Name: Chin Enhancement Options
Uploaded: 07/23/2021
Description: Chin Enhancement Options

Question 1

What is Kybella?

Accepted Answer

Kybella is an injectable treatment that dissolves fat cells, to reduce small areas of excess fat. It’s the only FDA-approved cosmetic injectable for permanently reducing submental fat, commonly called a double chin. Doctors also use the treatment "off-label" to treat other small pockets of fat on the body, including above the knees and elbows, upper arms, and the “bra roll.”

The active ingredient in Kybella is a synthetic form of deoxycholic acid, a naturally occurring bile enzyme in the gut.

Each Kybella treatment session requires multiple injections in the targeted area, and patients typically need a series of treatment sessions to see significant results. “Generally, three to four Kybella treatments are needed for the submental area,” says Dr. Michele Green, a dermatologist in New York City. She often starts with CoolSculpting to treat chin fat, using the CoolMini applicator to “debulk” the area. “Once the area of fat has been reduced, the remainder is treated with Kybella,” she explains.

Some Kybella patients have a mild skin tightening effect in the submental area, but if laxity is a concern, you may get a better result with a complementary treatment. “Noninvasive skin tightening, such as Ultherapy or Thermage, are ideal for additional firming and tightening of overlying skin, especially in the older patient,” explains Dr. Susan Van Dyke, a dermatological surgeon in Paradise Valley, Arizona.

Your outcome will depend on your anatomy, the amount of fat you need to treat, and whether your skin has good elasticity (or the potential to sag once fat is removed). It could work really well for you, or you may need more treatments than others to get the slimming results you want.

RealSelf Tip: Doctors on RealSelf are divided over how effective the injectable is at reducing abdominal fat. It can be used “off-label” to treat small pockets of belly fat, but the number of treatments needed for optimal results can very quickly run up your total cost. Dr. Green says that “for larger areas of excess fat, patients may need up to six treatments to see their desired results.” Because of this, Kybella isn’t the fat-reduction treatment of choice for larger areas like thighs, where other noninvasive body contouring treatment options can deliver better fat reduction in fewer treatment sessions—or a surgical option like liposuction can create dramatic results with a single procedure.

Question 2

What are Kybella’s pros and cons?

Accepted Answer

Pros

Kybella injections can permanently dissolve fat cells without incisions, surgery, anesthesia, or scars.
It’s a quick procedure, taking just 15 minutes to perform.
It doesn't usually come with much discomfort, if your provider numbs the injection area in advance and applies an ice pack immediately afterward.
You should have minimal downtime, if you don’t have severe swelling, a relatively rare side effect.
Because it kills fat cells, results can be very long-lasting or even permanent.

Cons

Results can be difficult to predict: some people have a robust reaction after just two treatments, but in clinical studies, 59% of patients needed six treatments each.
You’ll have to wait 4-6 weeks between each treatment, so a full treatment plan can take months.
Even small pockets of fat can require two or more vials (at $600–$800), so the cost can add up quickly.
Kybella injections are only recommended to reduce small pockets of unwanted fat.
Some patients experience severe swelling (commonly called “bullfrog neck”) for up to a month after their treatment.
It’s essential to make sure you’re the right candidate for this procedure, to ensure good results. Younger patients typically see better results than people over age 50, who may have droopy excess skin once the fat is gone.
There is a possible link between fat-dissolvable injectables like Kybella and alopecia that leads to hair loss in male patients.

RealSelf Tip: Chin liposuction is still considered the gold standard in double chin treatment, but Kybella injections can be a good nonsurgical option for people who don’t want to commit to a surgical procedure.

Question 3

How much is Kybella?

Accepted Answer

The price you pay will depend on how many vials are used, the experience level of your provider, their practice location, and a few other key factors.

This is an elective cosmetic procedure, so it’s not covered by health insurance.

You might think Kybella injections would be cheaper than liposuction (and chin lipo can be costly), but those vials add up quickly. If you need just two vials per treatment and two treatments, the price difference between Kybella and chin liposuction may only be only a few hundred dollars—and you’ll have to wait months longer to see real results.

See our complete guide to Kybella costs

Question 4

Who makes a good candidate for Kybella?

Accepted Answer

The best candidates for Kybella treatment are:

at least 18 years old
bothered by the appearance of a double chin, due to moderate to severe submental fat
looking for a nonsurgical alternative to facial plastic surgery procedures, such as chin lipo or a neck lift

You may also be a good candidate for “off-label” Kybella treatment if you have small pockets of fat in other areas, like the bra roll or knees.

Your provider may recommend a different treatment option if you:

are pregnant or nursing
have trouble swallowing
have an infection or another medical condition near the treatment area

Question 5

Kybella before and after pictures

Accepted Answer

The Kybella photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 6

How does a Kybella treatment work?

Accepted Answer

Here’s what you can expect during your first appointment.

Your appointment will start with an anatomic analysis and assessment by your doctor, along with a photo so you can measure your progress later. Some doctors also weigh their Kybella patients, because post-treatment weight gain can lead to suboptimal results.
You and your provider will discuss your goals and expectations, and they will let you know how many treatments (and how many vials of Kybella) you’re likely to need to achieve those goals.
They will measure the treatment area and mark the injection sites in a grid-like pattern.
Next, they’ll cleanse the area with an antibacterial.
Some doctors apply a topical numbing cream up to 60 minutes before injecting, to reduce the discomfort of the tiny needles.
Then your provider will administer a series of quick Kybella injections into the subcutaneous fat (below the skin). Dr. Van Dyke says that the number of injections typically ranges from 20 to 30, depending on how much fullness you have and the number of vials you need.
Most treatments take just 15–25 minutes, though they can take up to 30.

Question 7

Does Kybella hurt?

Accepted Answer

Reviewers on RealSelf report varying levels of pain during Kybella treatment: some say it's painless, while others call it excruciating. Most say there is a slight burning sensation as the medication starts to disrupt the fat cells. According to Dr. Van Dyke, this typically lasts about 10 minutes.

Icing the area immediately can reduce this discomfort. If you’re worried about pain, give the numbing cream a full hour to work prior to your treatment, ask if your provider has a small ice pack ready, and get their recommendation for an over-the-counter pain reliever.

Dr. Van Dyke also recommends applying a chin strap after the procedure, to ease the discomfort and reduce swelling.

Question 8

How long does Kybella recovery take?

Accepted Answer

Most patients return to work the day after treatment, so true downtime is minimal.

That said, the swelling can be unpredictable, so don’t plan on getting Kybella injections in the weeks just before a wedding or another big event.

Here’s what to expect during your Kybella recovery:

Most patients have mild to moderate swelling for up to a week after treatment.
Some patients have more severe swelling, commonly called “bullfrog neck.” If this happens to you, it may take a month for the swelling to fully resolve. “Significant swelling generally happens with patients who have a large amount of submental fat. This reaction usually minimizes with subsequent injections,” explains Dr. Green.
Most patients have bruising around the injection sites; this can be covered with makeup and should fade within a week or two.
The treatment area may feel tender or even painful for up to two weeks. Your provider may recommend an over-the-counter pain medication like ibuprofen, as well as light ice packs.
Some patients experience a “jiggling” sensation as the area swells and fat cells dissolve. Dr. Mark Berkowitz says “This process is gradual, and the ‘gobble neck’ takes approximately 5-10 days to significantly reduce. This is directly dependent on the volume of product placed.”

Doctors on RealSelf recommend a few different ways to reduce swelling after Kybella:

Icing the area a few times a day can help.
Wearing a chin strap or compression garment can also reduce swelling, so ask your provider if you should consider getting one.
Avoid hot tubs, saunas, and hot yoga, as heat can make swelling worse.
Dr. Nick Slenkovich, a plastic surgeon in Littleton, Colorado, advises his patients to “avoid any strenuous exercise for 4-5 days following the injections. We do not want to increase the amount of blood flow to the injected area, which could increase swelling and delay healing.”

Question 9

Is Kybella safe?

Accepted Answer

Kybella is FDA-approved, and doctors widely view it as a safe fat reduction treatment. However, your provider should discuss potential risks and side effects of Kybella during your initial consultation.

The most common side effects include swelling, pain, numbness, redness, and some areas of hardness in the treatment area. All of these side effects are temporary, though numbness can last from 3 to 6 weeks, with sensation returning gradually.

In clinical trials, “72% of subjects treated with Kybella experienced hematoma/bruising.” There’s a heightened risk of excessive bruising in the treatment area if you have bleeding abnormalities or are undergoing antiplatelet or anticoagulant therapy.

Some doctors on RealSelf say that if you have a lot of fat to treat and need multiple vials, there is a risk of more serious side effects that can be longer-lasting.

Currently, there’s not enough research data to know with certainty that Kybella is safe for nursing or pregnant women.

See the FDA's full list of precautions and dosage information.

Question 10

When will you see Kybella results?

Accepted Answer

Most doctors say that patients need at least 2 treatments before they’ll see Kybella work.

The National Library of Medicine recommends spacing the treatments 1 month apart, but some doctors on RealSelf say there are benefits to waiting longer. New York City dermatologist Dr. Sheryl D. Clark says she has found that 5 to 6 weeks between treatment sessions is ideal. “By waiting a bit longer, you will see results from the prior treatment more fully,” she explains. “Some patients decide they don't need to do more.”

Dr. Richard Zienowicz, a plastic surgeon in Providence, Rhode Island, agrees that “results should begin to be seen in 5 to 6 weeks” and may continue to improve for up to 12 weeks.

RealSelf Tip: This treatment can cause some skin to tighten and some to sag. Dr. Kouros Azar, a plastic surgeon in Thousand Oaks, California, says that it mostly depends on your age and how much resilience your skin has. If you already have laxity and a loss of elasticity, Kybella could make that situation worse. If you’re young with tight skin, you might see some mild skin tightening. To enhance that effect, Kybella injections are often combined with nonsurgical skin tightening treatments.

Question 11

Is Kybella permanent?

Accepted Answer

Kybella permanently kills fat cells, so it is considered a long-term fix for unwanted fat.

However, remaining fat cells (including those in or around the treatment area) can expand if you gain weight, which will diminish your results.

Your best bet to maintain your results is a healthy lifestyle and diet, to keep your weight stable.

Question 12

Which is better, Kybella or liposuction?

Accepted Answer

Chin liposuction is the preferred treatment option in most cases because it can remove submental fat more effectively, in a shorter amount of time than Kybella.

Chin lipo is a relatively minor surgical procedure that sucks out fat through a cannula, a thin tube that’s inserted into a small incision under the chin. Usually performed under local anesthesia, this procedure can remove significantly more fat than nonsurgical procedures like Kybella, creating an immediate, noticeable difference in your profile.

RealSelf members think more highly of it too, giving it a much higher Worth It Rating than Kybella.

If your skin has lost some of its elasticity, you may need to pair chin lipo with nonsurgical skin tightening, or even a neck lift (a surgical procedure that removes excess skin and tightens what’s left) to get the best result.

You may also consider chin implant surgery, which can help address submental fullness caused by a weak chin by giving the jawline more definition and improving the chin profile. This cosmetic procedure is often combined with chin liposuction.

Learn about a variety of chin enhancement options from Dr. Jennifer Levine, a board-certified plastic surgeon in New York City, and two RealSelf members who had chin procedures.

Question 13

Sources & studies

Accepted Answer

Cheung K., Kim L., Sebaratnam D., Wong X., Alopecia Following Deoxycholic Acid Treatment for Submental Adiposity (2019)

Allergan plc, Kybella Clinical Results (2018)

U.S. Food & Drug Administration staff, Kybella Prescribing Information (2018)

Emerson A., Gioe O., Hooper D., Souyoul S., Alopecia after injection of ATX-101 for reduction of submental fat (2017)

Shamban A., Noninvasive Submental Fat Compartment Treatment (2016)

KYBELLA

Dr. Susan Van Dyke

Julie Ricevuto

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	Kybella nonsurgical	Chin Liposuction surgical	Neck Lift surgical	Chin Implant surgical
Worth It Rating	47%	94%	91%	90%
Average Cost	$1298	$3982	$12422	$7827
Downtime	Minimal downtime	3–5 days of downtime	1–2 weeks of downtime	Up to 1 week of downtime
Anesthesia	No anesthesia	Local anesthesia	General anesthesia	Local anesthesia with IV sedation

Dr. Susan Van Dyke

Julie Ricevuto

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