Double chin is a very common issue among patients. Although usually associated with the aging process, it can be seen at younger patients due to genetic predisposition, muscle anatomy, fat accumulation or a combination of the above.

Double chin can significantly affect overall face appearance since it distorts face symmetry and proportions. Clinically investigating the cause of the problem is the first step to a successful treatment.

In most cases treatment options include both surgical and non-surgical procedures.

Treating skin laxity

The skin under the chin is very prone to skin laxity as we age. However, genetic predisposition can be the cause of skin laxity even at a very young age.

Depending on patient’s age, gender, habits (such as smoking) and severity of skin laxity, treatments of skin laxity include:

  1. Skin tightening mesotherapy
  2. Threads
  3. Skin tightening devices such as Thermage®, Fractional Laser, Morpheus8® or Ulthera®
  4. Surgical Neck lift

It goes without saying that tightening the skin under the chin is crucial. However, no matter how much we tighten the skin, the results won’t be good enough if there is implication of muscle anatomy and/or fat deposits accumulation.

Treating the muscle - Platysmaplasty

The platysma is a thin, sheet-like layer of muscle below the skin of the neck and jawline. There is often a gap in the midline which varies in size among patients. Aging usually makes the gap wider, so that platysma looks like two completely separate muscles. Genetic predisposition can also lead to a substantial gap, even at a very early age.

This gap in the platysma can be the main or secondary cause of a double chin.

Botox injections can help at a very early stage, although the only effective treatment is surgery (Platysmaplasty).

A platysmaplasty involves tightening the platysma muscle and lifting it upwards. Typically a small incision is made under the chin to access the area where the two muscle bands are separated. The bands are sutured together in the midline (midline platysma plication), lifting the muscle up and eliminating the double chin.

Upon waking from surgery the neck will feel tight. The sensation of tightness settles gradually as healing progresses. Usually patients need a few days of downtime, although some develop bruising and swelling along the jawline and neck which may take a week to subside.

The results from a platysmaplasty are visible immediately after surgery and continue to improve over approximately 3-4 weeks.

The procedure is very often combined with liposuction or VASER liposuction to additionally treat fat deposits.

Platysmaplasty is also commonly performed in combination with deep plane facelift and neck lift.

Treating fat deposits

Fat deposits are very common under the chin.

Dr Pagkalos give his patients the option to treat fat deposits surgically or non-surgically.

The non-surgical approach includes lipolytic agents, such as Kybella®.

It is an injectable treatment that dissolves fat cells. Each treatment session requires multiple injections and patients typically need a series of treatment sessions to see significant results. Under certain conditions (e.g. stable body weight), the results can be permanent.

If the patient opts for the surgical solution, the gold standard for double chin is VASER® liposuction.

Dr Pagkalos uses VASER® liposuction to meticulously suction subcutaneous fat in an atraumatic manner. VASER® allows the plastic surgeon to safely remove even the most superficial layers of fat, completely eliminating fat deposits and, at the same time, to achieve a mild contraction of connective tissue and consecutive tightening of the skin. When performed correctly, VASER® liposuction can lead to astonishing, permanent results.

Although VASER® liposuction can be combined with face lift or neck lift to further tighten the skin, in most cases, especially in younger patients, the treatment itself offers a decent degree of skin tightening.