Sagging bulge / double chin 6 months after Kybella (photos)

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

A double chin is not caused by having an abnormal fat distribution. Double chins are not a fat related problem. That said well done fat removal can give impressive results in some individuals.
The primary problem that causes a double chin is a facial skeletal issue which happens on individuals who have a mandible that is small or lacking in projection. This in turn causes the underlaying platysma muscle to drape the neck in a more oblique fashion. Other issues that come from this skeletal imbalance is an overbite dental occlusion, premature jowls, on profile pictures the upper lip will have more forward projection than the lower lip, and finally a loss of jawline definition.
The pictures you included look like they are more than six months apart. If they are you seem to have gained a significant amount of weight.
In regards to fat removal I’m not a fan of using Kybella. I think you will find that few plastic surgeons use or recommend it. The providers who recommend Kybella tend to be those who can not offer liposuction which is in my opinion a better procedure by every measure.
If you want a quality assessment then consult with quality plastic surgeons. Having had Kybella makes things a little more complex. The key to consistent quality aesthetic outcomes patient need to understand their candidacy for various procedures and be in the hands of of the best providers.
Thread lifts are probably not the right follow up procedure.
Consult with senior plastic surgeons in your community. Alternatively consult with oral surgeons or surgeons with craniofacial background who tend to have a better understanding of in impact facial skeletal structure and how that contributes to how each one of us looks. The neck is complex and many tissue layers contribute to what it looks like. By far the most important in bone structure. More or less 100% of individuals seeking submental/chin-neck fat removal have a small mandible.
Best,
Mats Hagstrom, MD