Scar tissue from kybella? 3 treatments; first time I saw results, second & third possibly look worse after (Photos)

The first session (1 vial) I saw an improvement. 2nd didn't help. The third time (I believe 3 vials) not only did I not notice a difference, but I believe it May look worse. My surgeon suggested trying it again, a second surgeon said leave it alone, because perhaps I built up scar tissue from it & that is why it even appears to be fuller.. I do scar easily, from my breast aug I had gotten hypertrophic scarring.. Is this possible? Wouldn't want to go for a fourth treatment if I will look worse.

Doctor Answers 14

Kybella results

From your post I was not sure which photos were before and which were after.   The ones in the white shirt look slightly fuller to me although the angle is slightly sideways.  The before and after photos always have to be at the same angle and with your neck in the same neutral position. 

If the ones in the white shirt are "after" photos, my next question is how long it has been since your last treatment.  When the fat cells lyse they do cause inflammatory cells to come in and eat up the debris. It may be that time is all you need. I would certainly wait longer than 1-2 months. Go back to the surgeon who performed the service at the three month mark and see if you can take a look at before and after photos together.  If it is worse than before then try to figure out if the tissue there is totally soft or if firm then maybe still inflamed. Scar is possible but not common and really much less likely than a vigorous inflammatory response.  

Finally just to be you remember if you have gained, lost, or had stable weight during this process?  If you have not weighed yourself, are you wearing the same clothes/jeans as previous?  

Fort Worth Dermatologist
5.0 out of 5 stars 2 reviews

Scar Tissue and Kybella

Without seeing you in person, it’s difficult to tell whether or not you have scar tissue. If you have scared from past treatments you may be susceptible to scar tissue. After three unsuccessful treatments I recommend to leave it alone for a while. Please consult with your treating physician about your concerns. Best of Luck!

Hardik Soni, MD
Summit Emergency Medicine Physician
5.0 out of 5 stars 45 reviews

Your experience with Kybella

I do not see any hypertrophic scarring evident in these pictures.  I assume that the photos you posted were taken after your treatments.  Keep in mind, Kybella injections can cause swelling that may last a week or longer, which can modify the appearance of the treated area.  Though I can't assess your situation accurately without an in-person examination, I do think your submental region looks quite good.  If the "fullness" you describe is due to fatty tissue, Kybella might be helpful.  If it is due to loose skin (or "skin laxity"), then Kybella would not work here.

Jill C. Fichtel, MD
Columbus Dermatologic Surgeon
5.0 out of 5 stars 16 reviews

Kybella & Scar Tissue

Without seeing you in person, it is impossible to say whether or not your fullness is due to scar tissue. However, given the fact that you are not seeing improvement, I would definitely recommend that you hold off on a fourth treatment and get a second opinion regarding the potential scar tissue from another board certified plastic surgeon in your area. I am sorry that you've had such a negative experience. 


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.9 out of 5 stars 33 reviews

Kybella results

Thank you for your question. Without consulting with you in person, it’s difficult to tell whether you have scar tissue or not. If you have scarred in the past, with other treatments, you may be more susceptible to scar tissue. After three treatments, and no improvement, it may be best to leave it alone for a while. Please consult with a board-certified expert to discuss what your options may be to improve. Best, Dr. Katz

Bruce E. Katz, MD
New York Dermatologic Surgeon
3.8 out of 5 stars 17 reviews


Thank you for your photos.  It is unclear how long it has been since your last treatment.   Swelling can last for several days.  I typically wait 4-6 weeks before treating again.  I have had patients feel some lumpiness which is typically scar tissue.   This feeling eventually went away.   I would wait and let things settle down before treating again.  An experienced injector would be able to assess you and decide if what you have is fat, or something different.  Best of luck! 

Shahin Fazilat, MD, FACS
Mountain View Plastic Surgeon
4.8 out of 5 stars 13 reviews

Results after Kybella

You did not mention the time between treatments. I generally like to wait at least six weeks. If your before photo looks anything like your "current" photo, I would have anticipated that it would have only needed one or two treatments with probably just one vial each time. If you are still not seeing any improvement I would suggest trying something else like Coolsculpting.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 77 reviews

Scar tissue from kybella? 3 treatments; first time I saw results, second & third possibly look worse after

Hello S21915,

Kybella can be a great treatment to treat a double chin for the right candidate.  It usually involves using more syringes up front and fewer syringes as treatment goes on, although it appears you were the other way around.  Further treatments are based on an in person exam.  The fat is rolled between the fingers to see if any remains.  If it does, then Kybella can treat that.  After a treatment there is swelling and there can be a firmness that lasts for up to 6 weeks while it keeps working.  It would not be expected that this would lead to a "worsening of your appearance."  Since you have been getting mixed messages from two surgeons, I would probably err on the side of caution and not get another treatment.  Give yourself some time to allow the areas to heal, and consider getting a third opinion.

I hope this helps and good luck. 

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Kybella and Skin Tightening Results

Kybella is a great procedure and usually has great results but if you feel that you feel that you have scarring then you need to consult an expert in Kybella to evaluate the neck.  Thermage can help fix this problem and tighten the skin in the jowl and neck area.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

Hold off on 4th treatment for now, consider skin tightening procedure such as Ultherapy or ThermiRF

Thank you for your question and photos! I am not entirely sure which photos are before and after (one photo is not labeled), but if you do not feel like you have seen a difference after 3 treatments I would hold off on a 4th Kybella treatment for now. I am not sure how long ago your last treatment was, but in some patients the healing process with Kybella takes a lot longer than for others. If your 3rd treatment was just a few weeks ago, I would wait at least 8-12 weeks before considering another treatment. If by that time, you still do not see an improvement I would consider a skin tightening procedure such as Ultherapy or ThermiRF to help contour and lift the submental area.

I hope this answer is helpful! Best of luck.

Tracy Leong, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 7 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.