You Can't Gua Sha Away a Double Chin

By Nicola Dall'Asen

Welcome back to the Learning Curve, a monthly column where we unpack the complicated experience of accepting your own body in a world that doesn't seem to want you to. This month, Nicola explores the internet's obsession with (and misunderstanding of) gua sha and how that obsession could be the result of fatphobia hiding beneath the surface.

I picked up the practice of gua sha in 2020 as a way to add moments of peace to my day and to revive dull, dry skin caused not just by pandemic stressors, but by plain ol' aging too. It seems like just about everyone on TikTok discovered the practice at the same time. In fact, it's probably the thing that influenced me to get a gua sha tool in the first place as the technique has since skyrocketed in popularity with fierce consistency. Though I've been lucky enough to develop my own gua sha routine based on the expert guidance I have access to as a beauty editor, most other consumers seem to be turning to the app for laid-out routines, technique tips, and other ways to get the most out of their gua sha purchases. Since the first time my fingertips felt the cold, smooth surface of a gua sha tool, one belief about it has been pounded into my head more than any other: that it can make a double chin disappear like a magician with a cape. Though I've never gone actively looking for it, I can't halt the flood of gua sha, lymphatic drainage, and other types of facial massage content that has snaked its way onto my For You page multiple times a day for the past couple of years. An overwhelming amount of that content focuses on reducing the appearance of or trying to eliminate a double chin. A small sample: "If you have a double chin, here is a way to get rid of it," one TikTok user says while demonstrating a jaw massage technique. "Ever wondered why you have a double chin?" another person asks via text on the screen while they glide a gua sha up and down their neck. "A double chin is not always fat or genetics. It can come from bad posture and stuck fluid. Try these exercises with your gua sha." Much of the gua sha or facial massage content I see is punctuated by before and after photos with results ranging from subtle to drastic, such as one video I came across that had a voiceover declaring, "I'm gonna show you how to get rid of your double chin naturally… I noticed great results just after one treatment and they got incredible after three weeks of consistent use."

When I did a curious search for "gua sha" on TikTok while writing this piece, the suggested search terms the app populated included the standard "gua sha routine" and "gua sha tutorial," but also included phrases such as "gua sha for double chin" and "gua sha for slim face."

Even for a person who's made a career of preaching body acceptance, this type of content to which I'm exposed, whether or not I want to be, is sneakily effective at chipping away at a healthy self-image and, more importantly, enforcing a beauty standard that awards thinness above all else, especially in women.

I don't even have a double chin. Still, my unfortunate reflex when I see a person who is more often than not thinner than me gliding rose quartz across their face and insisting I can achieve similar results is to believe just that: that I could look like them with nothing but a few passes of a gua sha… that I should look like them with nothing but gua sha. And therein lies the problem: It's not really possible unless you already look like that.

By Gabi Thorne

By Kara Nesvig

By Gabi Thorne

For context, you should know that gua sha is not a new practice and its origins have nothing to do with aesthetics. "Gua sha is an ancient Chinese medicine practice that goes back centuries," Sandra Chiu, a certified acupuncturist, herbalist, and traditional Chinese medicine practitioner based in Brooklyn, tells me. "It is first and foremost a healing technique used to relieve pain and strengthen the immune system." Stephanie Zheng, a licensed esthetician based in New York City and founder of Mount Lai, a gua sha brand rooted in traditional Chinese medicine, elaborates: "Gua sha loosely translates as 'to scrape' in Chinese and is the practice of using a flat tool against the skin to target stagnation and help restore the flow of qi. Qi is vitality energy in the body and has a close relationship with blood flow." Today, gua sha remains "an important modality" that traditional Chinese medicine practitioners use for the treatment of pain and to support the immune system, according to Chiu.

"Calling gua sha a lymphatic drainage technique is kind of like calling yoga a type of Pilates because they both stretch the body."

The practice wasn't used on the face until recently and, even then, the intended use of facial gua sha is not to erase a double chin or to slim the face by any means. "Facial gua sha is a relatively new 'cosmetic' treatment derived from traditional gua sha," Chiu says. "It is a gentler, softer variation that improves blood circulation, releases excess muscle tension, and smooths fascia" (the connective tissue that essentially holds all your muscle fibers, bones, blood vessels, etc., together). "The goal is still to target stagnation and restore the flow of qi for healthy skin and healthy tissue," Zheng concurs.

Western culture more or less took that concept and threw it out the window in favor of methods that seem to provide more drastic visual results at the cost of muddling the intentions and abilities of traditional gua sha. On our side of the world, the practice has been widely lumped together with lymphatic drainage, which Chiu credits to the West's cultural appropriation of the practice. While the two are similar in many ways, they are not the same. "The idea that gua sha is a lymphatic drainage practice comes largely from estheticians, Western MDs, and influencers who interpreted gua sha through that lens," Chiu clarifies. "Calling gua sha a lymphatic drainage technique is kind of like calling yoga a type of Pilates because they both stretch the body."

When you apply that perspective to TikTok, it's clear to see how people on the app got wrapped up in the idea that gua sha can and/or should be used as a tool for double chin reduction and general facial slimming — lymphatic drainage is actually intended to lessen swelling and puffiness, after all. But in the case of gua sha, the subtly sculpted appearance of the face is merely a side effect of improved circulation and the release of tension in the chin, neck, and jaw. "Stagnation can look like excess fluid buildup in the face, which gua sha can help with, resulting in less puffiness or more defined facial features," Zheng explains. Connecticut-based, board-certified dermatologist Mona Gohara, MD, agrees: "Gua sha can help to shift fluid from one area to another," she explains, likening the shift of internal fluids toward the lymphatic nodes to pushing water toward a drain using a mop or broom. "It can increase circulation, raising radiance."

By Gabi Thorne

By Kara Nesvig

By Gabi Thorne

So those before and after photos you see on the app of "double chin transformations" may not all be exactly fake — gua sha can, indeed, give the chin and jawline a more defined appearance — but only if you have the appearance of a double chin resulting from built-up fluid rather than an actual double chin comprised of adipose tissue (widely referred to as body fat), bone structure that lends itself to a round facial shape, or skin that naturally becomes droopier with age. "Stagnation can look like excess fluid buildup in the face, which gua sha can help with, resulting in less puffiness or more defined facial features. Gua sha cannot, however, change bone structure," Zheng explains. Chiu agrees: "The issue with claiming gua sha can reduce a double chin is the misunderstanding of anatomy and physiology," she says. "If heaviness of the chin is due to an out-pocketing of adipose tissue, there is no way gua sha is going to eliminate that."

"The issue with claiming gua sha can reduce a double chin is the misunderstanding of anatomy and physiology."

Ultimately, Dr. Gohara calls any claims that gua sha can reduce or eliminate a double chin "scientifically unsound. There is nothing about this tool that alters adipose, collagen, or elastin content." It means, she says, that any kind of facial contouring or fat loss is off the table with gua sha as that is not what the practice is actually intended for. The belief that it is has gotten passed around so quickly, Chiu explains, because the overwhelming majority of people who make gua sha content on the internet are not qualified to offer advice on the subject. "Most viral influencers are not actual experts with any real connection to gua sha or Chinese medicine," she says. "If we want to stop the misinformation, it's important to help people understand that gua sha is a Chinese medicine technique that is practiced by acupuncture and traditional Chinese medicine professionals who have on average four years of post-graduate training and are licensed by their state to practice on clients."Aside from this inaccurate gua sha content being disrespectful to the roots and intentions of the practice, another one of the big problems is the lack of distinction that content creators make between "the appearance of" a double chin and an actual double chin. For someone who's simply a little bit bloated from drinking one too many glasses of wine the night before, yeah, gua sha can lessen some of the "heaviness" underneath the chin, as Chiu calls it. But anyone with a real double chin could very well become confused and ashamed when they realize they've been fed a false narrative about the "incredible" results they can achieve with gua sha — or even worse when they don't realize the narrative they've been fed is false. Considering TikTok is an app where you have only a split second to grab a viewer's attention and mere minutes to state your case, it seems unlikely that this lack of distinction will change.

By Gabi Thorne

By Kara Nesvig

By Gabi Thorne

Regardless of what gua sha can and can't achieve, to put so much focus on using it as a double chin eraser is to insist that double chins are something that should be gotten rid of and therefore something to be ashamed of. And to me, there's little explanation for that other than fatphobia, whether outright or internalized. As Chiu points out, not all people associate double chins with fatness, but when I think about Western culture specifically and its general hatred not only of fatness but also of roundness — of round bodies, of round faces — the connection between the online gua sha craze and fatphobia only becomes stronger in my mind as I attempt to explain why we're so quick to admonish the appearance of those with double chins. (This is also a matter of ageism, but that's a story for another day.)Why, then, does this specific type of fatphobia fly so silently under the radar? Why is the area under the chin the first place targeted when tools and techniques like this gain popularity or when injectables such as Kybella hit the market? Why are we all so fascinated by surgical procedures such as buccal fat removal? Fat acceptance and liberation have come so far in the digital age, but while we're finally coming to terms with the existence of big butts, bellies, and thighs, double chins remain feared with great vigor. Therefore, encouraging people to eliminate them gets an unquestioned pass on the internet.

What you do with your body is your business and your business alone. If you have a double chin and want to seek out tools, procedures, or what have you in order to get rid of it, who am I to judge? I've gotten Kybella before. I've followed "jaw-snatching" gua sha tutorials that popped up on my feed out of morbid curiosity. I, too, feel and have succumbed to the never-ending pressure to make my face appear thinner, tighter-skinned, and more sculpted.

I just wonder what gua sha and other facial massage content would look like in a world where double chins were seen more often in media (and not in a weight-loss-centric context). I've written in this column before about how what little plus-size representation we do have in this country is riddled with yet another impossible beauty standard, one that attempts to show fatness without roundness and (you guessed it) without double chins. We've also touched on practices such as padding — wherein straight-size models are hired to showcase plus-size clothing and wear pads to give the appearance of having a fatter body without a fatter face. All of this creates an illusion of plus-size representation while giving fat people yet another unattainable body standard to hold themselves to (and for other people to hold them to).

By Gabi Thorne

By Kara Nesvig

By Gabi Thorne

Were double chins positioned in our media as neutral facial features that are okay as they are, would the westernized version of gua sha be as ubiquitous as it is? Would we be so quick to search "gua sha for slimmer face" on TikTok? Would we be clicking that "add to cart" button so reflexively? I think you now know the answer to that.

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