Double chin and jawline

Four phase 3 randomized placebo-controlled trials support the FDA approval. In REFINE-1, significantly more ATX-101 patients than placebo patients improved at least 1 grade on both clinician and patient submental fat scales 12 weeks after the last treatment, with MRI-confirmed fat reduction. A European phase 3 trial published in 2014 showed the same pattern. In the long-term CONTOUR follow-up, most responders maintained improvement, consistent with permanent fat cell destruction.

A 2025 systematic review and meta-analysis of 8 studies (206 patients) found cryolipolysis reduced submental fat thickness by a mean of 2.78 mm and volume by about 19.6 cubic centimeters, with transient side effects. An earlier prospective study using 3D imaging measured a 3.77 mm mean fat thickness reduction after 2 cycles, with 93 percent of participants satisfied. The catch: all pooled studies were pre-post designs without sham controls, so the grade stays moderate.

HIFU is marketed for under-chin tightening and small-volume fat reduction, and the 2025 systematic review covering skin tightening and body contouring reports submental improvement in included studies. However, submental-specific controlled data is much thinner than for facial laxity, and for actual fat volume the evidence favors dedicated options like cryolipolysis or deoxycholic acid injections.