Kybella before and after photo courtesy of Dr. Douglas Seinbrech, board-certified plastic surgeon in New York City. Treatment results may vary.
Kybella is an injectable treatment that dissolves fat cells, to reduce small areas of excess fat. Itâs 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 âbra roll.âÂ
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. âGenerally, three to four Kybella treatments are needed for the submental area,â says Dr. Michele Green, a dermatologist in New York City. She often starts with CoolSculpting to treat chin fat, using the CoolMini applicator to âdebulkâ the area. âOnce the area of fat has been reduced, the remainder is treated with Kybella,â 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. âNoninvasive skin tightening, such as Ultherapy or Thermage, are ideal for additional firming and tightening of overlying skin, especially in the older patient,â 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.Â
RealSelf Tip: Doctors on RealSelf are divided over how effective the injectable is at reducing abdominal fat. It can be used âoff-labelâ 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 âfor larger areas of excess fat, patients may need up to six treatments to see their desired results.â Because of this, Kybella isnât 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 sessionsâor a surgical option like liposuction can create dramatic results with a single procedure.
Pros
Cons
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 donât want to commit to a surgical procedure.
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 itâs 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 dollarsâand youâll have to wait months longer to see real results.
The best candidates for Kybella treatment are:
You may also be a good candidate for âoff-labelâ 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:
The Kybella photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.
Hereâs what you can expect during your first appointment.
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 youâre 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.
Most patients return to work the day after treatment, so true downtime is minimal.
That said, the swelling can be unpredictable, so donât plan on getting Kybella injections in the weeks just before a wedding or another big event.Â
Hereâs what to expect during your Kybella recovery:
Doctors on RealSelf recommend a few different ways to reduce swelling after Kybella:
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. Â
In clinical trials, â72% of subjects treated with Kybella experienced hematoma/bruising.â Thereâs a heightened risk of excessive bruising in the treatment area if you have bleeding abnormalities or are undergoing antiplatelet or anticoagulant therapy.Â
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, thereâs not enough research data to know with certainty that Kybella is safe for nursing or pregnant women.Â
See the FDA's full list of precautions and dosage information.
Most doctors say that patients need at least 2 treatments before theyâll 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. âBy waiting a bit longer, you will see results from the prior treatment more fully,â she explains. âSome patients decide they don't need to do more.âÂ
Dr. Richard Zienowicz, a plastic surgeon in Providence, Rhode Island, agrees that âresults should begin to be seen in 5 to 6 weeksâ and may continue to improve for up to 12 weeks.Â
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 youâre 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.
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.Â
Your best bet to maintain your results is a healthy lifestyle and diet, to keep your weight stable.Â
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 thatâs 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 whatâs 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.
Updated September 6, 2023