Kybella, why only 6 rounds maximum? I had a "moderate to severe" double chin. (photo)

Question

I started the Kybella process because I was told I would only need 2 treatments. Well, two treatments of 2 vials was definitely not enough. I've seen decent results, but I just finished my 5th treatment (each treatment had 2 vials).

David Gilpin, MD · Answer

Thank you for your question.  I am sorry you are not seeing the results you would like with Kybella.  It seems as if you have had a reasonable treatment, as 2-3 vials per treatment is typical.  If you have not sen the results you wish after 5 treatments, I would consult with a board certified facial plastic or plastic surgeon for other options to help with this fullness under the chin.  You may be a good candidate for submental liposuction and/or a neck lift.  The studies for Kybella looked at patients who had up to 6 treatments, and that is why this is the 'maximum'.  It most likely is safe to have more than this, it is simply that this has not been studied as of yet.  I hope that this helps!-David Gilpin

Michael P. Morrissette, DDS, FACS · Answer

In looking at your photos, you probably have some fat behind the muscle under the chin that will not be dissolved by Kybella. To some degree, if you are satisfied with the improvement, you can continue with further Kybella treatment. If you want to eliminate the double chin in a more dramatic fashion, I would recommend submental liposuction and platysmaplasty and possibly a necklift to remove excess skin. I have not seen patients with severe fullness obtain excellent results with Kybella alone. Usually, a combination approach is necessary whether invasive involving surgery or non-invasive treatment.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Based on the number of treatments you have already received you can continue with Kybella as an off-label use but I would recommend you consider a small in-office liposuction procedure to obtain the greatest improvement.  See an ASPS board certified plastic surgeon in consultation to discuss.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. Depending on the severity of submental fat, between two and four Kybella treatments may be required for optimal results, Most patients begin to see results after only two treatments. I would be interested to see before and after photos along each phase of treatment. Please discuss your treatment plan with your surgeon.
Best wishes,

Andrew T. Lyos, MD, FACS · Answer

Hello and thank you for your question and photos. I would recommend you have a consultation with a board certified plastic surgeon.  There are many options of treating this submental fat which would give you great satisfaction. If liposuction is not an option, we would recommend treating to complete.  Usually coolsculpting would be our recommendation and then may be followed with some kybella, depending on your desired results. We typically treat with 3-4 vials per treatment when using kybella and may possibly treat up to 3 treatments.  Kybella studies only extended up to six rounds, however, they used 3 and 4 vials per round.  I hope this information helps you and best of luck!

Jason Emer, MD · Answer

Keep in mind, Kybella is good for dissolving fat under the chin, but a combination approach is needed to get the most improvement with non-invasive options.  I recommend a combination approach with thermage, ultherapy, exilis. However, based on your picture, you would get more improvement with liposuction. VASER liposuction in combination with ThermiRF is the best alternative for contouring the chin. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Kouros Azar, MD · Answer

As long as you are still seeing results with Kybella, you can go beyond 6 treatments. However, there may be a different procedure that might be better for you so discuss options with your surgeon.

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question anon20000. I understand your concern. Kybella is the first and
thus-far only FDA-approved non-surgical injectable treatment for the double
chin. The pivotal studies were done with up to 6 treatments. There is no reason that more treatments cannot be performed if improvement is being seen with previous treatments and there is still submental fullness. I treat my patients every 3 months. Please
consult with a doctor for specific recommendations. Good luck!

Michele S. Green, MD · Answer

If you had consulted with me I would have started you with the Cool-mini to reduce the submental fat appropriately first and then after it reached a smaller size I would reduce the rest with Kybella.  The average person needs three or four treatments but there  is no reason that you can't continue your Kybella treatments to reduce the submental fat.  Please consult an expert in Kybella for the best cosmetic results.  Best, Dr. Green

William Marshall Guy, MD · Answer

Hello Anon20000,Kybella can be an excellent treatment for the appropriately selected patient.  Looking at your before most would not have recommended 2 vials and 2 treatments to get a full correction.  The reason that Kybella stops at 6 treatments is because that is where the study went to.  Going beyond that is probably ok, it just hasn't been studied.  Since you aren't seeing the results you want, I would recommend you consult with a facial plastic surgeon to learn about all of your options for treating the neck, including surgical.  At the least you should get a second opinion before proceeding with more Kybella injections.  I hope this helps and good luck.

Kybella, why only 6 rounds maximum? I had a "moderate to severe" double chin. (photo)

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