must be stopped for at least 4 weeks before and after surgery, and you must tell us at consultation about any medications or supplements that affect blood clotting. Results and recovery periods vary by individual, and the risks and how they are managed are explained fully at consultation.
The content on this page is general medical information provided in accordance with the Medical Service Act. The results of surgery and treatments and the recovery period may vary by individual. All surgeries and treatments carry a risk of side effects, so please decide after a thorough consultation with a specialist.
Surgery for the sagging stage that lifts and fixes the skin together with the SMAS layer
Learn more Related CoolSculptingCoolSculpting reduces localized fat by cooling, without incisions
Learn more Related UltheraFocused ultrasound lifting that tightens down to the SMAS layer, planned by area and depth
Learn more Related FillerFiller that looks at the structure of the face first and designs for balance
Learn moreConsultations are conducted by the Director herself. Schedule one by phone or KakaoTalk, or leave an online consultation request.
