The area beneath the chin is often one of the first places people notice signs of facial aging. Whether it is called a “double chin,” “turkey neck,” or simply a loss of jawline definition, these changes result from a combination of fat accumulation, skin laxity, and weakening of the underlying muscles—not just one isolated problem.
Until recently, treatment options were largely limited to surgery or procedures that targeted only a single tissue layer. EMFACE® introduces a different approach by simultaneously addressing the skin, fat, and muscle, making it one of the first non-invasive technologies designed to improve multiple contributors to submental (under-the-chin) aging.
Why Does a Double Chin or “Turkey Neck” Develop?
Many people assume that a double chin is simply excess fat. In reality, the aging neck undergoes complex anatomical changes involving every layer of tissue.
1. Skin loses collagen and elastin
Beginning in our twenties, collagen production declines approximately 1% per year. Elastin fibers also become fragmented with age and ultraviolet (UV) exposure. As these structural proteins diminish, skin becomes thinner, less elastic, and less able to resist gravity. The result is loose, hanging skin beneath the chin and along the neck.
This process is accelerated by:
- Chronic sun exposure
- Smoking
- Genetics
- Hormonal changes
- Weight fluctuations
Peer-reviewed studies have demonstrated that intrinsic aging and photoaging both contribute significantly to collagen degradation and reduced dermal elasticity.
2. Fat redistributes with age
The aging face is not simply a matter of “losing fat.” Different fat compartments behave differently.
The submental fat pad beneath the chin often enlarges while fat in the cheeks and temples may shrink. Weight gain can further increase fat volume in this area, blunting the cervicomental angle—the natural angle between the neck and jawline that creates a youthful profile.
Importantly, even individuals at a healthy body weight may develop submental fullness due to inherited fat distribution.
3. The supporting muscles weaken
One of the less appreciated aspects of facial aging is muscle atrophy.
The muscles supporting the lower face and neck gradually lose tone and strength with age. In the submental region, weakening of the anterior belly of the digastric muscle contributes to soft tissue descent and diminished jawline definition.
As muscles lose volume and strength, the overlying skin loses structural support, allowing tissues to sag despite relatively stable body weight.
4. Bone remodeling changes facial support
The facial skeleton also changes throughout adulthood. Gradual resorption of portions of the mandible reduces the structural foundation that supports the lower face, further contributing to jowling and loss of neck definition.
These skeletal changes amplify the effects of skin laxity and muscle weakening.
Why Treating Only One Layer Often Produces Limited Results
Traditional non-surgical treatments generally target a single tissue layer:
- Fat-dissolving injections reduce adipose tissue.
- Radiofrequency devices tighten skin.
- Neuromodulators relax muscles.
- Fillers restore volume.
However, if skin laxity, weakened muscles, and excess fat all contribute to the appearance of the neck, improving only one layer may not fully restore contour.
This understanding has led to interest in multimodal technologies that address several tissue layers simultaneously.
How EMFACE Works
EMFACE combines two energy modalities during the same treatment:
High-Intensity Facial Electrical Stimulation (HIFES™)
HIFES produces supramaximal muscle contractions that are considerably stronger than voluntary contractions. These contractions stimulate muscle remodeling, increasing muscle thickness and improving muscle function over time.
Synchronized Radiofrequency (Sync RF+)
The synchronized radiofrequency component heats tissue to temperatures that stimulate fibroblasts to produce new collagen and elastin. In the submental applicator, synchronized RF+ also appears capable of inducing apoptosis (programmed cell death) in adipocytes (fat cells), allowing gradual reduction of submental fat.
Rather than treating only the skin or only the fat, EMFACE is designed to improve:
- Skin quality
- Collagen remodeling
- Muscle support
- Submental fat volume
What Does the Clinical Evidence Show?
Although submental EMFACE is relatively new, early peer-reviewed studies have produced encouraging objective findings.
MRI-confirmed fat reduction
A prospective study of 33 patients receiving four weekly EMFACE treatments evaluated changes using MRI and three-dimensional photography.
At three months after treatment investigators found:
- 36.2% reduction in total submental volume
- 30.4% reduction in submental fat volume
- Average 10.25 mL reduction in neck volume measured by 3D imaging
- Improvement of approximately one full grade on the Clinician-Reported Submental Fat Rating Scale
- Nearly 94% patient satisfaction
Importantly, improvements continued for several months after the final treatment, consistent with ongoing tissue remodeling rather than immediate swelling reduction. (PubMed)
Histologic evidence of fat cell apoptosis
A separate human biopsy study examined tissue after treatment using microscopic analysis.
Researchers demonstrated:
- A 511% increase in caspase-7 activity 24 hours after treatment, indicating activation of programmed fat-cell death.
- An 89% reduction in Bcl-2, a protein that normally inhibits apoptosis.
- Microscopic shrinkage and disruption of adipocytes.
- No serious adverse events.
These findings suggest that synchronized RF+ can initiate biologic mechanisms that gradually reduce submental fat rather than simply heating tissue temporarily. (PMC)
What Does Treatment Feel Like?
Most patients describe the procedure as comfortable.
During treatment, patients experience:
- Gentle warmth from the radiofrequency
- Rhythmic muscle contractions beneath the chin
No needles are required.
No anesthesia is necessary.
There is generally no downtime, and most patients return immediately to work and normal activities.
How Many Treatments Are Needed?
The most commonly studied protocol consists of:
- Four treatment sessions
- One treatment every 5–10 days
- Approximately 20 minutes per session
Because collagen remodeling and muscle adaptation continue after treatment, improvements generally become more noticeable over the following 8–12 weeks rather than immediately after the final session. (PubMed)
How Long Do Results Last?
Long-term data are still emerging, but current clinical practice suggests many patients benefit from maintenance treatments approximately every 6–12 months, depending on:
- Age
- Skin quality
- Weight stability
- Individual rate of aging
- Personal aesthetic goals
Patients who maintain a stable weight and good skincare routine often enjoy longer-lasting improvements.
Who Is the Best Candidate for EMFACE® Double Chin Treatment?
EMFACE works best for patients who have:
- Mild to moderate submental fullness
- Early skin laxity
- Loss of jawline definition
- Mild “turkey neck”
- Good overall skin quality
- Realistic expectations
Ideal candidates are seeking natural improvement without surgery or downtime.
Patients with severe skin redundancy, very large fat deposits, or significant platysmal banding may achieve better results with surgical procedures such as neck lift surgery or liposuction. During consultation, a qualified aesthetic provider can determine whether EMFACE alone is appropriate or whether combination treatment would produce superior results.
Setting Realistic Expectations
EMFACE is not a replacement for surgery.
Instead, it offers gradual, natural-looking improvement by stimulating the body’s own regenerative processes.
Patients should expect:
- Progressive improvement over several months
- Better jawline definition
- Reduction in submental fullness
- Improved skin firmness
- More youthful neck contours
The most satisfied patients are those with mild to moderate aging changes who understand that non-invasive treatments improve—but do not completely erase—the effects of aging.
The Bottom Line
The appearance of a double chin or “turkey neck” is rarely caused by a single issue. Aging affects the skin, fat, muscles, and underlying facial support simultaneously.
EMFACE represents a newer generation of facial rejuvenation technology by addressing several of these tissue layers during one treatment. Early peer-reviewed research demonstrates measurable reductions in submental fat volume, improved jawline contour, and high patient satisfaction, while maintaining the advantages of being non-invasive and requiring essentially no downtime.
For patients seeking subtle, natural rejuvenation without surgery, EMFACE offers a scientifically supported option that works with the body’s own biology to restore a firmer, more defined profile.
Selected References
- DiBernardo B, et al. High-Intensity Focused Electrical Stimulation and Sync Radiofrequency+ Technology for Submental Volume Reduction: An MRI Study. Aesthetic Surgery Journal. 2025. (OUP Academic)
- Goldberg DJ. Adipocyte Apoptosis Following a Novel Method for Double Chin Reduction: A Pilot Human Histology Study. Journal of Cosmetic Dermatology. 2025. (PMC)
- Quan T, Fisher GJ. Role of Age-Associated Alterations of the Dermal Extracellular Matrix Microenvironment in Human Skin Aging. Gerontology. 2015.
- Coleman SR, Grover R. The Anatomy of the Aging Face: Volume Loss and Changes in Facial Fat Compartments. Clinics in Plastic Surgery. 2006.
- Mendelson BC, Wong CH. Changes in the Facial Skeleton With Aging: Implications and Clinical Applications in Facial Rejuvenation. Aesthetic Plastic Surgery. 2012.
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FAQs:
Does EMFACE get rid of a double chin?
EMFACE® Submentum can reduce mild to moderate submental fullness by combining synchronized radiofrequency with High-Intensity Facial Electrical Stimulation (HIFES™). Clinical studies have demonstrated measurable reductions in submental fat volume while simultaneously improving muscle tone and stimulating collagen remodeling. It is most effective in patients with mild to moderate fullness rather than very large fat deposits. (The Daily Beast)
How many EMFACE treatments are needed?
Most patients undergo four treatment sessions, typically spaced about one week apart. Improvements continue for approximately 8–12 weeks after the final treatment as collagen remodeling and muscle adaptation occur.
How long do EMFACE results last?
Results are long-lasting but not permanent because the natural aging process continues. Many providers recommend a maintenance treatment approximately every 6 to 12 months, depending on age, skin quality, and aesthetic goals. (The Daily Beast)
Is EMFACE better than surgery?
EMFACE is not a replacement for a surgical neck lift. It is designed for patients with early to moderate skin laxity and submental fullness who want noticeable improvement without incisions, anesthesia, or downtime. Patients with significant loose skin or severe muscle banding typically achieve more dramatic results with surgery.
Does EMFACE hurt?
Most patients describe EMFACE as comfortable. During treatment, you’ll feel rhythmic muscle contractions beneath the chin along with a gentle warming sensation from the synchronized radiofrequency. No needles or anesthesia are required.