Almost every week, someone sits in my practice and says: "I'm not overweight, but this double chin is driving me crazy." Most of the time, they're slim people who can't understand why this particular area won't cooperate. Here's why that happens and what you can do about it — without a scalpel.
Why do I have a double chin even though I'm slim?
I get this question constantly. And the answer surprises most people: a double chin has only a limited connection to body weight. Yes, excess weight causes fat deposits under the chin too. But the majority of my patients with a double chin have a perfectly normal BMI.
The most common causes:
- Genetics: Where your body stores fat is largely hereditary. Some people gain weight at the hips first, others under the chin. Look at your parents — if someone in the family has a double chin, you have your answer.
- Bone structure: A short chin or a flat mandibular angle makes everything beneath it more prominent. Sometimes the problem isn't fat at all, but a lack of structural contour.
- Ageing: From your mid-30s onward, connective tissue loses its firmness. The skin becomes looser, the transition between chin and neck gets softer. A process you can't stop, but you can treat.
- Posture: Sounds trivial, but spending all day staring at a screen shortens the front neck muscles. The chin pushes forward, and the submental area — the area under the chin — becomes visually emphasised. Not a medical problem, but it reinforces the impression.
Which methods exist — without surgery?
There are essentially three approaches I use in my practice. Each has its place, and often a combination works best.
1. Fat dissolving injections (injection lipolysis)
This is the most obvious method when fat is genuinely the problem. A substance — typically deoxycholic acid — is injected in small amounts under the chin. It destroys the fat cell membrane, and the body then clears the cells through the lymphatic system. This takes a few weeks, and you usually need two to three sessions. But the result is permanent: fat cells that are gone don't come back.
What I always tell my patients: the first few days after treatment don't look pretty. There's swelling, it can feel warm, and sometimes there's bruising. That's normal and shows the substance is working. After a week, the worst is over, and after six to eight weeks you see the result.
2. Jawline contouring
If the double chin is more noticeable because of an undefined jaw line, jawline contouring is often the better choice. Hyaluronic acid is used to strategically build up the contour of the lower jaw. The effect: a clearer transition between face and neck. The double chin itself isn't treated — but it becomes far less noticeable because the proportions are right.
The result is immediately visible and lasts nine to fifteen months. For many patients, this is the preferred method because it's done in a single session with no downtime.
3. Chin augmentation
With a receding chin — one that barely projects forward — there's automatically a soft transition to the neck. It looks like a double chin but has nothing to do with fat. In this case, chin augmentation with filler can help: the chin is subtly projected forward, and suddenly the entire lower half of the face looks firmer.
It might sound counterintuitive — you want to treat the double chin, not the chin itself. But that's exactly the point: sometimes the solution lies somewhere different from the problem.
What doesn't work?
I have to be honest here, even if it's not what some people want to hear:
- Chin exercises and facial gymnastics: There is no credible study showing that facial exercises reduce subcutaneous fat. You can train muscles, but you can't "exercise away" fat deposits.
- Creams and serums: No topical product can dissolve fat tissue. Regardless of what the packaging says.
- Cryolipolysis ("CoolSculpting") on the chin: Works in principle, but the area under the chin is small and hard to grip. I've seen too many disappointing results during my training to recommend it in good conscience.
That's not to say losing weight doesn't help — if you're overweight, weight loss can certainly reduce a double chin too. But targeted fat loss in one specific area is a myth that refuses to die.
My recommendation: understand first, then treat
The most important thing is the diagnosis. Sounds dry, but it's crucial. Before I suggest a treatment, I look at three things:
- Is it fat? Can you pinch and squeeze the tissue under the chin? Then fat dissolving injections make sense.
- Is it the contour? Is the jaw line undefined or the chin short? Then jawline contouring or chin augmentation will help more.
- Is the skin lax? With significant skin excess, non-invasive methods have their limits. In that case, I'd honestly say: a surgical lift will give you a better result than ten sessions with me.
Often it's a mix, and then I combine. First reduce the fat, then build the contour a few weeks later. Together, that produces the most natural-looking result.
What does it cost?
Fat dissolving injections start from 149 EUR per session. With two to three sessions, you're looking at roughly 300-450 EUR total. Jawline contouring from 349 EUR, chin augmentation likewise from 349 EUR. A combination of fat dissolving and jawline contouring costs around 500-700 EUR altogether.
Compared to surgical chin liposuction (from 2,000-4,000 EUR), that's considerably less expensive — with the advantage that you don't need anaesthesia and can go back to work the next day.
My conclusion
A double chin is not fate, and it's not a sign of poor discipline. It's usually genetic or anatomical, and it can be treated effectively. Which method is right depends on the cause — and that's exactly what the consultation is for. Come in, and I'll honestly tell you what will make the biggest difference for you. Even if the answer is: nothing, for now.
