Drooping neck fat and pronounced neck wrinkle. Kybella or neck lipo? Botox for wrinkle? (Photos)

Question

I would like to get rid of the patch of drooping fat under my chin. It seemed to appear suddenly, a month after I turned 36 last yr, despite no weight gain. I do carry abt 10 lbs of extra weight, despite mindful eating & exercise. But weight was/is stable, and neck fat just appeared! Am I a candidate for neck lipo, as I'd like to get it over with rather than numerous visits for Kybella? Or should I try Kybella first? And would botox make that bottom neck wrinkle less pronounced? Thanks!

Sabrina Fabi, MD · Answer

My personal preference in your case would be to go with Kybella, simply because you do have some drooping skin. CoolSculpting and face lipo with small cannulas would both do an excellent job of removing the fat. And it’s possible that your skin would adjust to the loss of volume, or could be tightened with Ultherapy. 
The advantage with Kybella is that the deoxycholic acid actually causes some skin contraction, so you may not need anything other than the Kybella to get a sleeker jawline. As for the neck wrinkle, Botox may help a bit, but sometimes a non ablative fractionated laser works best. Consulting a board-certified dermatologist will help you decide how to remove your double chin; you have a lot of excellent options.

Jason Emer, MD · Answer

"Injecting soft fillers like Belotero in this area can reduce lines, wrinkles and folds as well as improve skin texture with long-term collagen production. Fillers are being used more frequently to contour and lift rather than solely line fill. Of course, fillers are best used in combination with lasers and microneedling with PRP to get the optimal outcome.

I suggest getting a formal evaluation with a cosmetic dermatologist to create an individualized treatment plan that works for you. Best, Dr. Emer"

I suggest getting a formal evaluation with a cosmetic dermatologist to create an individualized treatment plan that works for you. Best, Dr. Emer"

Elham Jafari, MD · Answer

Hi and thank you for your question! Based on the picture, I think you are a good candidate for non-surgical treatments. You can see very good results with Kybella for the fat under the chin. We can also use some filler treatment to create a sharper chin angle. For your neck area, you can try radiofrequency treatment to tighten the skin. We can also use superficial fillers such as Belotero to treat the lines on neck. Botox can also be used for neck, but it's mostly for vertical lines (platysmal band). Please consult an experienced cosmetic doctor for best results. I hope it helps and good luck!

Jonathan Kulbersh, MD · Answer

Both Kybella or neck liposuction are good options and will improve the double chin.  It depends on your lifestyle and personality which would be better for you. 
Kybella is best for patients that:
1)  Do not want surgery 
2)  Are not surgical candidates 
3)  Not willing to wear a compression dressing around the face for 1 week 
4)  Patient-  The results of Kybella will take months
Kybella take 1-3 treatments every 6 weeks.  Patient will develop swelling and possible bruising after each injection that may last a few days.  The benefit of Kybella is each treatment is quick and completed in the office.
Neck Liposuction is best for patients that:
1)  Want a single treatment 
2)  One recovery time-  Downtime for neck liposuction require wearing a wrap around face for 1 week. 3)  Less painful 
4)  Quicker results 
5)  Cost is a concern
Neck liposuction is a quick surgical procedure that can be complete while the patient is awake.  It cost around the same price a Kybella and can be less in patients with heavier necks.  The single recovery of neck liposuction may be a better option for some patients.
I hope this helps.

Calvin Jung, MD · Answer

Hi Tngirl,Kybella will take multiple treatments and if you add up the cost for kybella vs neck lipo it will end up relatively the same since kybella will take about 2-4 treatments.  Neck liposculpture with microcannulas and laser/vaser for skin tightening will help improve your neckline from the pictures that you have posted.  The horizontal neck line can be improved with fillers.See a lipo expert for best results!

Daniel Barrett, MD · Answer

Dear TNgirl8,Kybella typically takes 3 to 5 treatments to work. This is why I've stopped carrying Kybella in my office.  I recommend neck liposuction more often then any injectable procedure for the neck now. It provides superior results gives me more control over the area than any injectable. The liposuction can be done under local while awake in the office and recovery is about the same as kybella.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Richard E. Moore, MD · Answer

Thank you for your question and posting your photo. We have largely gone away from using Kybella because we have found the recovery to be roughly equal to slightly more invasive procedures. Further, most patients typically require a minimum of 3 sessions to get the desired fat destruction. From a cost perspective the minimally invasive treatments are usually less expensive than Kybella. In your case, I would recommend the combination of liposculpture (small volume lipo) combined with either FaceTite or J-Plasma. This will give you more dramatic skin tightening as well deal with the sub-mental fat in a single session.I hope this was helpful - Dr. Moore.

Laura Phan, MD · Answer

Based on the photo, the submental fat is mild, perhaps mild to moderate. This should respond well to Kybella, which is deoxycholic acid. This is the same substance found in gallbladder that dissolves dietary fat. Once the fat cells are dissolved, they do not return. I will warn that the area will swell significantly after the injections for several days to a week. Most patients need two or even more treatments. I think you will benefit from two treatments six weeks apart. If there is excess skin afterwards, you may consider Ultherapy or Thermage to tighten the skin. The skin tightening results vary from patient to patient.

Mohamad H. Bazzi, MD · Answer

Hello,
It looks like you would be a good candidate for Kybella or surgical options. Kybella will give you improved contour with some skin retraction.  You can even aid with additional tightening by using a radio frequency or laser treatment however if you are looking for significant tightening of the skin I would consider surgical options. 
Take care.

Shaun Patel, MD · Answer

Both surgical and nonsurgical treatments could help with your concerns. Since my practice focuses on nonsurgical treatments, I will defer to the plastic surgeons on surgical options such as liposuction. When it comes to nonsurgical treatments, the best results are seen with combination treatments. Kybella is a great treatment options for reducing fat underneath the chin. Usually, several treatment sessions are required and usually spaced 1-2 months apart. Once the Kybella treatments have been performed, a skin tightening procedure such as Thermage could further improve the results. Of course, the results will not be as impressive as those seen with surgery but patients who opt for nonsurgical treatments are looking for reduced downtime, reduced risk, and subtle/natural looking results. Most importantly though is that these patients are simply looking to avoid surgery.