Face
What Causes a Double Chin? And How Can I Get Rid of Mine?
A double chin can reflect inherited fat distribution, overall body fat, loose skin or a combination. The treatment question is therefore what is creating the fullness. In this 2020 episode, Darren M. Smith, MD, a plastic surgeon in New York City, compares approaches to fat beneath the chin and skin along the neck.
In this episode.
Episode summary
A double chin can reflect inherited fat distribution, overall body fat, loose skin or a combination. The treatment question is therefore what is creating the fullness. In this 2020 episode, Darren M. Smith, MD, a plastic surgeon in New York City, compares approaches to fat beneath the chin and skin along the neck.
Dr. Smith explains why someone can have submental fullness despite regular exercise or a healthy weight. Weight change may affect the area, but exercising a particular body part does not selectively remove its fat.
Key takeaways
🔬 Identify fat versus skin.
Removing fat and addressing skin laxity are different goals; some people have both concerns.
🔎 Nonsurgical options have tradeoffs.
The recording discusses fat freezing and injectable treatment, including the possibility of multiple sessions and recovery after treatment.
🔬 Chin liposuction targets fat.
Dr. Smith describes it as an option for selected patients with localized fullness, sometimes performed with local anesthesia.
🔬 Skin treatment depends on the degree of laxity.
The discussion includes radiofrequency treatments and, for more substantial loose skin, neck lift surgery.
🔎 A combination may be considered.
The appropriate approach depends on anatomy and goals, rather than assuming one treatment fits every double chin.
Questions this episode answers
Can chin exercises get rid of a double chin?
The episode explains that targeted exercise cannot selectively remove fat from the chin. Overall weight change may alter fullness, but inherited fat distribution and loose skin can remain relevant.
Will liposuction also remove loose neck skin?
Liposuction removes fat. Dr. Smith distinguishes that goal from treating skin laxity and discusses additional procedures when loose skin is a separate concern. An assessment is needed to determine whether fat removal alone is suitable.
ℹ️ Current context for this 2020 recording
Kybella is an FDA-approved prescription drug containing deoxycholic acid for fat beneath the chin in adults; it is not an enzyme. Suitability and risks require a clinician's assessment.
In October 2025, the FDA issued a safety communication about certain uses of radiofrequency microneedling, reporting complications including burns, scarring, fat loss and nerve damage. This specifically concerns RF microneedling, which the episode discusses through Morpheus8; it should not be read as a finding about every type of radiofrequency procedure. Treatment preferences, prices and recovery examples in the recording reflect its original date.
🔗 Related information
Explore chin liposuction, FaceTite and AccuTite, neck lift surgery, or request a consultation with Dr. Smith in New York City.
Originally released July 5, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.
Original show notes
Double chin removal is one of the most common procedures performed by New York City board certified plastic surgeon Dr. Darren Smith. In this episode, Dr. Smith looks at what causes double chins and what we can do about them.
Read the conversation.
[00:08] I'm Board Certified New York City Plastic Surgeon Dr. Darren Smith, and this is Plastic Surgery Before and After, your source for the real deal about plastic surgery procedures, news about trends in aesthetic medicine, and candid sessions with industry insiders. We hope you enjoy today's episode. How do you get rid of a double chin? Let's begin by asking what causes a double chin in the first place. And like so many other things, the development of double chin is most likely due to a combination of genetic factors and also lifestyle factors. So, for example, it might be your balance of diet and exercise that leads you to put on weight, but it might be your genetic makeup that makes you more prone to deposit that weight in the form of fatty accumulation in the double chin area.
[01:07] And this is something that can be pretty clearly demonstrated by the fact that there are folks who are in very good shape, but they still have a double chin. For whatever reason, their body is essentially programmed to store their excess fat in the double chin, just like some people will preferentially store fat in their abdomen or in their hips or in their arms or their legs. Some people just preferentially store fat in the double chin area. And this can be particularly frustrating for someone who can successfully lose a great deal of weight, but they still have their double chin. So that being said, let's move on to discuss some double chin treatments. And I'll break these down into three basic categories. And the first one is double chin exercises.
[01:59] The next one is non-invasive treatments to get rid of the double chin. And the last one is surgery for double chin removal. And we'll just go through these one at a time. And the first one is pretty straightforward. And that is that for double chin exercises, we can go ahead and say, pretty accurately that they really aren't going to do that much. So for the same reason that doing lots of sit-ups won't necessarily burn belly fat, but instead burn fat from all over the body, any exercises that you're doing to try to burn fat specifically from your double chin area, or as we call it, the submental region, that means behind the chin because mentum means chin and sub is underneath or behind. You really just can't target that with specific diet or exercise maneuvers. If you do, however, manage to lose a significant amount of weight through diet and exercise, you likely will lose fat deposits all over your body and your double chin probably will get a lot better.
[03:12] but you really can't specifically target your double chin for removal with diet and exercise. So we can move on to the next kind of double chin treatment. And this is the category of non-invasive therapies for double chin removal. And there are three big ones that bear mentioning. The first one is CoolSculpting. And CoolSculpting is a wildly popular treatment that can do some good non-invasive body contouring for the right candidate, and that's the person who has very localized fat deposits. CoolSculpting can effectively treat these in some cases by putting the applicator over the area of interest and then the applicator will bring the fatty tissue in that area down to a critical temperature and induce those fat cells to die on their own. CoolSculpting can work for people that have very well-defined double chins. It can take multiple rounds of treatment and it can be fairly uncomfortable. It can end up costing quite a bit. But for someone who is really completely opposed to surgery, it's a reasonable thing to consider. But again, it requires a in-depth consultation with a body contouring expert who can really discuss your options with you. The next kind of tool in our toolkit for non-invasively dealing with a double chin and I'm including injectables and things like microneedling under non-invasive just to distinguish between surgical treatments and treatments that aren't surgical. So non-invasive in the sense that there's no surgery or incision involved is something called Kybella and Kybella is actually an injection that you can have in your double chin.
[05:11] And Kybella is essentially a enzyme that naturally occurs in the body that's been repurposed for the job of dissolving fat. And it is FDA cleared for use in the double chin or submental region. And this works by having a skilled injector essentially place the enzyme into your double chin. And over time, it literally dissolves the fat in the area. Now, the issue with Kybella is that it does require several rounds of treatment and multiple injections. And each round of treatment comes with significant swelling and bruising and discomfort. And over the course of these several treatments, they really do add up significantly in terms of cost.
[06:01] The next thing that we can discuss in terms of non-invasive ways to get rid of a double chin would be radiofrequency microneedling. And the device that I really like for this is called Morpheus 8. And the way that radiofrequency microneedling works is that tiny little needles are used to penetrate the skin and create micro injuries and these micro injuries as they heal cause collagen and elastin production and this causes soft tissue to contract and at the same time the micro needles from the Morpheus 8 device emit radio frequency energy and this radio frequency energy can actually melt the fat in the submental region so On the whole, this sounds very good in theory, but it really only works for the kind of perfectly selected candidate, and that's someone who has a very isolated low-volume double chin. And the reason for this is that the Morpheus 8 device can really only penetrate with its energy to a depth of about five millimeters, so there's only so much fat melting and contraction that you can get with this. So I think that Morpheus 8 is a really good device for generalized skin toning and resurfacing, but its ability to treat a double chin is limited except for in really the very carefully chosen candidate. So what then is a very reliable slam dunk way to treat a double chin? Well, to get into this category we really need to start looking at surgical options and the good news about the surgical options for double chin removal is that they really are minimally invasive and the two big surgical options for double chin removal are liposuction and skin tightening procedures and the choice of the correct surgery for double chin removal really comes down to what is causing that double chin. And there are three possibilities here. The first is that the double chin is caused purely by excess fat. The second is that the double chin is caused purely by loose skin or skin excess, and this is the least likely scenario.
[08:27] And the third possibility is that the double chin is caused by a combination of excess fat and loose skin or skin excess. So in the case of the double chin caused purely by excess fat, this is very nicely dealt with with just some very limited targeted liposuction. And to do this, two to three millimeter tiny incisions are made. One behind each earlobe and usually one right in the chin crease so nobody is ever going to see these. Numbing medicine is placed through these incisions and the excess fat is simply suctioned out. And this is an operation that is so straightforward and really causes minimal discomfort that we often do it while the patient is wide awake. They come in, have the procedure, and they leave. The one thing to know about this procedure is that We do like our patients to wear a compression device, a chin strap, for about 48 hours afterward. So if you're a busy working professional, you might want to do it on a Friday so you could be back at work on Monday without your chin strap. Now, for the case of loose skin, for mild to moderate cases, We really like radio frequency energy for this in the form of a device called FaceTight or Acutight. And they're really the same device except for the Acutight device is a bit smaller so it allows us to target smaller areas of skin excess and the FaceTight device is really better for treating kind of global neck and jawline problems. And that works by putting one prong of the device through the same kind of incision that we used for liposuction.
[10:12] And the other prong of the device goes on the outside of the skin, and it essentially fires radiofrequency energy across the skin between the two prongs of this device. And there are thermometers on both of the prongs, the one that's internal and the one that's external. So the temperature is very precisely monitored, and the tissue is heated to the point that it's going to shrink and contract. And again, there's collagen and elastin production that helps with this process. So now getting to the last kind of double chin, the one that is caused by a combination of fatty excess and loose skin. As you might imagine, this can often be treated very effectively by a combination of liposuction and face tight or acutite. So again, we're really taking a problem-based approach to this issue.
[11:05] And having done many of all kinds of these procedures ranging from CoolSculpting to Kybella and micro needling and liposuction and the different skin tightening procedures like Accutight and Facetight. I can tell you very objectively that, believe it or not, the recovery from liposuction with or without some kind of skin tightening is really just as easy, if not easier, than the recovery from CoolSculpting or from Kybella. I will say that the recovery from Morpheus 8 is a bit easier than all of these things, but it really isn't nearly as effective, so I won't add it into this comparison. swelling and bruising and discomfort that you're going to feel after Kybella or CoolSculpting really often ends up being worse than what you're feeling after this kind of micro-targeted liposuction with skin tightening when it's performed by an expert in the procedure. And it's also important to remember here that with pretty much all of these procedures you're going to be repeating them several times to get a result that might only come close to what you could get with just one round of liposuction by a body contouring expert. Now, for people that have extremely severe double chins with a very large component of significant skin laxity, then we would have to move away from these minimally invasive procedures and start talking about more invasive procedures like a neck lift.
[12:36] For the garden variety of double chin and for the vast majority of people that are coming in to see us for these, and they're often in their 30s, 40s, or 50s, the liposuction with some form of skin tightening is really gonna do a super job here. Another question that we're very frequently asked is, how much does double chin removal surgery cost? And double chin removal surgery is going to vary in cost significantly according to a few factors, the skill of your surgeon, the geographical location of your surgeon, and also the exact kind of technology that's being used, and also the severity of your problem, the complexity of the procedure that's required to deal with it. And I would think that it's fairly safe to say that on average you could probably have a procedure like this done looking across the country taking kind of all comers into account for anywhere from two to seven thousand dollars for any of these kind of non-invasive or minimally invasive approaches. So the bottom line with a double chin is that it's a very common problem.
[13:50] It's a nuisance. It's really hard, if not impossible, to entirely get rid of on your own. So hopefully, this overview has provided you with a sense of what options are available so you can start to think about what might be your favorite way of approaching double chin removal. Thanks for listening, and don't forget to subscribe, share the show, and head over to GarenSmithMD.com for more real-world plastic surgery talk.
Sources and context.
Original Captivate episode. Original release date: 2020-07-05. The recording is the source for the transcript and episode discussion. Later context in the written summary is identified separately.
Behind the conversation.
Darren M. Smith, MD, FACS