Kybella or Thermitight w/fat removal? Can you compare the 2 results and/or tell me pros and cons for results and price? (Photo)

understand the difference in procedure/technology. ..I'm 42, and noticing chin fat. It's taken away from any refined jawline. These pictures are very unflattering, but I wanted to show how I see it...I'm considering Thermitight with some fat removal or Kybella. A nurse I spoke to about Kybella claims results are great and skin tightens over time...

Doctor Answers 9

Kybella versus other options

If you are looking for a non-surgical approach for the neck then a combination of Kybella and Thermage would probably be best for you.  Between Kybella and Thermage you will have 

New York Dermatologist
5.0 out of 5 stars 76 reviews

Kybella vs Coolmini vs Liposuction

Fantastic question! Good to know all of your options.
There are multiple factors that go into answering this question...
If there is a lot of fat, liposuction is your best bet. This can be done in-office under local anesthesia.
If surgery is not something you are comfortable with, Coolsculpting would be your best bet financially... as long as the Coolsculpting applicator fits and you are okay with more time to see full results (than liposuction). If your jaw is too small or the amount of fat too little, the CoolMini may not fit.
Lastly, if you have a small amount of fat and the CoolMini applicator doesn't fit your face, I would go with Kybella. There is a significant recovery period with Kybella and the product is not cheap. That is why I reserve it for people with a small amount of submental fat.
My best,
Dr. Nazarian
@drsheilanazarian on Instagram

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Kybella or Thermitight w/fat removal? Can you compare the 2 results and/or tell me pros and cons for results and price?

Hello rockymtnhigh,
Thanks for your question.
Looking at your anatomy, it would seem that long-term you would do best with the ThermiRF with liposuction. The results relative to cost, risk, and downtime are superior.  Most people can wear makeup to cover any bruising on the neck and go out with a scarf after 48 hours as my patients do.
Kybella is a simple in-office procedure that in your case would probably require 1-2 treatments each with up to a 2 week social downtime.  I'm not sold on skin tightening with time even though you probably get a little.  Price on Kybella is less relative to ThermiRF with liposuction.

All this being said, if you were my patient, I would recommend the following:
1.  VASER liposuction of the submental fat pad
2.  Submental platysmaplasty (repair of loose muscle)
3.  Placement of a Small - Medium silicone chin implant

Here's why I recommend the above:
1.  VASER uses ultrasound to safely destroy fat cells with moderate tissue heating and skin tightening, prior to the liposuction
2.  With a short chin comes weak muscle that typically needs repair to tighten the angle of the neck 
3.  The chin implant makes up for the short chin further tightening the muscle

I have two patients in my Before and After gallery on RealSelf that have had this exact procedure.  All the work was done from one 1 inch incision under the chin in a natural crease most of us already have.  See the link in Web Reference...

If you have further questions, my practice is located in Cherry Creek and I would be happy to speak with you further.
Take care,
Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 55 reviews

Comparing options for improved jawline and submental fat.

Dear rockymtnhigh,
Your timing is great because there are so many options now available. The tough part will be deciding on which path to take, but they will likely all provide substantial improvement. I will try to break down some pro's and con's, and go from most aggressive to least aggressive. Of course an examination would be very helpful in advising you for which might be the best option. Many also have similar risks (bruising, selling, numbness, motor nerve weakness, scabbing or necrosis, hyperpigmentation, and discomfort).
1) Face and neck lift- This is the most aggressive choice and best when skin laxity, muscle banding (muscle laxity), jowls, and maybe excess submental fat are all components in what causes the unappealing look. In general older patients will fall into this category, but when performed on younger patients the results can be truly fantastic and more long lasting than when done in older patients. It is the most expensive, has the most downtime, and longer scars (though very well concealed). Based on your photos I would consider this to be overkill.
2) Liposuction alone- If you have good skin elasticity this is an option. There can always be some surface irregularities and skin laxity following this procedure, just like with liposuction done on other body parts. A compression wrap is recommended for about a week, and then at night only for a few more weeks. 
3) ThermiTight with Liposuction- This is a very nice minimally invasive combination because the liposuction can more quickly remove the fat (higher temp settings of the thermi can also melt the fat) and the skin will be tightened from the Thermi. This is well tolerated under local anesthesia, and the liposuction does not really add to any downtime. Incisions are generally 3 small (2-3 mm) poke holes, one at each earlobe and one under the chin. Obvious swelling is present for about one week, and it is best to use compression to help during the first few days, and then at night for a couple of days. The tightening from the Thermi will continue for a year, and each patient's result will be different based on their physiologic response.
4) Kybella is a great option of an injectable procedure for melting fat, and it works by creating a strong inflammatory reaction that starts within seconds of the injection. There is quite a bit of early swelling (and it does hurt), then the body clears the fat over about 1-2 months, when the next injection should then be performed as needed. It is likely that the fibrosis caused by the inflammatory reaction adds to the tightening effect of the skin.
5) Coolsculpt Mini- This is a brand new hand piece that is specifically designed to treat fullness under the chin, using cryolipolysis (a frost bite type injury isolated to the fat) that is well proven. This is completely non invasive, and can be repeated after 1-2 months for a more dramatic effect. Skin tightening depends on your own elasticity. A benefit is the smoothness achieved as compared to liposuction, and again no scars with only hours of downtime.

I would not look at this list as either/or, but rather which is the smartest start. Some patients may want to go for the most aggressive approach, for others it might be drawn to the most convenient, quickest downtime, cheapest, or least scary. If you have good skin elasticity you could start with something like Coolsculpting (the cheapest) or Kybella. I have also been very happy with the Thermi and Liposuction option and I have been doing this for about a year. I personally had Thermi (without lipo) and then used one injection of Kybella to get the little ball of fat under my chin. It worked great (ouch though!), but I would have gone for the Mini had it been available then. The gold standard face and neck lift is still going to be very popular for those who really need it.
Also, your results will look best with a little filler in your marionettes (based on your photos) regardless of which procedure you select.

Best of luck to you. I hope this was helpful!

Stacey Folk, MD
Denver Plastic Surgeon
4.8 out of 5 stars 24 reviews

Kybella is Superior

Thank you for your question, rockymtnhigh. Kybella is a much more superior treatment, based on clinical studies, its classification as the only FDA-approved injectable drug that contours and improves the appearance of "double chin" and its provision of a quick in-office treatment followed by a short recovery time with little to no discomfort. I suggest you consult with a board certified facial plastic surgeon.

Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 116 reviews

Kybella candidate

Thank you for your question and for sharing your photos and concerns with us. As a trainer for Kybella, I spend a lot of time teaching the safe and effective practice of administering Kybella, and assessing patients to help determine if they would be a candidate. As a plastic surgeon, I can also offer different options such as a neck lift and/or liposuction as well as many other non-surgical procedures that can affect the neck such as the Coolsculpting mini, Ulthera and Profound. As with any procedure, the experience and technique is the most important determinant of a good and safe outcome.  Based on your photos, you have a several good options but will it depend on what downtime you may be willing to experience and whether you mind a staged approach.  I would recommend visiting with a plastic surgeon who also has a great deal of experience with non-surgical options so you can determine which option(s) are the best for you.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 37 reviews

Kybella vs Thermitight with liposuction

Dear rockymtnhigh:
These two treatments are both excellent approaches for your submental fullness, and both will reduce your submental fullness and tighten the skin under your neck. #Kybella would be less expensive and have less downtime and potential side effects, and I believe you would get great results with resolution of the submental fullness as well as tightening the skin with as little as two treatments.  
To my eye, it appears that the submental fat is more of a problem than any laxity, but for someone more concerned about looseness or laxity than fat, #Thermitight with liposuction, or focused ultrasound (#Ultherapy) with liposuction or Kybella could be better options. For those who don't want any discomfort or downtime at all, I have seen remarkable improvements in neck laxity with a series of 4 to 6 #Pellevé radiofrequency treatments.
Some practitioners have addressed what they or perceive as recession of your chin and recommended a chin implant,  While implants can balance facial features and improve the appearance, you did not ask about this and it may not trouble you. I have found that reducing submental fullness sharpens the profile of the chin and can help to make it appear more prominent even without an implant or fillers. A round face can also appear slimmer without the submental fullness.
All the best,
Dr. Clark

Sheryl D. Clark, MD
New York Dermatologist
5.0 out of 5 stars 8 reviews

Double Chin Treatment / Laxity-- SmartLipo/VASER/ThermiRF, Botox, Venus Legacy, Kybella

In my practice we combine various treatments to get optimal results. I suggest liposuction with energy based devices to remove the fat, lift the skin, and contour the jawline. I treat my patients 1-2 weeks prior to surgery using Botox to relax the neck muscles, to allow optimal skin retraction post-operation. Following surgery, we use Venus Legacy to tighten skin and reduce swelling. Kybella may also be an option. Kybella is for skin tightening/lifting as well, but often takes 4-6 treatments and will cost $1000-$2000 per treatment to see any significant results. I suggest seeking out a meticulous surgeon and having a formal consultation. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

Neck lift with chin implant candidate

 The photographs demonstrate a weak chin profile and fatty deposits in the neck. A  Silastic chin implant can be inserted through the submental crease to give better projection to the chin to help with giving a stronger chin which will be complementary to the work that is performed underneath in the neck. In our practice, we would recommend a neck lift which would involve removal of the fatty deposits above and below the platysma muscle which includes a platysma plasty. The platysma plasty itself significantly enhances the jawline underneath the chin. There is no skin removal required at age 42. These 2 procedures are performed under a  general anesthetic, and anticipate approximately 2 weeks of visible bruising and swelling.
Kybella Is only indicated for  fat removal  above the platysma muscle, not below it. The skin does not tighten from  this treatment. Kybella  is usually performed 2-4 times in order to obtain fat dissolving results. Anticipate 2 weeks of swelling after each treatment.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.