The area under the chin may be small, but for many people, it has an outsized effect on how they feel about their appearance. Submental fullness, commonly known as a “double chin,” can obscure the jawline, soften the neck, and create a sense of heaviness that doesn’t always reflect how you feel on the inside. It’s a feature that doesn’t always respond to weight loss or lifestyle changes, and it can affect people of all ages, body types, and genders.
At Ethos Plastic Surgery, we see patients every week who are frustrated with fullness beneath the chin. Whether it’s due to genetics, aging, or structural anatomy, this concern is incredibly common and very treatable. Harvard-trained plastic surgeon Dr. Ginger Xu offers a range of modern, minimally invasive techniques to sculpt and refine the lower face and neck with precision, artistry, and care.
Below, we’ll walk through the main causes of a double chin and the most effective treatment options to restore definition and confidence to your profile.
Understanding the Cause of a Double Chin
There’s no one-size-fits-all explanation for submental fullness.
Some people are genetically predisposed to storing fat under the chin, while others experience it as part of the natural aging process. Over time, the skin loses elasticity, soft tissues descend, and the muscle bands in the neck become more visible or less supportive.
For others, the appearance of a double chin stems not from excess fat, but from a recessed chin, which makes the transition between the jaw and neck appear less defined.
It’s also common for the issue to be multi-layered, involving a combination of fat accumulation, skin laxity, muscle sagging, and bone structure.
During your consultation, Dr. Xu will evaluate the quality of your skin, the tone of your neck muscles, and the underlying facial framework to determine the best approach for your goals.
Chin Liposuction: A Targeted, Minimal Downtime Solution
For patients who have good skin tone and a clear pocket of fat beneath the chin, liposuction offers a direct, effective solution. Through a tiny incision (often placed discreetly beneath the chin), Dr. Xu uses a fine cannula to gently remove the fat, creating a smoother and more sculpted transition between the face and neck. Since the procedure targets fat without affecting deeper tissues, the recovery is relatively quick. Most patients are back to light activity within a few days.
Dr. Xu often performs chin liposuction using only local anesthesia, meaning you can stay awake during the procedure without the risks or side effects of general anesthesia. You’ll wear a soft compression garment afterward to minimize swelling and support healing. The result is a refined, natural-looking profile that enhances the overall harmony of your face.
This option is ideal for younger patients with good skin elasticity and isolated fat accumulation under the chin.
Neck Lift or Lower Face Lift: When Skin and Structure Need Support
If your concerns extend beyond fat, such as sagging skin, visible neck bands, or jowling, a surgical neck lift may be the most appropriate solution. A neck lift focuses on tightening the platysma muscles, removing excess fat and skin, and repositioning the remaining tissues for a smoother, more youthful contour. When combined with a lower facelift, this approach also addresses laxity along the jawline and sides of the face.
Dr. Xu’s aesthetic philosophy emphasizes balance, elegance, and natural outcomes. Her surgical lifts are designed to restore youthful structure without creating a pulled or overdone appearance. Every incision is placed with intention, often hidden behind the ears or beneath the chin, and her closure techniques are meticulous to ensure minimal scarring.
Most patients who undergo a neck lift or lower facelift require about two weeks of social downtime, though discomfort is typically very manageable. The results are long-lasting and often transformative, particularly for those who feel that their external appearance no longer matches their inner vitality.
Fat Transfer to the Chin and Jawline: Subtle Enhancement for Structural Support
In some cases, a double chin is not just about what’s there but also about what’s missing. When the chin is recessed or the jawline lacks strong definition, the neck can appear shorter or heavier. Rather than removing tissue, one elegant solution is to strategically add volume where it’s needed.
Dr. Xu uses fat transfer to enhance the chin and jawline using your body’s own tissue. First, she gently harvests a small amount of fat from another area, such as the abdomen or thighs. After purifying the fat, she reinjects it into areas where structure or projection is lacking. This can help improve facial balance, lengthen the profile, and reduce the appearance of fullness under the chin, all without implants or synthetic materials.
Fat transfer is often combined with chin liposuction or other contouring procedures to provide both reduction and enhancement. The result is a harmonious lower face that reflects your natural anatomy, just more refined.
Combination Approaches: Addressing Multiple Layers at Once
Many patients benefit from combining techniques to address multiple contributors to a double chin. For example, someone with mild to moderate skin laxity and fat accumulation might undergo chin liposuction along with fat transfer to the chin for added projection. Others may choose to combine a lower facelift with platysmal tightening to address both jowls and the neck in a single procedure.
Dr. Xu takes a comprehensive, holistic view of facial rejuvenation. Rather than isolating one feature, she considers how the chin, jawline, and neck all work together to create balance. This integrative approach ensures that no part of the face looks out of sync with the others. Her goal is always the same: results that look like you, only more defined, lifted, and refreshed.
The Gentle Awake Approach: Local Anesthesia, Less Downtime
One of the defining features of Ethos Plastic Surgery is Dr. Xu’s expertise in performing many facial procedures under local anesthesia. This approach, often called “awake surgery,” allows patients to remain comfortable and calm without the risks or recovery associated with general anesthesia.
Patients often report feeling more in control, more comfortable, and more at ease throughout the process. Awake surgery also typically means a smoother recovery, less swelling and bruising, and the ability to return to normal activities sooner.
Dr. Xu has spent years refining her techniques to make awake procedures feel effortless. Her calm demeanor, gentle touch, and clear communication make the experience feel more like a collaboration than a medical procedure.
Recovery and Healing: What to Expect
Your recovery will depend on which procedure you undergo, but Dr. Xu’s approach to post-operative care is consistent: personalized, attentive, and focused on your comfort and results.
For patients undergoing chin liposuction or fat transfer, swelling is typically mild and resolves within one to two weeks. You may need to wear a compression garment under your chin for several days, but most people return to work within a few days and can resume normal exercise within a couple of weeks.
Those who undergo a neck lift or lower facelift will need a bit more recovery time. Bruising and swelling may last up to two weeks, and strenuous activity should be avoided for at least three weeks. Dr. Xu and her team will provide detailed aftercare instructions and remain closely involved in your healing process. Follow-up visits are scheduled regularly to ensure you are healing beautifully and on track to see your best results.
The Ethos Philosophy: Honest, Holistic, and Highly Personalized
At Ethos Plastic Surgery, every treatment begins with a thoughtful conversation. Dr. Xu is deeply invested in understanding your motivations, preferences, and personal aesthetic vision. Her consultations are not just about facts and options; they are about you as a person.
She will never push you toward a procedure that doesn’t align with your goals. Instead, she will help you understand all your options and recommend the path that is most likely to give you long-lasting satisfaction. Her warm and intuitive style helps patients feel seen, heard, and fully supported throughout their aesthetic journey.
From the first consultation to the final follow-up, you’ll be cared for with precision, empathy, and an unwavering commitment to excellence.
Ready to Refine Your Profile? Let’s Talk.
You don’t have to settle for a profile that doesn’t reflect how you feel on the inside. Whether your concern is minor or more advanced, Dr. Xu offers refined, modern solutions that can restore confidence and redefine your lower face with elegance.
If you’re ready to explore your options for double chin removal in San Francisco, we invite you to schedule a consultation at Ethos Plastic Surgery. Dr. Xu will take the time to understand your goals, educate you on the most effective approaches, and create a plan that brings your vision to life.To get started, call us at (415) 506-4300 or request a consultation online. We look forward to meeting you. Be sure to also review the Ethos Collection, our one-of-a-kind collection of healing and wellness strategies. We look forward to hearing from you soon!