What concerns can you come in with?
Common reasons for consultation include fullness under the chin, a double chin visible in profile, loss of jawline definition or a less defined angle between the chin and neck.
In some patients, fat is the main issue. In others, skin laxity contributes even when there is relatively little fat.
Patients who have previously had injections, energy based treatments or liposuction but did not achieve the contour they wanted can also be reassessed.
Changes in the chin and neck after significant weight gain or weight loss can also be evaluated.
When should a swelling be medically assessed first?
A new, rapidly enlarging, one sided, firm or painful swelling under the chin or in the neck should not be approached as a routine cosmetic double chin concern.
The cause of the swelling should first be medically assessed.
What do I assess during consultation?
The first step is to determine what is creating the fullness under the chin.
The amount and distribution of superficial fat, skin elasticity, the appearance of the platysma, continuity of the jawline and forward support from the chin can all change the treatment plan.
When relevant, I also consider whether deeper neck structures are contributing to the contour and whether there is associated lower face descent.
Previous liposuction, laser treatment, radiofrequency, injections or surgery also matter. Earlier procedures can leave firmness, scar tissue or adhesions that may affect the planning of further treatment.
We also discuss the amount of change the patient actually wants. Reducing fullness under the chin and creating a very sharp chin and neck contour are not the same goal.
What treatment paths can the consultation lead to?
Different treatment paths may be appropriate depending on the findings.
When superficial fat is the main problem and skin quality is suitable, submental liposuction may be considered. If the skin has limited ability to retract, reducing the fat can make laxity more noticeable.
When fat and mild or moderate skin laxity are present together, liposuction may be combined with an energy based treatment intended to support skin tightening. When there is little fat and only limited laxity, a minimally invasive tightening treatment may sometimes be considered on its own.
When there is significant excess skin, a platysma problem, lower face descent or an important contribution from deeper neck structures, superficial treatment may not be enough. Face and neck lift surgery or, in appropriate patients, deeper neck surgery may then enter the discussion.
If limited chin support is contributing to the appearance, I discuss this separately from the double chin treatment itself. Fat reduction, neck lift surgery and deeper neck surgery do not change the bony projection of the chin.
For the general surgical scope of neck treatment, see the Face and Neck Lift page.
When do energy based treatments enter the plan?
Endolaser and FaceTite are not routine requirements in double chin treatment.
In my practice, I consider these options when the skin may benefit from additional support alongside fat reduction, or in some patients where the amount of fat is limited.
Liposuction and an energy based treatment can also be combined in the same session. This does not automatically produce a better result. A patient with good skin elasticity may not need the additional treatment. When there is true excess skin, an energy based procedure does not replace surgical skin removal.
I therefore choose the treatment according to the amount of fat, skin quality, the contour the patient wants and the amount of treatment they are willing to undergo rather than according to a device name.
Evidence for laser assisted treatments depends on the exact way the treatment is performed. Results from one laser protocol should not automatically be applied to every laser treatment.
The scientific and clinical limits of these options are discussed in more detail in How to Choose the Right Treatment for a Double Chin in the Knowledge Center.
What happens after the treatment plan is decided?
Depending on the procedure, treatment may be performed under local anaesthesia, sedation or general anaesthesia.
Procedures suitable for local anaesthesia can be performed in the clinic. Procedures requiring sedation or general anaesthesia are performed in a hospital operating theatre.
All of these treatments, including those performed under local anaesthesia, have their own risks and recovery considerations. We discuss these in relation to the specific procedure once the treatment plan is clear.
Not every patient is suitable for local anaesthesia. The choice depends on the scope of the procedure, the patient and the conditions required to perform it safely.
I do not perform more substantial surgical procedures such as submental liposuction on the same day as the consultation. The procedure is scheduled separately so that the patient has time to consider the recommended treatment and the alternatives without feeling rushed.
Early swelling, tissue firmness and temporary contour irregularities can obscure the true result. Follow up and recovery planning depend on the procedure performed.
What will you know by the end of the consultation?
By the end of the consultation, my aim is for you to understand which anatomical structure is most important, what level of treatment is appropriate, whether one procedure or a combination is likely to be needed and what the expected change means in relation to the treatment burden.
Some patients have one clear treatment path. Others may have a choice between a more limited and a more extensive option.
The plan is based not only on the result that may be achievable, but also on the amount of intervention and recovery you are comfortable accepting.
What information is useful before your appointment?
If you have previously had liposuction, injections, laser treatment, radiofrequency or another procedure under the chin or in the neck, it is useful to know approximately when it was performed and, if possible, the name of the treatment.
The timing of any significant weight loss or weight gain can also be relevant.
Older profile photographs can be helpful when trying to understand how the jawline and neck contour have changed over time.
Consultation for double chin treatment
Choosing the appropriate treatment starts with identifying which anatomical structure is creating the visible fullness.
During consultation, we consider your anatomy, the change you want and the amount of treatment you are comfortable undergoing before deciding on the appropriate path.
You can arrange a consultation for double chin treatment.
How are the treatment options different?
For a more detailed explanation of why non surgical treatment, liposuction, laser assisted procedures and neck lift surgery may be appropriate in different situations, see How to Choose the Right Treatment for a Double Chin in the Knowledge Center.