Why Weight Loss Doesn’t Clear a Double Chin — It May Not Be Fat

Hello. I am Dr Song Myeong-seung of NUWA Clinic Gangnam, where I diagnose the concern before I treat the face.

Over more than ten years of double chin consultations in my Gangnam practice, there are things I hear often. “I’ve lost weight but only the double chin is left.” “I had contouring injections and the area under my chin is exactly the same.” Most people think of submental fat first when they hear “double chin”, but it is not fat more often than you might expect. And if it is not fat, dissolving fat naturally changes nothing.

Today I want to divide the causes of a double chin into four and set out which approach applies to each.

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There are four causes of a double chin

A double chin arises from four causes — submental fat, descent of tissue from the cheeks and around the mouth, the structure of the chin tip, and posture together with neck structure — and cases combining two or more are the most common.

A different cause changes whether you dissolve, lift or connect. So before deciding on a treatment, you have to establish what is filling the area under the chin.

If submental fat is the cause: contouring injection and Shurink

A double chin that feels thick when you pinch it, and that grows and shrinks along with your weight, is caused by fat. Here I look at dissolving it with a contouring injection, or tidying it with ultrasound lifting such as Shurink.

The contouring injection is a lipolytic injection, so it suits places where fat has gathered, such as under the chin. Where fat can be pinched thickly I look at the contouring injection first; where the skin has also loosened along with the fat I look at ultrasound lifting first, and I plan the two together if needed.

There is one thing I should point out here, though. The area under the chin is not a place where reducing as much as possible is always better. If the volume that was providing support goes with it, the jawline can end up looking slacker instead. So even when fat is the cause, I look at how much to reduce as well.

If sagging is the cause: double chin lifting with Titanium or Ultherapy

A double chin where tissue from the cheeks and around the mouth has come down and settled below the jawline is not fat that has increased but something from above that has descended, so it stays even when you lose weight.

Double chin lifting is an approach that lifts the descended tissue and rebuilds the jawline. Where skin resilience has declined at an early stage I look at Titanium Lifting (Soprano Titanium); where the descent has begun at the fascial layer I look at Ultherapy (Ultherapy PRIME). Ultherapy delivers ultrasound as far as the SMAS fascial layer and lifts descended tissue from the inside, which suits a double chin that has come down from above.

People who say they have lost weight but the double chin alone remains often fall into this type.

If the chin tip is short: chin volume

Where the chin tip is short or set back, the jawline runs straight into the neck even without fat and reads as a double chin. Here I look at supplementing chin volume to create a boundary between chin and neck.

If the chin looks particularly absent in profile photographs, this is worth suspecting. It is an approach that connects rather than removes.

If posture and neck structure are the cause: treatment will not solve it

Where you spend long periods with your head down, or the neck sits forward, tissue under the chin folds and a double chin forms. This part is not solved by treatment.

In these cases, rather than recommending a treatment, I say that posture and neck structure need to be looked at as well. Distinguishing first between what treatment can address and what it cannot is our job.

Fat or sagging? How to check at home

Pinch under the chin, lift the cheek, and take a profile photograph with your head slightly raised — between them you can gauge whether it is fat, sagging or the chin tip.

If it feels thick when you pinch under the chin between thumb and forefinger, it leans towards fat. If lifting the cheek slightly with your hand also tidies the area under the chin, it leans towards sagging. If the boundary between chin and neck stays indistinct even in a profile photograph taken with the head slightly raised, the structure of the chin tip needs looking at too. Far more people have two of these combined than just one.

Where sagging and fat are both present, the order matters

Where a double chin involves both sagging and fat, dissolving the fat first can take the supporting volume with it and leave the jawline looking slacker instead.

So where sagging is present, I establish the line with lifting first and look at the fat afterwards, in small amounts. With the same contouring injection, a different order gives a different result.

Three things to check before double chin lifting

Whether what you can pinch under the chin is fat, whether the area tidies when you lift the cheek, and whether the chin tip is sufficient in profile. These three settle whether to dissolve, lift or connect.

If you feel you have lost weight but only the double chin remains, I will look at what it is that remains with you. You can also see how the lifting options compare in our lifting guide.

This has been Song Myeong-seung of NUWA Clinic Gangnam, where face shape concerns are diagnosed first.

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Frequently asked questions

Q. Will losing weight get rid of my double chin?

A. If fat is the cause, it can reduce. If sagging or the structure of the chin tip is the cause, it often remains regardless of weight.

Q. What if contouring injections don’t work on my double chin?

A. The cause may be sagging or the structure of the chin tip rather than fat. In that case, rather than having more contouring injections, I look at lifting or chin volume first.

Q. For double chin lifting, is Ultherapy or Titanium better?

A. It depends on which layer the sagging came from. Where skin resilience has declined at an early stage I look at Titanium; where the descent has begun at the fascial layer I look at Ultherapy.

Q. Can I have a contouring injection and lifting together?

A. Where sagging and fat are both present, they are sometimes planned together. The correct order, though, is to establish the line with lifting first and look at the fat in small amounts afterwards.

Q. Does chin filler help with a double chin?

A. Where the chin tip is short and the boundary between chin and neck is indistinct, it can help by carrying the jawline forward. It does not apply to those whose cause is fat.

Q. Shurink or contouring injection for a double chin?

A. Both can be considered where there is submental fat. Where fat can be pinched thickly I look at the contouring injection; where skin laxity accompanies the fat I look at ultrasound lifting such as Shurink first, and plan them together if needed.

Q. Is it better to remove as much submental fat as possible?

A. No. If the supporting volume goes with it, the jawline can end up looking slacker, so I look at how much to reduce as well.

Q. How long do the results last?

A. It depends on the cause, the type of treatment and the condition of your face. I give precise guidance after diagnosis.

*Effects and results of this treatment may vary with individual condition, and responses such as swelling, bruising or discomfort may appear afterwards. Accurate diagnosis and the decision on whether to proceed should always be made through consultation with a specialist.