From middle schoolers mewing their way to more defined mandibles to 60-somethings flaunting their impossibly acute angles, we are, unequivocally, in our jawline era. Experts pin our collective fascination on the usual suspects: selfie culture, the persistence of Zoom, and the popularization of procedures aimed at improving the geometry of our jawlines.
One such technique captivating the social-media masses is submental liposuction, a minimally invasive fat-removal method that shrinks double-chins and sharpens profiles. Doctors use the terms submental lipo, chin lipo, neck lipo, and jawline lipo somewhat interchangeably, explaining that while treating the submentum (the area under the chin) is key, concerns are rarely isolated to this zone, so they typically sculpt along the jawbone and sometimes down the neck, as well.
With quick-fix vibes and striking before and afters, submental lipo has long held widespread appeal—attracting both men and women, younger folks (with naturally full necks) as well as older ones (with weakening jawlines). Last year, though, the American Society of Plastic Surgeons (ASPS) recorded a 6% increase in the procedure. And doctors confirm the spike. “Over the last two years, chin lipo has become the most common procedure I do,” says double board-certified facial plastic surgeon Sagar Patel, MD. In his Beverly Hills office, it has completely supplanted the buccal-fat craze that preceded it. Even after raising prices to help curb the demand, he hasn’t seen a slowdown. In experienced hands, “it’s a very high-yield, low-risk procedure,” he adds. Offering further evidence, he points to Reddit—more specifically, a chin lipo subreddit created in late 2023—where “the majority of people are, like, blown away by their results.”
Likewise, board-certified plastic surgeon Meredith Vandegrift, MD, tells me that, in the past year, requests for chin and neck improvements have “probably quadrupled” in her Huntington, New York practice. “Everyone’s focusing on the neck,” she tells me. And not just patients: In August, Jerry Chidester, MD, a board-certified plastic surgeon in South Jordan, Utah, had over 100 cc’s of fat sucked from his own neck. “You can store up a lot of fat in this area,” he says. And removing superfluous cells can deliver “pretty awesome results.” His post-pregnancy patients often include submental lipo in their “mommy makeovers,” finding under-chin fat to be especially stubborn.
Not every surgeon is a chin-lipo enthusiast, however. Jonathan Cabin, MD, a double board-certified facial plastic surgeon in Washington, D.C., believes the ASPS-reported uptick is more a reflection of patients’ general desire to improve their jawlines—in some way—than it is a testament to the power or popularity of submental liposuction. “We’re talking about an area that bothers a lot of people,” he says. “And those people are looking for all kinds of ways to improve it. Submental lipo is one option, but it’s not the best solution for everyone.”
So, who is a candidate for jawline—or submental—liposuction?
The ideal candidate for jawline lipo is someone in their 20s or early 30s with reasonable expectations and good skin elasticity, who “genetically carries extra fat under their chin,” says Dr. Vandegrift. “Their skin is going to retract and their jawline is going to be nice and refined after the procedure.” That’s assuming the unwanted fat lies superficially, just below the skin. If the fat responsible for neck fullness sits deeper, under the platysma muscle, due to genetics or age, then doctors can’t access it with a liposuction cannula. Removing fat from beneath this broad muscle requires a scalpel and a surgeon who specializes in deep neck surgery.
To assess the precise location of submental fat, surgeons may “pinch the tissues of the neck and have the patient smile forcefully to activate the platysma,” says Dr. Cabin. “In someone with little to no superficial fat [under the skin], the muscle will pull away from our fingers. But if we’re grabbing fat [that’s on top of the muscle], we won’t feel the tissue pull away as much.”
A pre-operative exam can also reveal if there are other structures contributing to neck fullness, like bulging salivary glands, which lipo cannot address. Dr. Cabin frequently sees 20- and 30-somethings, “who have great skin quality and minimal gravitational aging, but they’ve inherited an obtuse neck” due to large glands or a poorly positioned hyoid bone (which supports the tongue). “Submental lipo is going to give them minimal improvement, if any,” he says. For this group, he typically recommends a deep neck lift to more dramatically change the angle of the jawline. If they’re older, with these same genetic concerns plus bothersome sagging, he may recommend a facelift, as well.
There comes a point, experts agree, where patients essentially age out of submental lipo, since stripping fat from a mature neck can exacerbate skin laxity and drooping and expose cord-like bands in the platysma muscle. The exact point varies from patient to patient.
Given the complex anatomy of the neck and the vague sort of age limit for lipo’ing it, “I’d say 9 out of 10 patients who come in asking for submental lipo are not good candidates,” Dr. Cabin tells me. But every surgeon defines “good” a little differently—and some offer wider windows of opportunity. “Chin lipo in older people is something I probably do more than other surgeons,” Dr. Patel says. But he’s always transparent about the potential downsides. “I tell patients, Hey, you’re not a great candidate—you could be left with crepey skin or some fat from the deeper layer—but the alternative is a bigger surgery,” he says. “I find that a lot of people, because they don’t want to jump into a face and neck lift, are willing to make trade-offs and accept less-than-ideal results.” That said, “there are patients whose skin laxity is so bad that lipo just isn’t possible,” he adds. “I really only offer it as an option to about 50% of those over 35.”
Dr. Vandegrift shares a similar philosophy: “Not everyone wants to sign up for a facelift, so then we talk about what we can realistically achieve with liposuction.” The conversation around expectations is more nuanced with massive weight loss patients—those who have, with the help of GLP-1 agonists, bariatric surgery, and/or lifestyle modifications, shed at least half of their excess weight. “Even in younger people, their skin elasticity is just gone,” she says. And that means lipo could leave their tissues hollow and hanging. Still, many of those looking to fine-tune their jawlines after slimming down are happy with better-but-not-perfect outcomes.
What happens during jawline liposuction?
Surgeons commonly do the procedure with patients awake, using local anesthesia (numbing injections) plus an oral sedative, like Xanax, to quell anxiety. After making a centimeter-long incision under the chin and, in some cases, two additional poke holes, one behind each earlobe, doctors insert a steel cannula to break up and suction out excess fat. “I lipo people from earlobe to earlobe,” says Dr. Patel. “You want to lipo laterally [along the jawbone] in order to release the skin, so that when it lays back down onto the platysma, it’s nice and smooth. If you only lipo centrally [under the chin], the skin may not lay as evenly or tightly as you want it to.”
While traditional liposuction can trigger a modest amount of skin tightening—the friction from the cannula creating a kind of mechanical damage that spurs collagen production, Dr. Chidester explains—some doctors choose to follow fat removal with a dose of radiofrequency energy (from devices like Renuvion or FaceTite). They’ll pass the charged wand beneath the skin (through the lipo incisions) to internally heat the tissues for a (theoretically) greater degree of skin contraction. While some surgeons insist this add-on boosts results, especially in people with heavier necks or borderline-loose skin, others are unconvinced. Says Dr. Patel, “I find it makes absolutely no difference.” In his experience, basic liposuction, when done well and on the appropriate patient, provides sufficient tightening on its own.
With or without energy, “we’re able to address all the angles and problematic areas from our three poke holes, which can later be closed with a stitch or left open to heal—but there is a little bit of an art to knowing when you’re done with submental liposuction,” Dr. Cabin tells me. “I err on the side of conservative lipo, because I never want to create problems that are permanent or hard to fix, and I always want to leave a layer of fat in the neck as a soft, youthful cushion.”
What are the risks involved with jawline liposuction?
Beyond the universal risks and side effects of cosmetic surgery—unmet expectations, swelling, bruising, bleeding, hematomas (pooled blood), seromas (pockets of fluid), infection, poor scarring—submental lipo carries its own unique set of potential problems. Removing or reducing the layer of fat between the skin and the platysma can cause contour irregularities (like lumps and dents) and fibrosis (scar tissue formation), particularly if lipo is done aggressively or paired with excessive energy. If the skin is traumatized, broken blood vessels and discoloration can also appear and linger for weeks or months.
A systematic review and meta-analysis of 29,368 patients published in the Aesthetic Surgery Journal in 2024 found the overall complication rate for liposuction to be 2.62%, with the most common complication being contour deformities (2.35%), followed by hyperpigmentation (1.49%) and hematoma (.27%). A 2022 study out of Brazil looking at submental lipo specifically states that complications are “rare,” but can have “disfiguring consequences” if they occur.
The neck “is just a really sensitive area, with the platysma right under the skin,” notes Dr. Chidester. “If you’re adding energy on top of liposuction, you can aggravate the muscle and get scar bands and other issues, especially if the skin is very thin.” He avoids energy when possible, “because the more you add, the greater your chance of having fibrosis,” he says. Which means “you could run into problems if you wind up wanting a neck lift down the road.”
As Allure recently reported, deep-energy devices can complicate face and neck lift surgery. “You may still be able to get a great result [from a lift],” adds Dr. Cabin, “but when the skin and soft tissues are scarred down, surgery is more challenging.” And recovery becomes less predictable if heat-based devices have recently disturbed the blood vessels feeding the skin. Energy aside, “lipo alone can cause problems,” he adds, because a natural-looking facelift hinges on having a plush blanket of fat under the skin. While a round of conservative chin lipo at 25 is unlikely to impact a facelift at 50—our tissues can repair and reorganize over time, notes Dr. Vandegrift—you’ll want to skip the lipo if you plan on having surgery in the near future.
Dr. Patel doesn’t combine lipo with energy, but he still warns patients that some form of fibrosis—be it tightness, lumps, or vertical scar bands—is pretty much “inevitable” following submental liposuction. For most, “the solution is lymphatic massage,” he says, which moves immune-related fluid out of the area to promote healing and keep the tissues pliable. Dr. Patel connects every patient with a masseuse who virtually teaches a DIY technique. “If we attack the fibrosis early on, by the six-month mark, everything should be nice and smooth.” Dr. Chidester also prescribes post-lipo massage to temper swelling, keep tissues soft, and stave off scar bands. He saw a lymphatic specialist almost every day for the first week of his recovery.
A rarer risk of submental lipo, temporary nerve weakness can occur if the cannula injures or “stuns” the marginal mandibular nerve, which lives in the jowl and controls the muscles of the lower lip. (Studies report an incidence of 1% to 5%.) While some surgeons routinely suction the jowls when contouring the jawline, others avoid them, staying below the jawbone and giving a wide berth to the delicate nerve. Bumping it can cause the mouth to move abnormally for weeks to months.
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What’s the recovery like?
While you can expect to be swollen and bruised for at least a couple of weeks, discomfort should be minimal, says Dr. Chidester. As a patient himself, he rates it as a one or two out of 10 on the pain scale, likening the sensation to a bad sunburn. “The pain is generally well managed with just Tylenol,” adds Dr. Vandegrift. “If patients have the procedure on a Thursday, most are back to work on Monday, maybe wearing a scarf if they’re self-conscious about bruising.”
To help keep healing on track in the early recovery, doctors advise skipping exercise and anything else that might strain the neck (like looking over your shoulder while driving or staring down at a screen). “I ask people to walk around like a robot for two straight weeks to allow the skin to adhere properly, so everything stays tight,” Dr. Patel says.
There’s some debate over the value of compression garments following chin lipo, because “there’s not a ton of actual evidence that they help one way or another,” explains Dr. Cabin. He has patients wear a “not super-tight neck garment” for three days with the intent of controlling swelling, preventing seromas, and helping the skin redrape. (Anything too snug could impede lymphatic drainage.) Other surgeons encourage patients to wear a head wrap or chin strap, around the clock, for a week or more. The garments can be uncomfortable, notes Dr. Chidester, speaking from experience. “I took mine off after two days—I couldn’t tolerate it,” he says. “I still like patients to wear it, but I tell them, if you need a break from it, totally take it off.”
Patients can usually see their new jawlines taking shape by two to three weeks post-op, but the real wow hits after two to three months (which is when many surgeons take their “after” photos). “By six weeks, 80% of the swelling is gone and people look fully healed,” says Dr. Patel, but results may not feel “final” until closer to six months when lumps and bumps have mostly resolved.
To read more about liposuction:
- The Most Popular Plastic Surgery Procedure Says a Lot About Our Culture Right Now
- Liposuction Is More Popular Than Ever
- Everything You Need to Know About Liposuction Surgery
Now watch Gwyneth Paltrow give a tour of her beauty space:
