Double chin got bigger after Kybella - where do I go from here? (photos)

Question

I got 4 vials of kybella in 3 months with the last vial over 4 months ago. The before picture looks better! I did have hard lymph nodes after but my dermatologist said it's nothing. I went to my PCP and he order a neck MRI without contrast which showed 2 enlarged lymph nodes. I'm not sure where to go from here. I was thinking lipo but I'm prone to keloids so that's why I went with kybella in the first place. Or is it just loose skin and I need a neck lift? I'm 26 and bmi of 29

Daniel Barrett, MD · Answer

Dear Generous791574,
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. It also costs about the same as what you paid for your first kybella session. The liposuction can be done under local while awake in the office and recovery is about the same as kybella.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jason Emer, MD · Answer

​It takes a series of treatments to get good results with Kybella. Keep in mind, Kybella is good for dissolving the submental fat under the chin area while contouring the jawline and making the chin more defined, but a combination approach is needed to get the most improvement with non-invasive options. I recommend a combination approach with Thermage, Ultherapy, and Exilis.

InMode FaceTite / AccuTite with VASER Neck Liposuction is the best option for contouring and tightening the chin, neck, and jawline area. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer​​

Darryl J. Blinski, MD · Answer

Though very rare rebound fat growth is a real entity with KyBella. Must see if you are a keloid former then would try aggressive neck/submental liposuction. Fee $5,000 under local anesthesia ...

Mats Hagstrom, MD (license on probation) · Answer

Based on your pictures it looks like you may have gained weight between your before and after picture.

If that’s the case then that is where you should focus your efforts first and foremost.

Personally I’m not a big fan of Kybella.

The incision points for Liposuction are very forgiving in regards to forming visible scars. The chin and below the ear lobes heal extremely well.

Liposuction is a much better procedure and that is perhaps where you should’ve started.

That said the shape of somebody’s neck and jaw line it’s an accumulation of many different tissue layers that all have an impact.  probably the biggest variable is bone structure but platysma muscle, sub platysmal fat, subcutaneous fat and skin can also contribute significantly to how this part of the body looks.

Consult with senior board-certified plastic surgeons who have extensive experience and a proven track record with facial aesthetic surgery.

Have you done that in the first place then you may not have needed to go through getting MRIs and all the other doctors visits and expenses you’ve been through to date.

Hopefully you have a scale and know what your accurate weight was when you had your procedure and what it is currently.

If your weight has gone up even a couple of pounds then that needs to be addressed first and foremost.

Even the subtle weight change has a big impact on how the face and neck looks.

Most people have one or two palpable lymph nodes in their neck.  This is normal.

Best,

Mats Hagstrom MD

Double chin got bigger after Kybella - where do I go from here? (photos)

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