Different treatments with different strengths
Fullness under the chin usually comes from fat, loose skin, or both. Neck liposuction and Endolift are both used for this area, but they are designed for different situations. Liposuction is built to remove fat. Endolift is built to tighten skin while reducing smaller pockets of fat. Neither is better in every case, and the right choice depends on how much fat there is and how firm your skin is.
It is also worth checking what else is going on. A small or receding chin can make the neck look fuller than it is, and heavy, hanging skin or prominent bands in the neck may need surgery rather than either of these treatments.
You can get a rough sense of the balance yourself. Look at your profile in a mirror with your head level, then gently pinch the skin under the chin. A thick, soft pinch suggests fat is the main issue. A thin pinch, with skin that creases or folds when you look down, suggests laxity matters more. Weight matters too. If you are still losing weight, it usually makes sense to wait until it is stable before choosing either treatment, because further weight loss changes both the fat and the skin.
How neck liposuction works, in general terms
Liposuction removes fat through a thin tube placed under the skin and connected to suction. Under the chin, it can take away a larger amount of fat than a non surgical treatment, and the effect on fat is direct. It is a surgical procedure, so ask any clinic offering it about the type of anaesthetic, the recovery, the risks and who will perform it.
The main limitation is the skin. Liposuction takes fat away but does not specifically tighten the skin above it. In a younger person with firm, elastic skin, the skin often settles well. Where the skin is already loose, removing fat can leave it looking slack, which is the opposite of what most people want.
How Endolift works under the chin
Genuine Endolift uses the LASEmaR 1500 laser by Eufoton at a wavelength of 1470 nm, with original single use fibres. A fibre between 200 and 600 microns wide is placed beneath the skin through a tiny entry point under local anaesthetic. There are no incisions and no stitches.
The 1470 nm wavelength is strongly absorbed by water and fat. It can liquefy small fat deposits, which the body then clears. It contracts the fibrous septa beneath the skin, which gives some tightening straight away. It also triggers collagen remodelling, in which weaker Type III collagen is replaced by stronger Type I, so the neck usually keeps improving for around 6 months. Treatment takes about 60 to 90 minutes, and most people need 1 session. The neck and double chin page explains the area in more detail.
Endolift is not a replacement for liposuction of large volumes. If there is a lot of fat, it will not remove enough.
Side by side
| Question | Neck liposuction | Endolift |
|---|---|---|
| Main job | Removes fat | Tightens skin and reduces small fat pockets |
| Best for | Larger volumes of fat with firm skin | Small fat pockets with mild to moderate laxity |
| Tightens skin | Not its main purpose | Yes |
| Nature of procedure | Surgical | Minimally invasive, local anaesthetic |
| Heavy, hanging skin | Not suitable alone; a neck lift is better | Not suitable; a neck lift is better |
A simple way to think about it:
- Lots of fat, firm skin: liposuction is often the stronger option.
- A little fat, some loose skin: Endolift is often the better fit.
- Mostly loose skin with little fat: Endolift may help if the laxity is mild to moderate.
- Heavy, hanging skin or marked bands: a surgical neck lift usually gives the clearest result.
Other options for small fat pockets are covered in Endolift vs fat dissolving injections and getting rid of a double chin without surgery.
Recovery and risks with Endolift
After Endolift under the chin, expect swelling, bruising, redness and tenderness. The skin may feel numb, and the treated fat can feel firm or lumpy as it settles. Most of this eases within days, though numbness and firmness can take 1 to 2 weeks or longer. A compression strap is worn for 3 to 4 days. Most people return to work the next day or within 48 hours.
Rarer risks include burns, skin irregularity, infection, scarring at the entry point and temporary nerve weakness. Near the jaw, irritation of the marginal mandibular nerve can affect the smile for a period. These are uncommon but you should hear about them before treatment. The side effects and safety page covers each in turn.
Results can last up to 2 years, depending on age, skin, weight stability, sun exposure and smoking. Results vary from person to person.
Cost and how to decide
At TK Medispa in Kensington, Endolift under the chin or on the neck is priced as a single face area at £1,500. The lower face (lower cheeks, jowls, chin and neck) costs £2,000. Each price includes the photo assessment, video consultation, treatment, local anaesthetic, aftercare and review. For a liposuction quote, ask the clinic exactly what is included.
Dr Seth's view "The first question I ask about any neck is whether this is mainly a fat problem or mainly a skin problem. If a patient has a generous amount of fat and good skin, liposuction can be the right operation. If there is a modest amount of fat and the skin has started to loosen, I generally prefer Endolift, because it tightens as well as reducing fat."
Next step
To find out which suits your neck, send 3 photos (front, left and right, in natural light, with your head level) for Dr Seth's free assessment through the booking page.
Questions people also ask
Can neck liposuction leave loose skin?
It can if the skin was already losing elasticity. Liposuction removes fat but is not designed to tighten the skin above it. In younger people with firm skin, the skin often settles well. Where laxity is already present, a treatment that tightens as well may give a neater result.
Is Endolift a type of liposuction?
No. Endolift uses laser energy to tighten skin and liquefy small fat deposits, which the body then clears. It does not suck fat out and is not designed for large volumes. It is a minimally invasive treatment carried out under local anaesthetic, usually in 1 session.
Can I have Endolift after neck liposuction?
Often yes, if loose skin remains once the area has fully healed. Dr Seth would want to know when the liposuction was done and how the skin has settled. Send photos and mention the previous procedure so he can advise on suitability and timing.
Will either treatment help neck bands?
Prominent bands in the neck are usually caused by the muscle beneath the skin rather than by fat or skin alone. Neither liposuction nor Endolift is designed to treat them directly. Where bands are marked, a surgical neck lift or another approach may need to be discussed.
This article is general information, not personal medical advice. Results vary between individuals and are not guaranteed. Endolift® and LASEmaR® are registered trademarks of Eufoton® S.r.l.