How to lose a double chin: is it fat or sagging?
Plenty of people who aren't carrying much weight tell me their chin turns into two in every photo. Not every double chin is the same. When fat leads and when loose skin leads, the right approach can be the opposite.
The short answer
A double chin comes from fat under the chin, loose skin, a short or set-back chin, and a head-down posture, often several at once. The first step is working out which leads. Most of the evidence is for injections that break down fat under the chin. In long-term follow-up of the phase 3 trials, response held in 86.4% at one year (placebo 56.8%) and 82.4% at three years (65.0%). If loose skin leads, though, removing fat isn't the right fix. At Miso Clinic, 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu (Exit 1, Kyungpook Nat'l Univ. Hospital Station), +82-53-428-2700, I sort out fat versus sagging. We don't perform liposuction.
Why does a double chin form?
Under the chin there is fat just below the skin and fat under the muscle. Some people store fat here first when they gain weight, and some slim people simply carry more here.
With age, the skin and the muscle at the front of the neck loosen, so the area below the jawline sags. A short or set-back chin makes the same amount of fat stand out more. Anyone gets two folds with their head down, so photo angle plays a big part too.
I couldn't find a study measuring how much each of these four contributes. Most people have two or more.
How do you tell fat from sagging?
| Check | If this happens | Likely cause |
|---|---|---|
| Pinch under the chin with thumb and finger | A thick roll gathers | Fat |
| Tilt your head up slightly | The second fold almost disappears | Posture and angle play a big part |
| Gently lift the lower face with your hand | The jawline comes back | Sagging skin |
| In profile, the chin sits close to the neck | Two folds even with little fat | Chin shape |
In clinic I check the same things with your sitting position and head angle matched. If your weight has changed a lot recently, tell me that too.
How well do submental fat injections work?
Fat-dissolving injections under the chin have a fair number of randomised trials. In a follow-up of 224 people from the phase 3 trials, improvement of one grade or more held in 86.4% at one year, 90.6% at two and 82.4% at three. The placebo groups were 56.8%, 73.8% and 65.0%, and some authors worked for the manufacturer.
A trial in people with only mild fat under the chin also showed 61.3% versus 6.7%, and most people improved by one grade within two to four sessions. In a Korean phase 2 trial of 140 people, the 1% group reached 84.4% against 41.7% on placebo. Note how high that placebo figure is.
Swelling and pain are common. Rarely, an injection near the nerve that moves the corner of the mouth causes an uneven smile, and skin damage has been reported. A 2024 review notes these injections don't suit cases where sagging is the cause.
What about Botox or exercises for a double chin?
If the neck muscles stand out as bands, Botox to those muscles can come up. Botox doesn't remove fat, though. I couldn't find a trial of Botox injected into a double chin to shrink it.
I also couldn't find research showing chin exercises or massage reduce a double chin. Losing weight lightens the area for many people, but older people sometimes find sagging shows more afterwards.
What about a double chin from loose skin?
When sagging leads, the aim shifts from reducing fat to tightening or lifting. I talk about RF or absorbable threads, and for people aged 50 and over I keep thread plans conservative.
If the laxity is large, the difference treatments can make is small, and I say honestly that a surgical consultation may fit better. No RF that day if you have metal or electronic implants, are pregnant or have skin inflammation.
→ More: Jawline sagging in Daegu: choosing devices and boosters in order
Double chin FAQ
I'm slim but still have a double chin.
Some people carry more fat under the chin because of jaw shape or build. Many second folds also come from head angle.
How many fat injection sessions are needed?
Trials allowed up to six, and most people improved by one grade within two to four. The number is best decided by how things go, not fixed in advance.
Do you do liposuction for a double chin?
We don't perform liposuction. If it looks necessary, I suggest a consultation where surgery is done.
Where can I get a double chin consultation in Daegu?
At Miso Clinic, 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu (Exit 1, Kyungpook Nat'l Univ. Hospital Station), +82-53-428-2700. Weekdays 11:00–19:00, Saturday 10:00–16:00, closed Sundays and public holidays.
Read next
Product pages
Related care: Lifting · Thread lifting
Who wrote this
Written and reviewed by Lee Chi-Hak, MD, director of Miso Clinic, Daegu. The treatment standards and injection design set out here are the ones we use in practice.
| Medical director | Lee Chi-Hak, MD |
|---|---|
| Address | 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, South Korea · Exit 1, Kyungpook National University Hospital Station |
| Phone | +82-53-428-2700 |
| Hours | Weekdays 11:00–19:00 (lunch 13:00–14:00) / Saturday 10:00–16:00 (no lunch break) / Closed Sundays and public holidays |
| Columns | All clinical columns |
| Reference library | All booster and device references |
References
- Three-year follow-up of submental fat injections — Humphrey S et al. Improvements in Submental Contour up to 3 Years After ATX-101. Aesthet Surg J 2021;41(11):NP1532-9. PMID 33617632. 224 people, includes manufacturer-employed authors.
- Analysis by session — Dayan SH et al. Efficacy and Safety of ATX-101 by Treatment Session. Aesthet Surg J 2018;38(9):998-1010. PMID 29401213.
- Trial in mild and extreme submental fat — Glogau RG et al. Dermatol Surg 2019;45(12):1531-41. PMID 30998531.
- Korean phase 2 trial — Paik SH et al. Dermatol Ther 2022;35(5):e15373. PMID 35142011. 140 people, placebo-controlled.
- Review of serious adverse events — Shridharani SM, Kennedy ML. Aesthet Surg J Open Forum 2024;6:ojae061. PMID 39247122.
- Korean medical advertising law — Korean Medical Service Act Article 56(2) (no treatment testimonials, no comparisons with other clinics, no superlatives). This is why this column carries no prices, reviews or before-and-after photos.
- Miso Clinic practice guidelines — Botox is offered for all areas; for hollow cheeks, dissolvable hyaluronic acid filler is considered first; no RF treatment that day if there are metal or electronic implants, pregnancy or skin inflammation; only absorbable threads are used and the plan is kept conservative for patients aged 50 and over; liposuction is not performed.
Everything in this column is general information and does not replace medical diagnosis or treatment. Effects and side effects vary with individual skin condition, age and underlying illness, and the same result is not guaranteed for everyone. Any decision to proceed should be made in an in-person consultation with a physician.