Double chin liposuction: how it differs from injections and a neck lift

A double chin has more than one cause

A double chin, in which the area under the jaw looks rounded and saggy, can be caused by excess fat under the skin, but it can also result from reduced skin elasticity or from deeper structures in the neck. The literature notes that when fat deposits in the face and neck persist or grow larger, the proportions of the face can look off balance, and many people seek treatment for this reason ^[6]. Which option to consider, whether liposuction, fat-dissolving injections, or a neck lift, depends on the cause.

How is liposuction under the chin performed?

A 2010 review explained that liposuction effectively refines the contours of the trunk, limbs, and area under the chin (submental area) in appropriately selected people ^[1]. The commonly used methods are tumescent liposuction, performed under local anesthesia, and superwet liposuction, performed together with anesthesia that acts on the whole body (systemic anesthesia) ^[1].

Both methods were assessed as having a generally good safety profile, but local anesthesia differs in that it can avoid the particular risks that come with general anesthesia ^[1]. The review concluded that no new technology could be said to produce better results than the established methods ^[1]. The most common complications were contour irregularities and temporary bruising ^[1].

Fat-dissolving injections as an option

Injection adipolysis is a method of reducing volume by injecting a substance that breaks down cells into fat tissue ^[5]. Early on, sodium deoxycholate and phosphatidylcholine were used together, and phosphatidylcholine was thought to be the main active ingredient, but it was later found that sodium deoxycholate alone can break down cells ^[5]. This ingredient showed an affinity for fat tissue, so the dermis and epidermis above it were relatively spared ^[5].

The US Food and Drug Administration (FDA) approved deoxycholic acid injected under the skin to improve fat under the chin, and it is said to have shown a moderate effect and good satisfaction in suitable candidates ^[5]. Another review explained that its safety and effectiveness were confirmed in several prospective clinical trials and that, with almost no recovery time, it offers a less invasive alternative to surgery ^[2]. The size of the effect and the number of treatments needed vary from person to person, and the scope of its approval in Korea needs to be checked separately.

Side effects of injection treatment

The adverse reactions commonly reported in clinical trials were pain, reduced sensation, swelling, bruising, and firmness at the injection site, and most were temporary and mild to moderate ^[3]. In real-world practice after the product went on the market, rare cases of hair loss, temporary nerve injury (neuropraxia), blocked or damaged blood vessels, and skin necrosis have been reported ^[3].

This review stated that clinicians should also keep in mind people who come to a hospital with side effects after being treated outside a medical setting ^[3]. It was also pointed out that using the injections anywhere other than under the chin is off-label use and requires an understanding of the anatomy of each area and the complications that can occur ^[2].

When the cause is a structure other than fat

For some people whose neck contour problem is relatively isolated, a short-scar neck lift is used, which refines the deeper structures through an incision under the chin alone, without cutting away skin ^[4]. Correcting the deeper layer lets the extra skin settle back over the now wider surface of the neck and creates a deeper angle between the neck and the jaw ^[4]. It was stated that facial appearance can be clearly improved in appropriately selected people, but this explanation is based on a surgeon's description of their own technique ^[4].

What to check during your consultation

Even when double chins look alike, the right method differs depending on the amount of fat, skin elasticity, and the condition of the deeper structures. It is best to identify the cause through an examination first and then compare the recovery time and side effects of each method. Results vary from person to person.

• The amount of fat under your chin and your skin elasticity
• Whether local or general anesthesia will be used
• If you are considering injections, the scope of their approval in Korea and the expected number of treatments
• How rare side effects would be handled if they occur