Can Kybella be used along the jawline? (photo)

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.

Doctor Answers 12

Kybella

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


Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 21 reviews

Caution with Kybella in certain regions of the neck

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. 

Michael T. Somenek, MD
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 29 reviews

Kybella

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. 

Kian Karimi, MD, FACS
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Can Kybella be used along the jawline?

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.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Can Kybella be used along the jawline?

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.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Kybella and indications

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

Kybella in areas other than the submental

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.

Kyle Coleman, MD
New Orleans Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

Kybella

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.

Kybella on the jawline

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!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 1 review

"No Fly" zone for Kybella to avoid nerve injury

That is a great question.  The short answer to your question is no.  The long answer: the marginal mandibular branch of the facial nerve travels in that area and supplies the muscles of the lower lip and chin.  This nerve could be injured by the Kybella injection, which could damage the protective cover of the nerve and lead to weakness of the muscles of the lower lip and chin.  This nerve injury was less common in the clinical trials (4%) and all cases did eventually recover but a few patients were reported to take up to a year.The submandibular glands are also in that area:
"To avoid potential tissue damage, KYBELLA should not be injected in close proximity (1-1.5cm) of salivary glands" per the labeling instructions that come with Kybella.So the "zone 2" that you show is a No Fly zone for Kybella.  Proper injection of Kybella in the central area does seem to give some effect laterally- one of the potential downsides of the cool mini is that it may not taper as well to the sides of the applied area.

Jonathan Hall, MD
Boston Plastic Surgeon
4.9 out of 5 stars 29 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.