Double Chin Lift: What Alternatives Are Available?

A double chin is a fat accumulation located beneath the chin, which can be associated with skin laxity. It can result from weight gain, skin aging, or genetic factors. This accumulation alters the facial contours and gives the lower face a sagging appearance.

The double chin lift, also known as cervico-mental rhytidectomy, aims to correct this tissue sagging by tightening the dermal layers and removing excess fatty deposits. Performed by a plastic surgeon, the operation redefines the cervico-mental angle and refines the facial contour. It is an aesthetic procedure typically performed under local or general anesthesia, with a subsequent postoperative recovery period. However, for patients seeking to avoid invasive surgery, several non-surgical alternatives may be considered.

It is important to note that a double chin lift is a surgical procedure. As such, it can be invasive, and a patient’s profile may not necessarily be compatible with the procedure. In some cases, this intervention can lead to transient side effects such as swelling, bruising, pain, or altered sensitivity. More rarely, complications such as infection, asymmetry, visible scarring, or nerve injury may occur. To avoid surgery, there are alternative methods to the double chin lift.

Sodium deoxycholate injections.

These injections contain, in their formulation, sodium deoxycholate. This lipolytic molecule is naturally present in the human body and helps ensure the destruction of adipose cells. Injections targeting the double chin therefore enable the elimination of fat in this area.

A study published in Plastic and Reconstructive Surgery involving over 500 patients demonstrated a significant reduction in submental volume after 2 to 4 sessions, with visible improvement as early as the first month. The effect is permanent since the destroyed adipocytes do not regenerate. However, temporary side effects such as swelling, bruising, or numbness occurred in some patients, but they resolved within four days.

Radiofrequency for non-surgical skin tightening.

Radiofrequency therapy is administered using a highly specialized device. It emits electromagnetic discharges that penetrate the deep layers of the neck to heat them. These discharges serve to stimulate the production of collagen, an essential factor in cellular regeneration. With skin cells renewing more rapidly, the skin becomes firmer and the overall appearance of the neck is younger and more toned.

A clinical study published in the Journal of Cosmetic Dermatology (2017) evaluated the effect of a radiofrequency protocol on 25 patients. After 6 weekly sessions, 84% of participants reported a visible improvement in the jawline contour and a reduction in skin laxity. This technique therefore appears suitable for mild to moderate skin laxity, particularly as an adjunct to cryolipolysis.

However, radiofrequency treatment may lead to mild, temporary side effects, such as redness, swelling, or skin sensitivity in the treated area.

Cryolipolysis for targeting localized fat deposits.

The cryolipolysis is a non-invasive technique based on the principle of eliminating fat cells through cold. The device suctions the skin and locally cools the submental area to about –10 °C, triggering adipocyte apoptosis (programmed cell death).

A clinical study reported an average reduction of 0.2 mm in submental adipose tissue three months after a single session in 14 participants. This technique would be particularly suitable for individuals with a moderate double chin without significant excess skin. However, it does not address skin laxity. Furthermore, the number of participants appears too small to confirm the findings of this study.

However, cryotherapy may induce redness, temporary numbness, tingling, or mild swelling of the treated area.

High-Intensity Focused Ultrasound (HIFU) for a progressive lifting effect.

HIFU (high-intensity focused ultrasound) is a non-invasive technology increasingly used in aesthetic medicine to treat the skin laxity, particularly in the facial and neck areas. It works by delivering high-intensity focused ultrasound waves that pass through the epidermis without causing damage and precisely target the deeper layers of the skin, notably the deep dermis and the SMAS (Superficial Musculoaponeurotic System), which is also targeted during surgical facelifts. This beam of thermal energy creates coagulation points at approximately 60–70 °C at depths ranging from 1.5 to 4.5 mm, depending on the treated area. This localized temperature increase induces an immediate contraction of collagen fibers, followed by a neocollagenesis : fibroblasts are stimulated to produce new fibers of collagen and elastin over several weeks to months. This gradual remodeling improves firmness, redefines the facial contour, and reduces the appearance of a double chin. It should be noted that the ultrasound may cause temporary redness, slight skin sensitivity, or localized swelling after the session.

• SADICK N. & al. Cryolipolysis for noninvasive body contouring: clinical efficacy and patient satisfaction. Clinical, Cosmetic and investigational Dermatology (2014).

• KO J. & al. High-intensity focused ultrasound for the treatment of wrinkles and skin laxity in seven different facial areas. Annals of Dermatology (2015).

• SHAMAN A. T. & al. Noninvasive Submental Fat Compartment Treatment. Plastic Reconstructive Surgery (2016).

• GAMMIO S. & al. Submental fat reduction using sequential treatment approach with cryolipolysis and ATX-101. Journal of Cosmetic Dermatology (2022).

• MANUSKIATTI W. & al. Efficacy and safety of monopolar radiofrequency for treatment of lower facial laxity in Asians. Dermatology and Therapy (2022).