Hello, I am Director Lee Yong-jae, a specialist at Shin Sang Clinic. Hello, I am Director Kim Jae-hee, a specialist at Shin Sang Clinic. Today, we will explore the difference between double chins that can disappear with dieting and double chins that won't go away even with dieting. Let's go! 

So, what are the causes of double chins? There are many, but the first and most fundamental one is fat. When there is a lot of fat, weight increases, which can happen due to various reasons, such as pregnancy in women, leading to hormonal changes that cause weight gain. This can result in either a lot of subcutaneous fat or visceral fat, or both. 

The second cause is related to having a short chin, which is referred to as muk-tuk. This condition occurs regardless of the size of the face; whether the face is small or large, if the lower jawbone is small and positioned further back, the lower part of the face appears smaller, creating a narrower space below.

There are children here, but when I come down, there are none, right? That's how it is. Now, since the chin is small, it protrudes, which causes the double chin. There may also be a third chin, and the muscles that help move the tongue are involved as well. So, on both sides, there are structures that can cause the double chin, and I think we can categorize it into three main types. When it comes to double chins that can disappear with dieting, what are they? In my opinion, the double chin that disappears with dieting is the one that didn’t exist when I was slim but appeared due to weight gain. That additional fat can be lost. I usually say that if men reduce their body fat to a single-digit percentage and women reduce theirs to around 10%, they might see improvements. But that’s not easy, right? Even with body profiles, it can be challenging.

This is the area where fat tends to be the last to leave the body, right? For those who exercise, it can be a challenging part. That's why I find it a bit difficult to talk about exercise. The visceral fat, which is the fat within our abdominal cavity, doesn't change much when dieting or losing weight. So, if you look at people who gain a lot of weight, their visceral fat increases, but when they lose weight, it doesn't just shrink significantly. It's really hard to completely eliminate it. Even with liposuction, the double chin that is already there remains. If we have about 1 to 2 cm of visceral fat, we can consider reducing it, but if there's about 3 mm, we can suggest some reduction. Those who have a significant amount above that can really just rely on liposuction. When we applaud together with the patients, we celebrate their success. Yes, that's how it is—100% liposuction.

It's not that we shouldn't do it, but the muscle fixation and double chin treatment are actually necessary. This is because as fat decreases, the skin tends to sag. It's important to pull the sagging skin tight and also to lift the muscles that are going to drop. So, even if you just do liposuction, a double chin won't completely disappear. To be precise, there can be a double chin without fat, but muscle fixation and liposuction are enough to address it. 

Now, they say that even with a thick neck, one can have a double chin. Could it be that the thickness of the neck makes the chin appear shorter, leading to a double chin? I think that's likely. A thick neck alone doesn't seem to be enough to cause a double chin; it could be due to issues with other structures or the chin itself being somewhat small. These factors seem to be complex. So, in fact, the surgery to address this is what we call the toad surgery, which is the first stage of the thick neck procedure.

There will likely be more cases that cannot be resolved. Regarding the thick neck you mentioned, it refers to the second stage of salivary gland removal, meaning when the neck is thick here, not the body itself. When we talk about the third stage, which involves the area of ear fat removal, we can think of it as being able to reduce the thickness of the neck somewhat. 

Now, if someone gains weight, does a double chin reappear? This is actually one of the common questions asked by patients. To explain this briefly, the fat cells on the outside are removed through suction, eliminating about 80 to 90% of them. The fat located below the platysma is completely removed through liposuction. Therefore, when gaining weight, the residual fat is minimal. So, essentially, we return to our original state.

If you want to come back, your weight really needs to be five to ten times higher for it to rise that much, so it's quite difficult to achieve that. When is it best to have double eyelid surgery, after dieting or before? Honestly, I think it doesn't really matter. Right now, I feel like the answer is to focus on the line. When there is a lot of fat, we should try to remove as much as possible first, and after that, as we diet, the area will tighten up, which actually enhances the beauty of the line. The good thing is that once we remove some fat, other areas will also lose weight more effectively during the diet. So I would suggest that it’s better to resolve this a bit earlier and then focus on dieting and exercising. The important thing is to get an accurate diagnosis and then decide if I really need this surgery after listening to the information.

Since it's not too late, exercising is great, but you should come and talk to us. We can discuss whether it's better to combine exercise with surgery or what to prioritize first. By having these conversations, you can find the best options to achieve the best results. That's what I believe. Yes, I think so too. This was Lee Yong-jae from Shin Sang Orthopedics and Kim Jae-hee from Shin Sang Orthopedics. Thank you very much. Yes, today as well, Shin Sang.

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