Sagging Skin Under the Chin: What Can Be Done? Solutions and Remedies

At IMAGE REGENERATIVE we offer an integrated approach to sagging skin under the chin, combining skin stimulation technologies and regenerative surgical expertise to restore profile definition.

At our Milano and St. Moritz locations we study each case with a complete facial rejuvenation pathway and, when a more structured lifting effect is needed, we direct the patient toward non-surgical lifting or regenerative face lifting with Lipogems®. The phenomenon of relaxed submental area is not only a matter of fat, it also involves the platysma, collagen and dermal quality, which is why a single treatment does not always resolve the condition.

Our methodology starts with an accurate clinical evaluation and proposes solutions calibrated on the patient's anatomy, age and degree of laxity present.

Causes of Submental Sagging Skin

Sagging skin under the chin develops through a combination of biological, postural and habitual factors that act synergistically over time. With advancing age, collagen and elastin production progressively decreases, reducing the skin's ability to maintain its tone.

The platysma muscle also loses tonicity and detaches from the mandible, generating the classic relaxed appearance of the neck. To these processes are added factors such as genetics, weight fluctuations, poor posture related to prolonged use of smartphones and tablets (the so-called tech neck), chronic sun exposure and habits like smoking, which accelerate the degradation of skin fibers.

There are also less obvious but equally relevant causes: the reduction of deep adipose tissue, downward sliding of soft tissues and weakening of supporting ligaments. The combination of these elements produces a clinical picture that varies from simple superficial laxity to marked sagging, and each degree requires a targeted strategy. Understanding the origin of the problem is fundamental to choosing the correct treatment, because an intervention designed for prevention will not give results on an advanced condition and vice versa.

Diathermy: How It Works and When It Is Indicated

Diathermy is an endogenous thermotherapy that uses electromagnetic energy to generate controlled heat directly inside skin and subcutaneous tissues. The heat stimulates immediate contraction of existing collagen fibers and activates fibroblasts, the cells responsible for producing new collagen and elastin. On the submental area this translates into a tightening effect that can manifest from the first sessions, accompanied by progressive dermal recompaction.

The treatment is performed in capacitive or resistive mode depending on the depth of action required, following Langer's lines to respect the natural orientation of skin fibers.

A session lasts about 50 minutes, is generally well tolerated, not painful and involves no recovery time. The standard protocol includes a cycle of 5-10 weekly sessions, followed by monthly maintenance sessions. Diathermy represents an indicated choice for those with mild or moderate skin laxity, for those who want to act preventively and for those seeking a progressive treatment that also improves microcirculation and tissue oxygenation. Its main limitation is the inability to treat severe sagging, where deeper structural action is needed.

Vivace®: Advanced Technology for Mild Laxity

Vivace® combines microneedling and fractional radiofrequency in a single device, acting simultaneously on superficial and deep skin layers. Sterile single-use needles penetrate with millimetric precision and release controlled thermal energy, stimulating neosynthesis of collagen and elastin through a dual mechanism: mechanical microlesions activate natural repair, while fractional heat promotes contraction of existing fibers. The result is visibly more toned skin, with improved texture and a recompacting effect that develops in subsequent weeks.

Vivace® technology is particularly appreciated for its versatility: in addition to counteracting submental laxity, it reduces fine wrinkles, minimizes enlarged pores and attenuates acne scars. Each session lasts 30-45 minutes, can be preceded by application of topical anesthetic cream to maximize patient comfort and involves minimal recovery time. The recommended protocol includes at least 3 sessions, spaced over time to allow the skin to regenerate between treatments.

Vivace® proves ideal for those with mild or initial laxity who desire global improvement in skin quality, but like diathermy shows clear limitations on skin with marked sagging or significant fat accumulation.

Neck Lifting with Lipogems®: The Advanced Regenerative Solution

When sagging skin under the chin has reached an advanced stage, superficial technologies are no longer sufficient. It is in this scenario that neck lifting with Lipogems® comes into play, the patented regenerative surgical approach by Professor Carlo Tremolada that represents the evolution of traditional lifting. The method involves harvesting a small amount of the patient's adipose tissue, processed in a closed system without enzymatic manipulation, to obtain a microfragment rich in regenerative cells, growth factors and intact stromal niche. This regenerative tissue is then reinfiltrated into the neck and submental areas to restore volume, stimulate new collagen production and improve skin quality from within.

Unlike traditional fillers that merely temporarily fill, Lipogems® acts on the biological cause of sagging, reactivating natural tissue repair mechanisms. The procedure is minimally invasive, performed under local anesthesia and allows correction of submental relaxation with progressive and lasting results over time. Post-operative course is brief, with moderate swelling that resolves in a few days, and improvements continue to evolve in subsequent months thanks to the regenerative activity of mesenchymal cells. For more severe cases, regenerative lifting can be combined with targeted liposuction of submental fat, ensuring complete remodeling of the mandibular profile.

Comparison Between Diathermy, Vivace® and Lipogems®

To better guide the choice, we provide a summary of the main characteristics of the three approaches, considering degree of laxity, invasiveness and duration of results.

Diathermy acts on the surface and microcirculation, Vivace® deepens collagen stimulation, while Lipogems® intervenes at a structural level regenerating tissue. The choice depends on the objective: prevent, visibly improve or correct already established sagging.

Prevention of Sagging Skin or Double Chin

Prevention remains the most powerful tool to delay the appearance of sagging chin. Correct posture during use of digital devices reduces chronic stress on neck tissues, while exercises targeted at the platysma help maintain muscle tone over time. Constant hydration, diet rich in antioxidants and daily sun protection represent fundamental habits to preserve skin collagen quality. Also avoiding drastic weight fluctuations protects skin elasticity, which repeatedly stretched and contracted progressively loses its elastic return capacity.

To these good practices can be added preventive aesthetic medicine protocols with periodic frequency.

Treatments such as biorevitalization, specific peels and cycles of diathermy or Vivace® performed annually keep collagen production active and counteract skin relaxation before it becomes visible. At IMAGE REGENERATIVE we establish personalized pathways that integrate prevention and treatment, starting from an in-depth evaluation of the skin and patient's objectives to build a tailored strategy over time.

Frequently Asked Questions

How can I tighten sagging skin under the chin?

To tighten submental skin there are various strategies graduated on the level of laxity. For mild sagging, diathermy and Vivace® are indicated, which stimulate collagen production without surgery. In moderate or advanced cases, neck lifting with Lipogems® offers lasting structural correction thanks to the patient's own regenerative tissue. Targeted exercises and professional skincare complete the pathway.

How much does surgery for sagging skin under the chin cost?

The cost of surgery for the submental area varies based on the chosen technique, extent of the area to be treated and complexity of the case. A neck lifting with Lipogems® involves a greater investment compared to non-invasive treatments, justified by the multi-year duration of results and deep regenerative action. For a personalized quote, an evaluation visit at the clinic is necessary.

How to tighten sagging skin without surgery?

To tighten submental skin without surgery one can use diathermy, radiofrequency with Vivace® microneedles, biorevitalization and combined protocols of collagen stimulation. These treatments act on skin quality and tone with progressive sessions, offering visible improvement in case of mild or moderate laxity. For severe sagging the results remain limited and the regenerative approach with Lipogems® becomes the most indicated choice.