Nonsurgical Management of Submental Fullness for Double Chin Reduction: A Systematic Review

ABSTRACT Background Submental fullness (SMF), commonly known as a “double chin,” is a prevalent aesthetic concern that can affect facial harmony and self‐perception. A range of surgical and nonsurgical treatment options are available for SMF reduction, including deoxycholic acid injections, energy‐based devices, and liposuction. However, a comprehensive synthesis of current evidence on the efficacy and safety of these interventions is lacking. Aims This study aimed to systematically evaluate the effectiveness, safety, and clinical outcomes of various nonsurgical interventions used to reduce double chin. Patients/Methods This systematic review was conducted in accordance with PRISMA guidelines. A comprehensive search of PubMed, Scopus, Web of Science, Embase, and Google Scholar was performed for studies published from January 2010 to March 2025. Out of 1805 initial records, 30 studies met the inclusion criteria. These included randomized controlled trials, prospective cohorts, and observational studies. Results The most frequently evaluated treatment was injectable deoxycholic acid (ATX‐101), followed by cryolipolysis, radiofrequency, high‐intensity focused ultrasound, and surgical liposuction. Injectable lipolysis with ATX‐101 demonstrated consistent efficacy, with ≥ 1‐grade improvement in SMF in the majority of patients and satisfaction rates between 67% and 86%. Energy‐based devices showed promising results with minimal downtime and high tolerability. Surgical interventions were effective but less commonly preferred. Emerging agents such as DWJ211, Tapencarium, and ascorbyl‐palmitate‐based solutions also showed potential in early‐phase trials. Most adverse events were mild, transient, and localized. Conclusions Injectable deoxycholic acid is currently the most studied and effective nonsurgical treatment for SMF reduction. Energy‐based modalities offer viable alternatives with favorable safety profiles. Surgical methods remain effective but are less desirable due to invasiveness.