Question 1

How can you tell whether your double chin is fat-type or sagging-type?

Accepted Answer

The simplest way to tell the difference is to pinch the skin under your chin with your fingers and observe how the volume under your chin changes when you lie down. When you pinch the area under your chin between your thumb and index finger, if you feel a thick, soft pad of flesh, fat is likely the main cause. If only thin skin is pinched but your jawline still appears collapsed, sagging skin and tissue are likely the main cause. Key points for distinction: fat type vs. sagging type. When pinching under the chin: a thick pad of flesh is felt vs. mainly thin skin is felt. When lying down: volume does not decrease significantly vs. volume appears to flow backward and reduce. Accompanying features: tends to correlate with weight changes vs. the entire jawline boundary becomes blurred. Another clue is age and weight changes. If you have had a thick area under your chin since a young age regardless of weight, it may be genetic fat accumulation. If your weight has remained the same but your jawline has collapsed at some point, it is more likely sagging due to aging. However, self-assessment has limitations, so it is advisable to have a specialist confirm the exact cause ratio through palpation and diagnosis.

Question 2

What procedure is suitable for the fat type?

Accepted Answer

If fat is the main cause, procedures that reduce the volume of fat itself, most notably fat-dissolving injections, are considered first. For localized fat deposits like the under-chin area, it is often difficult to achieve the desired reduction through diet or exercise alone, so a method that directly targets the fat cells in that area is more efficient.

At Heal House, we perform fat-dissolving injections for managing localized fat such as a double chin. Because fat-dissolving injections vary in their mechanism and the number of sessions needed depending on the ingredients and protocol, the number of sessions and intervals are customized for each individual after assessing the amount of fat and skin condition. Even if it is the fat-type, if your skin elasticity is already low, a plan that considers the contour after fat reduction is necessary.

Question 3

Is lifting better for the sagging type?

Accepted Answer

Yes, if sagging is the main cause, lifting that tightens the tissue is prioritized over reducing fat. A sagging-type double chin is not due to excess fat but rather a loss of support in the skin and SMAS layer, causing the tissue to droop. In this case, reducing only the fat can make the remaining skin more noticeable.

For the sagging-type, treatments such as Ultherapy PRIME®, which delivers ultrasound energy to the SMAS layer, Thermage® FLX, which uses radiofrequency (RF) to induce collagen remodeling in the dermis, and Alltite, which also uses RF to help improve elasticity, are selectively used depending on the depth of sagging and skin condition. Ultrasound and RF act at different tissue depths, so it is advisable to determine which device is suitable based on diagnostic results.

Question 4

How should a double chin with both fat and sagging be approached?

Accepted Answer

In reality, the mixed type with both fat and sagging is the most common, and in this case, it is typical to plan for both fat reduction and elasticity improvement together. For example, gradually reducing the volume under the chin with fat-dissolving injections while tightening the skin and SMAS layer with a lifting device so that the area where fat has been removed appears smooth. The order and intervals vary depending on the condition. If the amount of fat is large, fat reduction may be performed first, followed by elasticity management. If sagging is prominent, lifting may be the focus with fat management as a supplementary approach. Regardless of the combination, the two procedures should be scheduled with recovery intervals so that their timing does not overlap, so it is recommended to set the overall schedule through a consultation with a specialist.

Question 5

Can sagging occur after reducing fat?

Accepted Answer

If skin elasticity is sufficient, there is generally little to worry about, but if elasticity is already reduced and fat is reduced quickly, the excess skin may appear looser. Fat also plays a role in supporting volume beneath the skin, so when that volume decreases, if the skin cannot contract and follow accordingly, fine wrinkles or sagging may become relatively noticeable. Therefore, evaluating skin elasticity before the procedure is important in planning a double chin treatment. Young, elastic skin tends to contract naturally after fat reduction, but if reduced elasticity is present, it is appropriate to plan for both fat-dissolving and lifting from the beginning. Please check through a consultation which category your skin falls into.

Key differences	Fat-type	Sagging type
When pinching under the chin	A thick pad of flesh is felt	Only thin skin is felt
When lying down	Volume does not decrease significantly	Volume appears to decrease as it shifts backward
Associated features	Tends to change with body weight	The entire jawline becomes less defined

Double Chin: Fat or Sagging?

How can you tell whether your double chin is caused by fat or sagging skin?

If it is fat, which treatment is right?

If it is sagging, is a lifting procedure better?

If your double chin involves both fat and sagging, how should you approach it?

Can reducing fat cause sagging?

References