Witch‘s chin, What can I do? (photo)

For a double chin, InMode FaceTite with VASERlipo would give you the best result.With significant neck sagging you would need a facelift / neck lift with muscle tightening (platysmaplasty). At the same time, I would recommend lasers (Fraxel, CO2, or Erbium) and microneedling RF (Fractora, Morpheus8, Intensif) to improve the crepey skin and wrinkles. Overall, the neck can be treated with a combination approach:
1. Microneedling and laser treatments for texture
2. Botox, Dysport, Xeomin or Jeuveau to help platysmal bands
3. Intensif, Fractora, or Morpheus8 microneedling RF for crepey skin and lifting
4. Injectable fillers like Belotero, Restylane Silk, and Juvederm Volbella to improve lines and folds
5. Face/neck lifting if sagging is prominent or premature, with or without platysmaplasty (muscle tightening)
6. Renuvion (J-Plasma), ThermiRF, and InMode FaceTite/AccuTite 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 formal evaluation and to develop a personalized treatment plan based on your individual situation and goals.
Best, Dr. Emer

Thank you for your question and photos. I do not think you are a candidate for Kybella.  A full consultation is a good place to start to see the contraction of the muscles of the lower face during smiling, particularly, the mentalis or chin muscle. At rest your profile is beautiful. With smiling and showing your underchin area, I believe your mentalis or chin muscle is contracting and causing the undesired look. I suggest relaxation of the mentalis by precise placement of Botox Cosmetic by an experienced injector. After Botox relaxation is complete, I recommend a reassessment of the chin for further enhancement of the contour with fillers. To improve symmetry and shape.
Best Wishes,

Monica Bonakdar, MD

Hi thank you for your question.  If you are looking to reduce the downward projection of the chin Kybella may not be the best answer.  Kybella works great to reduce the double chin area, but will not change the projection of the chin. 
It appears from the photos you could benefit from Botox in the chin (mentalis muscle) to achieve the look you are desiring.  However, it is best to have an in person consultation with a board certified injector to find out which treatment is right for you. 

Hi Practical7053,The soft tissue on the chin area is composed of fibrofatty tissue and muscle, but the fat on this area is not the type that responds with kybella (not like the underchin area). To reduce the projection of the chin, surgery is usually the best option. However, if you are just concerned about the downward projection when smiling, botox usually helps. 

the chin does not droop in repose, so it is clearly a muscular animation reaction. the first thing I would try would be botox in the chin muscle. Messing with the fat itself will change the repose shape of the chin, which looks nice.