How to Get Rid of a Double Chin: Fat, Skin or Bone?

Direct Answer

First work out what your double chin is made of. If it is fat under the chin, the options with evidence are weight loss (if your overall weight is high), fat-dissolving injections, fat freezing or liposuction. If it is loose skin or neck bands, fat reduction alone can make it look worse, and tightening or a neck lift is the answer. If your chin is short or set back, the shadow is partly bone, and a chin procedure can change the profile more than removing fat. No controlled trial shows that chin exercises reduce chin fat.

The numbers: in two placebo-controlled trials of deoxycholic acid injections (Kybella), 66.5–70.0% of treated patients improved by at least one grade on both doctor and patient scales, versus 18.6–22.2% on placebo, and the gains lasted to 3 years in most. Fat freezing reduced chin fat volume by about 20 cm³ on average across eight studies. Chin liposuction had an adverse-event rate of 12.9%, mostly minor. In Japan, fat freezing at one large chain starts at ¥29,800 per area and chin liposuction at about ¥217,800; no fat-dissolving injection is approved there.

1. Fat, skin or bone: what is your double chin made of?

A double chin is a fullness under the jaw that blurs the line between chin and neck. It has three main ingredients, often in combination, and each one needs a different fix. A 2024 review of serious complications after fat-dissolving injections makes the same point from the other side: the authors recommend working out what is causing the fullness under the chin, and the mechanism of any jowling, before treating it.

What makes a double chin, and what helps

Cause	How to recognise it	What helps
Fat under the chin	Soft fullness you can pinch between finger and thumb; often present even at a healthy weight	Weight loss if relevant; injections, fat freezing or liposuction
Loose skin and neck bands	Skin that drapes or folds, vertical cords when you clench your neck, more common with age	Tightening devices, threads or a neck lift; fat removal alone can worsen it
Short or set-back chin	Weak chin in profile; the neck-to-chin angle looks soft even when you are slim	Chin filler, implant or bone surgery to change the profile
Posture and angle	Appears mainly in photos taken from below or when you tuck your head	Camera angle and posture; no treatment needed

Two quick checks at home: pinch the fullness under your chin (a thick pinch suggests fat), and look at your profile with your head level. If the fullness is mostly folds of skin, or your chin sits well behind your lower lip, fat reduction is not the main answer.

2. Exercise and weight loss: what they can and cannot do

Chin and jaw exercises are popular online, but we found no controlled trial showing that they reduce chin fat. The broader research on “spot reduction” is not encouraging. In a randomised trial, six weeks of abdominal exercises, five days a week, improved abdominal endurance but did not reduce abdominal fat, waist size or skinfolds. In a study of 104 people who trained only one arm for 12 weeks, MRI found fat loss in both arms equally rather than in the trained arm, although skinfold measurements suggested a small local effect in men.

Losing weight overall does reduce fat everywhere, including under the chin, so if your weight is high it is the cheapest first step. But many people have a double chin at a healthy weight, partly from genetics and chin shape, and for them fat under the chin is often the last to go. That is where procedures come in.

3. Fat-dissolving injections

The best-studied injection is deoxycholic acid, a synthetic version of a bile acid that breaks down fat-cell membranes, sold in the US as Kybella (development name ATX-101). It is approved for fat under the chin in the US, Canada, Australia, South Korea, the UK and several other European countries (as Belkyra outside the US), but not in Japan. Two large placebo-controlled phase 3 trials tested it:

REFINE-1 (506 people): 70.0% improved by at least one grade on both doctor and patient scales, versus 18.6% on placebo; 13.4% improved by two grades, versus 0%. 46.3% had an MRI-confirmed volume reduction, versus 5.3%.
REFINE-2 (516 people): 66.5% versus 22.2% improved by one grade, and 18.6% versus 3.0% by two grades.

Results lasted. In a follow-up of patients who had responded, 82.4% of the treated responders still had at least a one-grade improvement on the doctor’s scale at year 3, versus 65.0% of placebo responders, and 74% of those satisfied at 12 weeks were still satisfied at year 3. It takes time: in REFINE-1, 55% had a one-grade improvement after 2 sessions and 75% after 4.

The side effects are real but mostly temporary. Swelling, pain, numbness and firmness at the injection site are common. In REFINE-1, weakness of the nerve that moves the lower lip (marginal mandibular nerve) occurred in 4.3% of treated people, mostly mild and resolving without lasting effects. A 2023 meta-analysis confirmed the benefit but noted higher risks of firmness, pain, swelling, numbness and nodules, and found that all five trials had potential industry bias. A 2024 review of serious events in real-world use described skin ulceration, nerve injury, hair loss in men and infection, most linked to injection technique.

In Japan, “fat-dissolving injections” are usually not Kybella. No fat-dissolving injection is approved in Japan. Clinics widely use doctor-imported products such as BNLS, Kabelline and FatX, which are unapproved and outside Japan’s relief scheme for drug side effects. Their formulas differ from deoxycholic acid as tested in the REFINE trials, and the evidence behind them is much thinner. Older products based on phosphatidylcholine have also been criticised: a review argued that phospholipids do not dissolve fat, and that the effect comes mainly from the deoxycholate they contain. Ask which product, what it contains and how many sessions the clinic expects. Our Japanese-language guide to fat-dissolving injections compares the products in detail.

4. Fat freezing and HIFU

Fat freezing (cryolipolysis) cools fat cells until they die and are cleared by the body, without needles. A 2025 meta-analysis of eight before-and-after studies with 206 patients found an average reduction in chin fat thickness of 2.78 mm and in volume of 19.57 cm³, with minimal, temporary side effects. One rare side effect, paradoxical adipose hyperplasia (the treated fat grows instead of shrinking), does not go away on its own and may need surgery; Japan’s regulator required doctors to explain it before treatment as a condition of approval. None of the studies had a placebo group, so the size of the effect is less certain than for injections. One Japanese chain notes that treatment under the chin can cause a temporary feeling of tightness in the throat, usually gone within a week. CoolSculpting is approved in Japan as a device that reduces fat under the skin (approval no. 22900BZX00410000).

HIFU (high-intensity focused ultrasound) is sold for double chins too, but it is mainly a tightening treatment. One study, of 30 Asian patients followed for four weeks after one session (one author works for a HIFU device maker), reported improvement on a fat rating scale but had no comparison group and a very short follow-up. Treat HIFU as a skin-tightening option, not a fat-removal one; see our HIFU guide.

5. Chin liposuction

Liposuction removes fat directly through small incisions, usually under the chin and behind the earlobes, in a single session. It suits a clear fat pad with skin that still has good elasticity. A 2026 systematic review of 13 case reports and case series covering 2,085 chin liposuctions found 270 adverse events, a rate of 12.9% per procedure. Three quarters (74.8%) were minor: fluid collections (seromas), surface irregularities or asymmetry, and visible neck bands. The authors stress that the studies are of limited quality.

The trade-off is clear. Injections usually need several sessions and fat freezing may need more than one, with modest, gradual results; liposuction can give a larger change in one visit, with more swelling and a small risk of irregularities. If your skin is already loose, removing fat can make it hang more, which is why a surgeon should look at skin quality before agreeing to liposuction alone. Our liposuction guide covers techniques and recovery for other body areas.

6. When the problem is loose skin or a short chin

If loose skin or vertical neck bands are the main problem, fat-reduction treatments are the wrong tool. Discussing jowls, the 2024 safety review says fat-reducing injections are contraindicated when the jowl comes from thinning of the tissue under the skin, and that surgery is preferable when it comes from sagging. The same logic applies under the chin: if the fullness is skin rather than fat, fat reduction is the wrong tool. Options range from tightening devices and threads to a neck lift; our sagging jowls guide compares what each can realistically achieve.

A short or set-back chin makes any fullness under the jaw look bigger, because there is less projection to define the angle between chin and neck. In that case a chin procedure, from filler to an implant or bone surgery, can improve the profile more than fat removal. A surgeon who offers both fat reduction and chin procedures is better placed to tell you which matters more for your face.

7. What double-chin treatment costs in Japan

Double-chin treatment prices in Japan (tax included, checked 2 Oct 2026)

Treatment	Clinic	Price
Fat freezing (CoolSculpting Elite)	Shonan Beauty Clinic	From ¥29,800 per area
Fat-dissolving injection (BNLS Ultimate) unapproved in Japan; doctor-imported	TCB Tokyo Central	¥2,980 per cc (under 10 cc) · ¥1,980 per cc (10 cc or more)
Needle-based mini liposuction under the chin TCB’s 小顔脂肪吸引注射	TCB Tokyo Central	¥45,000 per area
Chin liposuction	TCB Tokyo Central	¥217,800 (standard) · ¥435,600 (premium, with feathering)

Prices are from the clinics’ own price pages and are planning figures, not quotes. Injections are priced per cc, so the total depends on how much the doctor uses and how many sessions you need. Anaesthesia, compression garments and aftercare may be extra. No product with the same ingredients and use as BNLS is approved in Japan, and BNLS is not approved as a drug in the US or EU; if a serious side effect occurs, Japan’s relief scheme for drug side effects does not apply. ClinicJapan has no partnership with the clinics listed.

Three questions to ask before you book. Which product or device, exactly? For injections, ask for the product name and ingredients; for freezing, the device. How many sessions, and the total? A per-cc price of a few thousand yen can add up across several sessions. Has the doctor checked your skin and chin shape? A plan that only removes fat should come after someone has ruled out loose skin and a short chin. Our guide to choosing a clinic in Japan covers what else to check.

Words that help at the clinic. Double chin: 二重あご (nijū ago). Fat under the chin: 顎下の脂肪 (agoshita no shibō). Liposuction: 脂肪吸引 (shibō kyūin). “Which product is this, and is it approved in Japan?”: これは何という製剤ですか？国内で承認されていますか？ (kore wa nan to iu seizai desu ka? kokunai de shōnin sarete imasu ka?). More in our clinic phrase guide.

8. Fitting it into a trip

Injections are usually a course. In the REFINE trials, people received up to six sessions about four weeks apart; 55% had a one-grade improvement after 2 sessions and 75% after 4. Fat freezing may also need more than one session. On a single trip, expect to start a course rather than finish it, and plan how you will continue at home.
Swelling under the chin is normal for days after injections; fat freezing can leave a temporary feeling of tightness in the throat. Neither usually stops sightseeing.
Liposuction needs the most time. Ask the clinic how long you will wear a compression band, when they want to see you again, and whether they can check your progress remotely once you are home. Leave time for that follow-up visit before you fly.
Tell the doctor about any blood thinners and medical conditions, and do not stop prescribed medicines without asking the doctor who prescribed them.

Related concerns. Fullness under the jaw often appears with sagging jowls and deepening marionette lines, which need lifting rather than fat removal. Tightening and lifting options are compared in our HIFU and thread lift guides, and jaw Botox slims the jawline by relaxing muscle, not by removing fat. If the puffiness is around the eyes rather than the chin, see how to get rid of eye bags.

9. What we would do

Identify the cause first: fat, loose skin, a short chin, or a mix. A consultation that only discusses one treatment is not a diagnosis.
If your weight is high, start there. It is free, and it shrinks fat everywhere.
For a moderate fat pad with good skin, compare a course of injections or fat freezing with a single liposuction, on total cost, number of visits and downtime.
In Japan, ask exactly which injection product is used, and treat unapproved products with appropriate caution.
For loose skin or a short chin, see a surgeon who offers neck and chin procedures, not only fat reduction.

10. FAQ

Can exercises get rid of a double chin?

We found no controlled trial showing that chin or jaw exercises reduce chin fat. Research on “spot reduction” elsewhere in the body is not encouraging: six weeks of abdominal exercises did not reduce abdominal fat in a randomised trial. Overall weight loss does reduce fat under the chin.

Do fat-dissolving injections for the double chin work?

Deoxycholic acid (Kybella) does, in trials: 66.5–70.0% of treated people improved by at least one grade versus 18.6–22.2% on placebo, usually over several sessions, and most kept the result for 3 years. In Japan, no fat-dissolving injection is approved, and clinics mostly use imported products with far less evidence.

What are the side effects of double-chin injections?

Swelling, pain, numbness and firmness under the chin are common and temporary. In REFINE-1, 4.3% of the 256 people given the drug had weakness of the nerve that moves the lower lip, mostly mild and temporary. Rare serious events reported in real-world use include skin ulceration, nerve injury, hair loss in men and infection, mostly linked to injection technique.

Is fat freezing or liposuction better for a double chin?

Fat freezing needs no incision and reduced chin fat volume by about 20 cm³ on average across eight studies, and may need more than one session; a rare side effect makes the treated fat grow instead. Liposuction can remove more fat in one session but has more downtime; a review of 2,085 procedures found an adverse-event rate of 12.9% per procedure, mostly minor. Neither fixes loose skin.

How much does double-chin treatment cost in Japan?

At one large chain each, fat freezing starts at ¥29,800 per area, fat-dissolving injections are priced from about ¥1,980–2,980 per cc, and chin liposuction costs about ¥217,800–435,600 (tax included, checked 2 October 2026). Ask for the total, including the number of sessions and any anaesthesia.

Why do I have a double chin when I am thin?

Fat under the chin can persist at a healthy weight, and a short or set-back chin, loose skin or posture can create the same look. If the fullness is not mostly fat, fat-reduction treatments will not solve it; a doctor can tell you whether chin shape or skin is the bigger factor.

11. Sources & Method

Each clinical figure is sourced to a PubMed-indexed paper. Every PMID was found by searching PubMed, confirmed against the PubMed record, and the figures were taken from the published abstract. Japanese prices and device information are from the clinics’ own pages, checked on 2 October 2026; prices change and campaign prices vary, so treat them as ranges, not quotes. The cause table, the home checks, the trip advice in section 8 and the plan in section 9 are our editorial judgement, based on the sources below, not findings from a single paper.

Peer-reviewed literature

Source	Used for
REFINE-1: phase 3 trial of ATX-101 for submental fat reduction (PMID 26673433) Jones et al., Dermatol Surg, 2016 · 506 subjects · accessed 2 Oct 2026	70.0% vs 18.6%; MRI 46.3% vs 5.3%; nerve paresis 4.3%; 55%/75% after 2/4 sessions (section 3, FAQ)
REFINE-2: ATX-101 for reduction of submental fat (PMID 27430612) Humphrey et al., J Am Acad Dermatol, 2016 · 516 subjects · accessed 2 Oct 2026	66.5% vs 22.2%; 18.6% vs 3.0% (section 3, FAQ)
Improvements in submental contour up to 3 years after ATX-101 (PMID 33617632) Humphrey et al., Aesthet Surg J, 2021 · 224 patients · accessed 2 Oct 2026	82.4% vs 65.0% at year 3 (clinician scale, responders); 74% still satisfied; up to 6 sessions about 4 weeks apart (sections 3, 8)
Deoxycholic acid for submental fat: systematic review, meta-analysis and industry bias (PMID 37806137) Inocêncio et al., Clinics (Sao Paulo), 2023 · 5 RCTs · accessed 2 Oct 2026	Benefit confirmed; side effects; potential industry bias in all trials (section 3)
Management of serious adverse events after deoxycholic acid injection (PMID 39247122) Shridharani & Kennedy, Aesthet Surg J Open Forum, 2024 · review · accessed 2 Oct 2026	Serious events; assess causes; contraindications in jowls (sections 1, 3, 6, FAQ)
Phospholipids do not have lipolytic activity: a critical review (PMID 18569265) Motolese, J Cosmet Laser Ther, 2008 · accessed 2 Oct 2026	Effect attributed to deoxycholate (section 3)
Cryolipolysis for submental fat reduction: systematic review and meta-analysis (PMID 40473257) Do et al., Facial Plast Surg, 2025 · 8 studies, 206 patients · accessed 2 Oct 2026	−2.78 mm thickness, −19.57 cm³ volume (section 4, FAQ)
HIFU for reduction of submental fat in Asian patients (PMID 40355620) Goo et al., Aesthetic Plast Surg, 2025 · 30 patients, 4 weeks · accessed 2 Oct 2026	Uncontrolled, short follow-up; industry author (section 4)
Adverse events related to submental aesthetic liposuction: systematic review (PMID 42235595) Girão et al., J Oral Maxillofac Surg, 2026 · 13 studies, 2,085 cases · accessed 2 Oct 2026	270 events, 12.9% per procedure; 74.8% minor; seromas, irregularities, neck bands (section 5, FAQ)
The effect of abdominal exercise on abdominal fat (PMID 21804427) Vispute et al., J Strength Cond Res, 2011 · 24 participants · accessed 2 Oct 2026	No reduction in abdominal fat after 6 weeks (section 2, FAQ)
Subcutaneous fat alterations resulting from an upper-body resistance training program (PMID 17596787) Kostek et al., Med Sci Sports Exerc, 2007 · 104 subjects · accessed 2 Oct 2026	MRI: no difference between trained and untrained arm (section 2)

Japan prices and product information

Source	Used for
Shonan Beauty Clinic — クールスカルプティングエリート official page, tax included · accessed 2 Oct 2026	From ¥29,800 per area; throat tightness after chin treatment (sections 4, 7)
PMDA — CoolSculpting review report Japanese regulator · accessed 2 Oct 2026	Approval as a fat-reducing device; paradoxical adipose hyperplasia and explanation requirement (section 4)
TGA — AusPAR: deoxycholic acid (Belkyra) · Allergan — European decentralised procedure regulator and manufacturer · accessed 2 Oct 2026	Approval outside the US (section 3)
TCB Tokyo Central Aesthetic Surgery — 料金表 official price list, tax included · accessed 2 Oct 2026	BNLS Ultimate per cc; needle-based mini liposuction; chin liposuction (section 7, FAQ)
ClinicJapan — 脂肪溶解注射完全ガイド our Japanese-language guide · accessed 2 Oct 2026	No approved fat-dissolving injection in Japan; imported products; relief-scheme exclusion (section 3)

About this guide: ClinicJapan is editorially independent. Where a clinic named on this site is an advertising partner, that relationship is disclosed on the page where it appears; no clinic named above is a partner, and nobody paid to be included. Prices change and vary by clinic; confirm before booking. Injections, fat freezing and liposuction are medical procedures; discuss your medical history with a doctor before starting them. Informational only; not medical advice, and not a substitute for consultation with a physician.