Can Kybella be used along the jawline? (photo)

Question

I wonder if Kybella can also be used at the submandibular area as shown in area two of the attached image. I got rid of my double chin with Coolmini, but I still fat some fat left on the laterals.

Kyle Coleman, MD · Answer

Kybella works by breaking down fat anywhere it is injected.  The main reason kybella isn't usually used in this area is the presence of a superficial nerve that can be temporarily paralyzed by the swelling.  The area can be treated by an expert injector superficially and with low doses.   However, it is important to see an expert to make sure that what you are seeing are not submandibular glands as well.   Only see an expert injector; pay a little more, it will be worth it.

Kian Karimi, MD, FACS · Answer

Kybella is FDA indicated for the submental fat area. Moving to the submandibular area increases the risk of injuring the mandibular nerve. At our office we have a nerve simulator to eliminate the risk of hitting this nerve. Kybella also comes with a chart that sticks on to the submental area that helps avoid the mandibular nerve.

Nelson Castillo, MD · Answer

Thank you for your excellent question. It is advised not to use Kybella in that region as it may interfere with the nerve that controls your lower lip muscle. This can leave you with an asymmetric smile that ultimately resolved spontaneously in all patients in the original Kybella study but which may take several months.  Oftentimes Kybella into the submental region (#1) will pull the tissues from number 2 and indirectly improve its appearance.  Hope this helps.

Sheryl D. Clark, MD, FAAD · Answer

Dear FrenchGarcon:
I love your illustration. Fullness under the jawline can be reduced with Kybella. When injecting, the physician will inject no closer than 1.5 cm to the jawbone itself, to avoid coming close to the marginal mandibular nerve which is tucked up underneath the jawbone, and no closer than 1 cm to the sternocleidomastoid muscle. An 0.2 cc aliquot of Kybella diffuses 1 cm in all directions, and will not approach the nerve. When you reduce the fat in this area, the jawline itself acquires more definition. This is an off-label area, but experienced injectors have found that patients are much happier when any excess fat is treated on the sides of the neck as well as just under the chin.
I will be demonstrating this technique on a male neck this Wednesday between 5 and 7, as well as offering complementary consultations and special pricing on Kybella, Ultherapy and other treatments. 
All the best,  Dr. Clark

Kouros Azar, MD · Answer

Kybella is only FDA approved for treating the submental fat area. You run the risk of nerve injury using it closer to the jawline. Hope this helps.

Kindly,

Kouros Azar

Michael T. Somenek, MD · Answer

Kybella is approved for the submental region and can be used very safely in this area. Going higher along the jawline has shown in the initial clinical trials to produce occasional nerve injury that was temporary. Use caution and make sure you are going to a skilled injector.

William Marshall Guy, MD · Answer

Hello FrenchGarcon,Kybella is only FDA approved for the submental area (double chin).  Use anywhere else is considered off label but can be done.  However, I would not recommend in the submandibular area.  There is not usually much fat there and what you are probably seeing is the gland in that area.  Furthermore, there is a nerve that helps control the bottom part of your smile that would be at a high risk in that area.  I hope this helps and good luck.

Michele S. Green, MD · Answer

Kybella is a fantastic injection for the submental fat. I often do Kybella after cool-mini if there is a small amount of fat left in the area. However, you cannot treat the area where the nerve inervates. Please consult an expert for the best cosmetic advice. Best, Dr. Green

Keith Denkler, MD · Answer

Kybella is tricky in the area you describe as it can temporarily bother the smile (submandibular) nerve.Small, superficial doses of Kybella may possibly avoid annoying the underlying nerve.Nerve issues were unusual with the Kybella studies and the company recommends avoiding areas close to the nerve.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question FranchGarcon. Kybella is a great treatment for the double chin. When performing a Kybella treatment landmarks are identified so that the injections are correctly placed. A line is drawn along the jawline itself and another line one to two centimeters below it. Injections are not placed above this lower line. This is because there is a nerve that passes there called the marginal mandibular nerve. If this nerve is hit it can affect muscles in the lower face and lead to a temporary asymmetric smile. This was a rare side effect seen in the pivotal studies. Please consult with a doctor for specific recommendations. Good luck!

Can Kybella be used along the jawline? (photo)

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