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Wrinkles & Contour The L Ultherapy PRIME®

Double chin, how to get rid of it?

Hanmi Jung, Director Hanmi Jung Dermatologist · Gangnam Branch

Last reviewed

For a double chin, the first step is to determine whether it is the fat type or the sagging type. For the fat type, fat reduction treatments such as fat-dissolving injections or LSSA are primarily considered; for the sagging type, lifting treatments such as Ultherapy PRIME®, Soprano Titanium, or Alltite are primarily considered; and for the mixed type combining both, the approach is to reduce fat first and then tighten elasticity.

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

A double chin is broadly divided into the fat type, where fat accumulates, and the sagging type, where skin and tissue have loosened. Identifying the cause is the starting point for choosing a method. If, when you gently pinch the area under the chin, you feel a thick layer of fat, it is closer to the fat type. If the skin folds loosely rather than feeling thick, the sagging type is more prominent.

The fat type is closely related to body weight, genetics, and accumulation of fat under the chin (submental fat). The sagging type occurs as collagen decreases with age and the jawline tissue descends. Collagen is known to decrease by about 1% per year starting from one's 20s, so the proportion of sagging factors tends to increase with age.

Since the two types often appear together as a mixed type, an evaluation that comprehensively considers fat volume, skin elasticity, and jawline shape is accurate. In clinical practice, most cases involve a combination of the fat type and the sagging type.

When are fat-dissolving injections effective?

A fat-dissolving approach is suitable when the main cause of the double chin is primarily 'fat.' If accumulated fat feels thick and skin elasticity is relatively maintained, reducing localized fat can help refine the jawline.

However, it is important to understand that fat-dissolving focuses on reducing fat and does not have a significant skin-tightening effect. If skin elasticity is already reduced, reducing only fat may make sagging more noticeable. Therefore, when sagging is also present, elasticity management is needed together. The degree of improvement and the number of sessions required for fat-dissolving vary depending on the amount of fat and individual differences, so it is difficult to generalize.

Double chin typeMain causePrimary approach to consider
Fat-typeAccumulation of fat under the chinFat-dissolving injections, AGNES, LSSA
Sagging typeDecreased elasticity and tissue descentUltherapy PRIME®, Soprano Titanium, Alltite
Mixed typeFat + saggingCombination of fat reduction treatment and elasticity lifting

Since the plan differs depending on whether the fat type is clear or sagging is mixed in, it is important to first determine the proportion of the cause.

If sagging is the cause, is a lifting procedure a better option?

If sagging is the main cause, lifting to improve elasticity is more suitable than fat-dissolving. Loose skin and descended jawline tissue are not resolved by reducing fat; in fact, excess skin may remain and make sagging more pronounced.

Among lifting options, ultrasound-based Ultherapy PRIME® is the most effective for double chin lifting. The number of shots for Ultherapy lifting for the double chin is determined based on the condition of the jawline, typically ranging from as few as 50 shots to about 150 shots. The effects generally begin to appear about 4 weeks after the procedure and settle over several months as collagen is remodeled.

Since the appropriate device and intensity vary depending on the degree of sagging and skin thickness, whether to use lifting and the combination are determined according to the condition of the jawline.

Why is skin tightening important after reducing fat?

After reducing fat, elasticity management of the remaining skin should be performed together to create a natural jawline. When the volume occupied by fat decreases, the skin that covered that area becomes relatively loose. If elasticity is insufficient, the skin may appear to sag again.

Especially in cases where you are older or elasticity has already decreased, combining fat reduction with elasticity lifting can help the skin settle smoothly to match the reduced volume. For this reason, in mixed-type double chins, the sequence and combination design of 'reduce fat → tighten elasticity' determines the naturalness of the result.

A plan that considers both fat and elasticity varies depending on individual skin condition, so designing the combination and sequence according to your condition is key to a natural result.

Which combination of treatments is right for you?

For a double chin, satisfaction tends to be higher when fat reduction and elasticity lifting are combined according to the proportion of the cause. For the fat type, a fat reduction approach is central; for the sagging type, lifting is central; and for the mixed type, sequentially combining both methods is commonly recommended.

At Heal House, we evaluate the amount of fat under the chin, skin elasticity, jawline shape, and age group together to adjust the proportion of each approach. Adding lifestyle habits such as weight management and good posture can help maintain an improved jawline for longer. However, if fat accumulation is very severe or sagging is significant, non-surgical methods may have limitations in the degree of improvement.

Since the appropriate combination and number of sessions vary greatly between individuals, we recommend establishing a double chin improvement plan through a consultation with a dermatologist.

References

Hanmi Jung

Dermatologist · Gangnam Branch

I strive to be a lifelong skin doctor you can trust with all aspects of your skin, not a doctor who is forgotten after a single procedure.