I had Kybella done 4 weeks ago today. I am wondering if you have to wait until all the nodules are gone before a 2nd injection?

Doctor Answers 19

Kybella injection nodules

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Post injection, one may occasinally see nodules and feel areas that are somewhat firmer than prior to the injection. Waiting for a month or so allows for this routine inflammation to subside. It also allows both the patient and the provider a chance to evaluate the results and also the need for addtional treatments.

Nodules after kybella

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As the principal investigator for the FDA trials on Kybella, and with over 400 treatments performed, we found that Kybella injections result in significant improvement in the appearance of convexity or fullness associated with submental fat. The procedure is very well tolerated by patients, fast, and can be performed in clinic. Kybella acts by destroying fat cells in the area injected. The lysed fat cell contents create an inflammatory reaction, resulting in skin contraction and tightening (in addition to reduction of fat). There is some swelling after the treatment and is directly related to the amount of fat present and the amount of kybella injected. In other words, if you have a large amount of fat under your chin, you would require a greater amount of kybella to treat the area effectively, and the greater the subsequent inflammatory response with swelling. As you mentioned, nodules may develop as part of the body’s inflammatory response, and in our clinic, can be easily treated with a steroid injection. Although in the clinical trials for Kybella, patients received Kybella injections every month, it’s probably best to wait a few months between treatment until the swelling or nodules fully resolve. If you have any concerns you should visit a board-certified facial plastic surgeon with extensive training in Kybella.

Corey S. Maas, MD
San Francisco Facial Plastic Surgeon
4.3 out of 5 stars 14 reviews

When to retreat

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I tell my patients to expect swelling and jiggling for 2-4 weeks. Numbness lasts about 6 weeks. And then there are lumps and bumps for up to 8 weeks as well. Swelling does not fully resolve for a few months so i don't re-inject for a few months.

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

Nodules after kybella

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Post-treatment, Kybella causes a significant inflammatory response that can last for several weeks.  The worst portion of this swelling is the first 3-4 days followed by slow resolution.  In some patients, hard lumps or nodules may be present.  These tend to resolve slowly.  Generally, it is best to wait for resolution of any significant edema or nodules before having another treatment. 

Kyle Coleman, MD
New Orleans Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

Kybella and Nodules

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Kybella is a fantastic procedure to get rid of permanent unwanted submental fat.  However, I would definitely wait until the nodules are gone before re-treatment.  I generally wait 6 weeks after the first treatment to evaluate the patient for the second series of Kybella injections.  Best, Dr. Green


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I let my patients know that the second Kybella injection can be done as soon as four weeks.However, I prefer to inject them every six weeks to make sure that their inflammation has resolved before starting a subsequent treatment.

Nodules with Kybella

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Thank you for your question.  I  would recommend waiting until your nodules are all gone before administering a second round of Kybella.  As a trainer for Kybella, I spend a lot of time teaching the safe and effective practice of administering Kybella, and assessing patients to help determine if they would be a candidate. Although in the clinical trials, patients had their next treatment at 4 weeks, in practice it is good to wait 6-8 weeks between treatments.

Kybella and nodules

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Nodules are a common side effect when receiving a Kybella treatment. Even though it is acceptable to receive a second treatment after 4 weeks, most doctors recommend waiting until the side effects are resolved before proceeding with the second treatment. Since results can continue to be improved upon after the fourth week, I recommend the second treatment around the 6 week range. Wishing you the best.

Sheryl D. Clark, MD
New York Dermatologist
4.7 out of 5 stars 10 reviews

Firm areas after Kybella are to be expected

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Nodules can occur as part of the body’s inflammatory response as the submental area is sensitive to begin with. On average, if one develops nodules they should smooth out between 4 – 6 weeks. It is best to wait for the nodules to dissipate and maintain communication with your provider before having another treatment.

Michael T. Somenek, MD
Washington DC Facial Plastic Surgeon

Waiting for Nodules After Kybella

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Thank you very much for your question.

Nodules are not uncommon after Kybella injections.  I typically do wait for the larger nodules to disappear before subsequent injections, as this allows me to fully appreciate the contour changes from Kybella.  If there are tiny nodules, I am not as concerned about waiting.

I typically space treatments out 6 weeks if there are no nodules, and 8 weeks if there are nodules present that I'm waiting to resolve.

I would discuss the nodules with your injector and see what their thoughts are.  Best of luck!

Daniel Krochmal, MD
Chicago General Surgeon

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.