Double chin lift: what alternative treatments are available?

Submental fat, commonly referred to as a double chin, is a collection of adipose tissue beneath the chin that can be associated with skin laxity. It may result from weight gain, skin ageing or genetic factors. This accumulation alters the facial contours and gives the lower face a sagging appearance.

The double chin lift, also known as a cervico-mental lift, aims to correct this sagging by tightening the skin and removing excess fat. Performed by a plastic surgeon, this procedure redefines the cervico-mental angle and improves the facial oval. It is a cosmetic intervention, generally carried out under local or general anaesthesia, with a post-operative recovery period. However, for those wishing to avoid invasive surgery, several non-surgical alternatives may be considered.

It should be noted that a double chin lift is a surgical procedure. As such, it can be invasive and the patient’s profile is not necessarily suitable for the intervention. Indeed, in some cases, this procedure 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 damage may occur. To avoid surgery, there are alternative methods to a double chin lift.

Injections of sodium deoxycholate.

These injections contain, in their formulation, sodium deoxycholate. This lipolytic molecule is naturally present in the human body and participates in ensuring the destruction of fat cells. Therefore, injections in the double chin area allow for the elimination of fat from this region.

A study published in Plastic and Reconstructive Surgery involving more than 500 patients demonstrated a significant reduction in submental volume after 2 to 4 sessions, with visible improvement from 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 subsided within four days.

Radiofrequency for non-surgical skin tightening.

Radiofrequency treatment is performed using a rather specialised device. It emits electromagnetic discharges that penetrate the deep areas of the neck to heat them. These discharges serve to stimulate the production of collagen, an essential component of cellular regeneration. As skin cells renew more rapidly, the skin is 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 noted a visible improvement in jawline contour and a reduction in laxity. This technique therefore appears suitable for mild to moderate skin laxity, particularly as an adjunct to cryolipolysis.

However, radiofrequency may cause mild, transient side effects such as redness, swelling or skin sensitivity in the treated area.

Cryolipolysis to target localised fat deposits.

The cryolipolysis is a non-invasive technique based on the principle of eliminating fat cells using cold. The device suctions the skin and locally cools the submental area to around –10 °C, inducing 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 and without significant excess skin. However, it does not address skin laxity. Moreover, the sample size appears too small to confirm the data obtained in this study.

However, cryotherapy may cause redness, temporary numbness, tingling or slight swelling of the treated area.

High-intensity focused ultrasound (HIFU) for a gradual 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 face and neck. It relies on the transmission of 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), a structure also addressed in 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 rise induces an immediate contraction of collagen fibres, followed by a neocollagenesis process : fibroblasts are stimulated to produce new fibres of collagen and elastin over several weeks to months. This gradual remodelling improves firmness, redefines the facial contour and reduces the appearance of a double chin. It should be noted that the ultrasound can 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).