Hello, this is LiMO Plastic Surgery Clinic.
 

When we consult with patients who want to get rid of their double chin, many of them believe that "all the fat under the chin can be removed through liposuction."

This is actually half true and half false. The fat under the chin consists of two layers, centered around the muscle: the "subcutaneous fat" above the muscle and the "submuscular fat" beneath it.
 

In the case of subcutaneous fat, a substantial amount can indeed be removed through liposuction. However, the submuscular fat beneath the muscle is a different story.
 

Today, we'll explain what "submuscular fat" - one of the crucial factors in improving a double chin - actually is, why it needs to be removed, and how to achieve reliable improvement.

 

1. The Structure of Double Chin Fat You Didn't Know About: Subcutaneous Fat vs. Submuscular Fat

Many people assume a double chin forms simply because the fat layer beneath the skin has thickened. In reality, however, the structure beneath the chin is more complex than most people think. The fat that forms a double chin is largely divided into two layers:

1) Subcutaneous Fat: Located between the skin and the muscle (platysma), this is the layer that can be removed through standard liposuction.
 

2) Submuscular Fat (Deep Fat): A mass of fat situated deep beneath the chin muscle (platysma).

▲ Actual ultrasound image of submental area 

Two layers of fat are distributed above and below the central muscle layer.

 

As shown in the ultrasound image above, the thickness of the subcutaneous fat above the muscle layer (platysma) and the deep fat below it is nearly a 1:1 ratio. In other words, no matter how much surface fat is removed, if the deep fat beneath the muscle remains untouched, the double chin will never show dramatic improvement.

 

2. Why Is Liposuction Alone Not Enough?

One question we frequently hear during consultations is, "Can't the deep fat also just be suctioned out?"

To answer directly: deep fat is nearly impossible to remove through suction. This is due to its distinct characteristics:

1) Tough Membrane: Deep fat is enclosed in a tough, dense membrane.
 

2) Larger Particles: Compared to subcutaneous fat, its fat particles are much larger and more tightly bound together.
 

3) Anatomical Risk: This area contains relatively large blood vessels and the major muscle supporting the underside of the chin, making it a high-risk zone for bleeding if a cannula (suction tube) is inserted blindly for suction.

Ultimately, since these fat deposits cannot be drawn out with a "needle" (cannula), they must be removed under direct visualization.
 

3. The Final Step in Resolving a Double Chin: "Submuscular Fat Removal" and "Muscle Tightening"

▲ Submuscular fat actually removed during surgery
 

As shown in the photo, the volume removed is quite substantial - roughly the size of two fingers.
With a fat mass of this size sitting deep beneath the chin, it's clear why external treatments like laser therapy or minor liposuction alone fail to produce a dramatically improved jawline.


 

▲ Ideal Cervicomental Angle: 90°–100°
 

Double Chin Surgery (Platysmaplasty) is not simply a matter of removing as much fat as possible.
If you still have a visible double chin or a persistent bulging pouch under the chin even after liposuction, you should have your submuscular fat (deep fat) and platysma muscle laxity evaluated.
 

To achieve an ideal cervicomental angle, it is sometimes not enough to simply tighten the muscle from the outside as the muscle must be opened, the submuscular fat must be removed manually, and then the platysma muscle must be tightened.
 

This surgery is not simple as it always requires precise diagnosis: from accurately assessing each individual's anatomy, thoroughly removing the submuscular fat (deep fat), to firmly tightening the platysma muscle where it's needed.

An accurate diagnosis can be confirmed through consultation with an experienced specialist and an ultrasound examination. So if you are struggling with big, heavy double chin, we hope that you can find the best approach to reveal your hidden beautiful jawline.