Double Chin Liposuction vs. Lifting Devices: Which Fits Your Chin?
In consultations, we often hear the question, "I'm bothered by my double chin. Would a lifting device be enough, or should I have liposuction?" It can be a hard choice between a device treatment that involves no skin incision and a surgery that reduces fat directly.
The two approaches address different things. So today, together with published studies, we will go over how the causes of a double chin are sorted, and in which cases liposuction or a lifting device may fit, and what limits each one has.
We Start by Sorting the Cause of a Double Chin
There is more than one reason the area under the chin looks thick. There may be a lot of fat under the skin, the skin may be loose, and the neck muscles or the bone structure can also play a role[1]. When the cause differs, the suitable approach differs too.
| Main cause | How it looks | Approaches to consider first |
|---|---|---|
| Fat | A thick layer can be pinched under the chin | Liposuction |
| Loose skin | Little fat can be pinched, but the skin is slack | Lifting devices; surgical methods if the sagging is severe |
| Fat + loose skin | Fat can be pinched and the skin is also slack | Planned around liposuction, adjusted to the condition of the skin |
| Muscle / bone structure | Vertical bands stand out on the neck, or the angle between the chin and neck looks blunted | Methods that only reduce fat have limits |
If Fat Is the Main Cause, We Look at Liposuction First
When the main cause of a double chin is fat, we at Venus Clinic consider liposuction first, because it is a method that reduces the fat layer directly. The layer that can still be pinched when you pull the corners of your mouth out to the sides and tense your neck muscles is the target of liposuction[3]. Even when fat extends below the jawline, this is regarded as a good fit if the skin has good elasticity[1].
We remove the fat that needs to be removed as thoroughly as possible, and smooth the contour so that the line is not bumpy. We plan by looking not only at the area under the chin but also at the lines that continue into the jawline and neck.
Advantages of Liposuction
For people who have enough fat to reduce, the amount of fat can be reduced directly, and the area under the chin and the jawline can be refined in a single surgery. Even in older patients, it is performed in selected cases when there is a lot of fat and the skin condition allows[2]. In addition, refining the fat under the skin can induce skin retraction, so loose skin may also improve to some extent[5].
Limits of Liposuction
Because it is surgery, a recovery period is needed. Small openings are made in inconspicuous places, such as under the chin or behind the ears, and a compression band is worn after surgery. Swelling, bruising, and pain may occur, and skin irregularities or left-right asymmetry may develop. Although rare, temporary facial nerve palsy, skin indentations, and scarring have been reported[4][10].
What Is Difficult to Change with Liposuction
A lot of loose skin with little fat, muscle bands, and the angle of the bone structure do not change with liposuction alone[1]. If body weight increases, the remaining fat cells can enlarge, and results may vary by individual.
How Do Lifting Devices Work?
Lifting devices deliver energy without cutting the skin and generate heat in the tissue. Let's look at three commonly used types. The product names are examples to aid understanding and are not a recommendation of any particular product.
Radiofrequency (e.g., Thermage, InMode)
Radiofrequency energy warms the deeper dermis to induce the tissue to remodel. The skin surface is cooled during the procedure, and changes may appear over several months, and the degree of change is described as varying[6]. Even among radiofrequency devices, the methods differ by device, and for equipment that also targets the fat layer, such as InMode, more evidence is needed on reducing fat under the chin[12]. In a clinical trial of a monopolar radiofrequency device studied for improving facial wrinkles (212 people), adverse reactions at the treatment site were reported in about 1 in 4 people, in the order of pain, redness, burns, and swelling. The burns in this trial included cases where redness lasted more than a day, and most were judged to be mild[9].
Ultrasound (e.g., Ulthera, Shurink)
Ultrasound is focused at a set depth under the skin to create tiny points of heat and induce new collagen formation[7][8]. The studies were mainly conducted on the Ulthera family of devices[8]. In a study of 93 people, improvement in sagging was observed in 58.1% by assessor rating on day 90, and people with a body mass index over 30 more often showed no change[7]. A systematic review summarized that it is effective for mild to moderate sagging, and listed severe sagging or a body mass index over 30 as relative contraindications[8]. A lift of the area under the chin has been reported, but there is also a study in which it diminished at 6 months[8]. There is pain during the procedure, and temporary redness or swelling may occur; altered sensation or burns have been reported rarely[8].
Microwave (e.g., ONDA)
Microwave energy delivers heat to the fat layer under the skin. In a study of 48 people treated under the chin 6 times at 2-week intervals, fat and sagging scores were reported to have decreased after 12 weeks[11]. However, it is a small study without a control group, so more evidence is needed to judge the size of the effect.
When Reading the Evidence on Devices
The study populations, number of sessions, and assessment methods differ from device to device, so the numbers cannot simply be compared side by side. Within the range we searched, we could not find a study that directly compared devices with liposuction.
The Pros and Cons at a Glance
Rather than one being better, they differ in what they address. The table below summarizes general characteristics, which differ from person to person.
| Item | Liposuction | Lifting devices |
|---|---|---|
| Main target | Fat under the skin | Skin elasticity and sagging |
| Method | Fat is suctioned directly through small openings | Heat is delivered without cutting the skin |
| When it may fit | When there is a lot of pinchable fat | When there is little fat and the sagging is relatively mild |
| Advantages | Reduces the amount of fat directly and refines the contour | No incision, so the recovery burden tends to be lower |
| Limits | Because it is surgery, a recovery period is needed, and side effects may occur | Changes may be small when sagging is severe or body mass index is high, and it is not a method that removes fat directly |
How We Tell Them Apart in a Consultation
At Venus Clinic, during a consultation we feel the area under the chin directly and look at the side profile as well. If a thick layer can be pinched, we judge it to be fat, and we check elasticity by how quickly the skin returns after being stretched and released. If fat is the main cause, our discussion centers on liposuction; if there is little fat and elasticity is the concern, we first look together at whether surgery is truly needed.
References
- Jacob CI, Berkes BJ, Kaminer MS. Liposuction and surgical recontouring of the neck: a retrospective analysis. Dermatol Surg. 2000;26(7):625–632.
- Doerr TD. Lipoplasty of the face and neck. Curr Opin Otolaryngol Head Neck Surg. 2007;15:228–232.
- Venus Clinic website. Chin liposuction.
- Klein JA. Tumescent Technique: Tumescent Anesthesia & Microcannular Liposuction. Mosby; 2000. Chapter 35.
- Shiffman MA, Di Giuseppe A (eds). Liposuction: Principles and Practice. Springer; 2006. Chapter 39.
- Serdev (ed). Book on liposuction and fat grafting. InTech; 2011. Chapter 8, Radio-Frequency Assisted Liposuction.
- Oni G, Hoxworth R, Teotia S, Brown S, Kenkel JM. Evaluation of a microfocused ultrasound system for improving skin laxity and tightening in the lower face. Aesthet Surg J. 2014;34(7):1099–1110.
- Contini M, Hollander MHJ, Vissink A, Schepers RH, Jansma J, Schortinghuis J. A systematic review of the efficacy of microfocused ultrasound for facial skin tightening. Int J Environ Res Public Health. 2023;20(2):1522.
- Wang Z, Li T, Wa Q, Liu Z, Yang B, Yan Y. Efficacy and safety of a novel monopolar radiofrequency device for skin tightening: a multicenter, randomized, 6-month, assessor blind, positive parallel-controlled, non-inferiority trial. Lasers Med Sci. 2026;41(1):39.
- Diniz DA, Gonçalves KK, Silva CC, Araújo ES, Carneiro SC, Lago CA, Vasconcelos BC. Complications associated with submental liposuction: a scoping review. Med Oral Patol Oral Cir Bucal. 2022;27(3):e257–e264.
- Salsi B, Fusco I. Non-invasive system delivering microwaves energy for unwanted fat reduction and submental skin tightening: clinical evidence. J Cosmet Dermatol. 2022;21:5657–5664.
- Chawvavanich P, Singthong S, Intarachaieua K. Effectiveness and side effects of bipolar radiofrequency to treat submental laxity. J Cosmet Dermatol. 2022;21(10):4392–4397. Note: This is a study in which the area under the chin of 22 people was treated 4 times at 2-week intervals with a bipolar radiofrequency device (FORMA). It reported that the submental laxity score improved and fat volume decreased for up to 6 months. However, it is a small before-and-after study without a control group.
In Closing
"Double chin" is a single name, but it has several causes. If fat is the main cause, you may first consider liposuction, which reduces fat directly; if there is little fat and elasticity is the concern, a lifting device can be an option. Before choosing a device by name, please first find out which case your own chin falls into.
Which method is suitable can only be known through an in-person examination of the amount of fat, skin elasticity, muscles, and bone structure. Results and recovery may vary by individual.
References: When Liposuction Under the Chin Is a Good Fit
Dr. Hakjun Kim, Director, Venus Clinic
