Kybella VS buccal fat removal, what makes more sense? (Photos)

most of my younger patients will do ether an early neck lift with buccal removal or Facetite with buccal removal.  if not done right , buccal removal can give you more hollowing and sagging so this has to be done well.
With significant neck sagging you would need a neck/face lift with muscle tightening (platysmaplasty). at the same time lasers (fraxel,  co2 or erbium( or microneedling RF (fractora, intensif) can be . performed to improve the crepe skin or wrinkles.  You need a formal consultation, as the neck can be treated with a combination approach:
1. micro needling and lasers for texture
2. botox, disport or xeomin to help platysmal bands
3. intensif or fractora RF microneedling for crepe skin and lifting
4. fillers like belotero, restylane silk, juvederm volbella to improve lines and folds
5. neck/face lifting if sagging is prominent or early starting +/- platysmaplasty (muscle tightening)
6. J plasma/Renuvion, thermiRF, inmode facetite for internal tightening
7. ultherapy and thermage for external tightening
8. regular Venus legacy, exilis ultra, or inmode forma treatments with facials to maintain tightness
9. PDO novathreads or silhouette instalift cone threads for lifting and long-term collagen production
see an expert for a full evaluation and treatment plan based on your individual situation and goals.
Best, Dr. Emer.

I presume what bothers you is the fullness in your above your jaw line. This fullness is not affected by removing buccal fat. This is not an area that should be treated by Kybella. Kybella is a highly inflammatory treatment that creates a chemical panniculitis that damages tissues and induces tissue necrosis. If the treatment is isolated to fat tissue, there will be less fat. If it affects muscles or nerves, you can have permanent damage to these tissues. Don't let anyone experiment on you by agreeing to treat you in areas that are not FDA approved for treatment. Buccal fat removed deep cheek fat above your area of concern. Focal liposuction, or alternatively, hyaluronic acid filler in the depressor anguli oris area in front of the "jowl." Choose wisely and please do not select the wrong procedure. You will find someone to do what you are asking and end up in trouble.

Hello and thank you for your question.  Buccal fat removal is unlikely to correct jowls as it is involving the lower face.  In addition Kybella is not indicated for the  jowls and also will unlikely correct this area as the problems is related to excess and lax skin.  I would recommend a neck lift or if you are adverse to a surgical procedure at this point in time, then I recommend a tightening modality using radio frequency energy.  I hope that answered your question.

Jowls are specific to the lower face near the mouth. This is usually genetic and due to a combination of hanging skin, stretched ligaments, and sometimes fat. Kybella is not FDA approved for this area and it may be difficult to control the reduction. Buccal fat pad removal does not address the jowls. The buccal fat pad is slightly more posterior too the jowls and removal accentuates the cheek bones. Overly aggressive buccal fat pad removal can actually make the jowls worse! Jowls are best treated with skin tightening procedures such as thread lifts or lower face lifts. It is best to have an in-office evaluation to determine the best treatment plan for your face. Hope this helps!Johnson C. Lee, MD
Board-Certified Plastic Surgeon

dr. Steinsapir pretty much nailed it in his answer.Kybella it's a pretty awful treatment options in general and it is a very bad idea to go outside of the FDA  approved  areas. People of developed facial nerve paralysis and lots of other horrible unpleasantries  from this treatment.  Buckle fat can look reasonably good in young people but can lead to very undesirable outcomes down the road when a lack of volume becomes a real issue. The buckle fat pad is also in a very discreet place and people benefit only when they look good having volume removed exactly where the flatbed is located.  Adding volume adjacent to the areas where you want five removed may be an option.  For example in the  pre Joel area in front of the area you want to look smaller.  Best, Mats Hagstrom MD