The great majority of plastic surgeons will recommend Liposuction as the gold standard for removing excess subcutaneous fat. Chemical fat destruction with the use of Kybella is inferior by every measure. The treatments are inherently unpredictable, and can lead to devastating, excessive fat loss, facial nerve paralysis, and many other issues. inflammatory response and swelling that comes with chemical fat destruction is far worse than surgical intervention. Considering that most patients need to have multiple treatments, this alone should be a sufficient reason to avoid Kybella. Liposuction can also be unpredictable based on discrepancy in skill and experience of providers. In the hands of a sufficiently talented provider, Liposuction is the best treatment option. Regardless of method, patients should recognize that fat removal, whether done surgically or with injections is permanent and irreversible. A substantial number of people seeking these treatments are poorly assessed, and do not have a good fundamental understanding of what The underlying primary problem is. The great majority of patients seeking submental fat removal do not have an abnormal fat distribution. To get long-term quality outcomes, I suggest beginning the process by getting an accurate in-depth assessment, getting a clear understanding of facial aesthetics, which should including a variety of treatment options, explaining the inherent benefits and limitations of each treatment choice. The great majority of patients seeking these treatments have as their primary underlying diagnosis, a facial skeletal imbalance with a mandible that is small in relationship to the maxilla. This is true for almost 100% of people seeking chin and neck liposuction as well as chemical fat destruction. I suggested having multiple in person, consultations with local, senior, board-certified plastic surgeons, who have a quality track record in regards to facial aesthetics. Best, Mats Hagstrom, MD