Which would you recommend; Kybella, Ultherapy, or chin Lipo/lift? (photos)

I am only 32 years old and have always had a very weak jaw and chin. I am very thin, however the loss in collagen over the years has caused me to look very FULL under the chin. I was hoping to have a procedure to tighten both the skin under my chin and the jowls. Is this possible? I know Lipo would help, however most doctors I have spoken to say they would stay away from my jowls due to possible nerve damage. As you can see in the image my jowls are a huge concern.

Doctor Answers 24

Thank you for your question

From this picture, it looks like the jowls aren't the problem. It is the underchin that is full, possibly a family tendency, as you are just 32. So a few recommendation, which are just recommendations and not a substitute for a consultation. The first part of the problem is excess fat in the underchin, and simply put Ultherapy doesn't bust fat, not at all. So your choices become
1)  Kybella, an FDA cleared series of injections to dissolve fat, not to the jowl, but the underchin.

2)  ThermiTightitm  a newer and I believe more precise way to both remove fat and tighten skin.

Laser lipo, Lipo/Lift, aren't standard procedures but a local marketing brand. Yes, you are right there is some risk, although small but still real, injury to nerves in treating jowl over the jawline, so choose your doctor wisely.

A surprise, and what's more important, there are easy miles to gain with using injectable fillers, such as Juvederm Ultra Plus, with building up the downward turning mouth crease folds (nasolbial folds) and its lower extention, (prejowl sulcus, that is the grooved hollow, just in front of the jowl) and you could build up the chin.
The truth is you need both the right use of fillers, and a wise choice for fat removal for your best result.

Portland Dermatologic Surgeon
4.5 out of 5 stars 15 reviews

Contouring chin and jowls

An in-person consultation is necessary to evaluate your condition and find the best treatment options that will achieve your goals. That said, in general, Kybella is a good choice for reducing fat underneath the chin non-invasively, but it will not tighten the skin. Chin lipo also will reduce fat under the chin; the downtime will be longer but more dramatic results can be achieved in one session. If you are concerned about skin laxity, Ultherapy or ThermiRF may be better choices. These procedures can both be used to tighten loose skin around the neck and jaw, reducing turkey neck and jowls. It may be possible that both a fat reduction and a skin tightening procedure will be needed for you to achieve the chin and jaw contour that you want. I recommend visiting a board-certified dermatologist with expertise in skin tightening and fat reduction procedures for a consultation and evaluation.

William Groff, DO
San Diego Dermatologist
4.8 out of 5 stars 46 reviews

Kybella vs. submental liposuction

For uncomplicated liposuction under the chin (submental  suction lipectomy), we charge $1750. This includes the preoperative appointment, procedure, and all postoperative followups. We have laughing gas available at no additional charge.  The procedure requires a single 4 mm (less than 1/4") incision and takes about 45" to an hour.  You will have to wear a compression garment 24/7 (minus showers) for 2 weeks and 16/7 for an additional 2 weeks. Please read the realself reviews of our practice, as some of our patients have posted pre- and postoperative photos of liposuction under the chin.

Kybella is a very reasonable alternative for those patients who do not wish to undergo liposuction.  However, it requires more treatments, more downtime, and greater expense.  Kybella typically requires 2 to 4 treatments, each with at least 2 weeks of associated social downtime due to bruising, swelling, and redness and typically runs $2000 to $4800.

Ronald Friedman, MD
Plano Plastic Surgeon
5.0 out of 5 stars 46 reviews

Chin and Jowls and Best Treatment

Thank you for posting your photos.  First, I would recommend injecting a filler into the chin such as Juvederm to fill in this area.  Then I would recommend a combination of Kybella  and Thermage for skin tightening of the neck and jowls. Please consult a board certified dermatologist with years of experience with cosmetic injections.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

Chin implant and neck lift

 There are 2 compartments of fat in the neck, above and below the platysma muscle. To rejuvenate the neck and remove both components of fat, a neck lift is required. This involves removal of sub-mental and sub-platysmal fat in addition to a platysma-plasty. At 32 years of age, skin tightening is probably not required. A small Silastic chin implant would also bring the chin forward to complement the new jawline. For many examples and more information, please see the link and the video below

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

Kybella Is Easiest Way to Lose Double Chins

Kybella uses deoxycholic acid to melt submental fat with a series of injections. You would probably need more than one treatment. Each session only takes about 5 minutes in the office. It is a relatively noninvasive procedure and is very safe. Something I noticed as an investigator for Kybella was that those that were younger and had a double chin typically had a component of chin volume loss.  So I would  consider augmenting the chin with Voluma to restore bony volume loss which will help with jawline definition and improvement in the appearance of your double chin. Please consult a board-certified dermatologist to determine if you are a good candidate for Kybella with Voluma.

Sabrina Fabi, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 84 reviews

Which would you recommend; Kybella, Ultherapy, or chin Lipo/lift?

Thank you for your question. Best option would be liposuction or kybella.  Good candidates for kybella are also good candidates for liposuction.  Patients with good skin tone and mild to moderate fullnesswill have good results.  You can liposuction jowls very conservatively.  A chin implant would also help improve your profile.  Consult with  board certified plastic surgeon to discuss the best option for you.

Jeff Angobaldo, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 104 reviews

Kybella vs Coolmini vs Liposuction- and maybe a chin implant too

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.
All three will give you some skin tightening.
My best,
Dr. Nazarian
@drsheilanazarian on Instagram

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

Which would you recommend; Kybella, Ultherapy, or Chin Lipo/Lift?

Kybella (injectable deoxycholate).  It has a fabulous ability to sculpt that area, with little downtime, only transient, relatively mild side effects, and nearly no serious long-term adverse side effects.  Having done deoxycholate injections into fat for TEN YEARS, treating hundreds, I have never had a single patient who was dissatisfied or unhappy with the results to their neck.  The results are truly permanent fat reduction and significant skin-tightening.  It is important to choose your physician injector wisely, as it is a very technique-dependent procedure.
In Europe, it has even been injected into blood vessels for fat emboli (fat clots), without any significant adverse effects on the vessel walls---it just dissolves fat!
Very safe procedure in the right hands.  And without all the many possible risks (not to mention downtime) with a surgical procedure that involves a scalpel.

Deborah Kessler Hudak, MD, MHA
Raleigh-Durham Ophthalmologist
5.0 out of 5 stars 1 review

Kybella / Ulthera treatment

Thank you for your question and sharing your photo.  I would recommend starting with Kybella to decrease the sub mental fullness.  You should also see a mild degree of tightening with this treatment.  I would follow this with Ulthera if you still have concerns about the laxity of the neck or simply plan on both as Ulthera will help you reduce the rate at which the neck continues to develop laxity with time.

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