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

Question

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.

Shahin Fazilat, MD, FACS · Answer

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!

Ronald Schuster, MD · Answer

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.

Jason Emer, MD · Answer

VASER/Thermi does best for contouring the neck, if you have had kybella ... exilis/venus legacy and botox can help give you more improvement.  Best, Dr. Emer.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  It is difficult without feeling your chin tissues what you may be experiencing.  After a Kybella treatment swelling and small areas of firmness can develop and persist for weeks to months, especially if you had your sessions within 4-6 weeks of one another.  I would advocate allowing more time to pass for your results to mature, and voice your concerns to your surgeon, they are in the best position to provide you with information and reassurance.

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question S21915. I am sorry to hear about your situation. Kybella is
the first and thus-far only FDA-approved non-surgical injectable treatment for
the double chin. It does not say which one is before and which one is after. Also it is important to take photographs at the same angles with the same position of the chin for best comparison. Most people have a series of 2-4 treatments, sometimes up to 6 treatments. We notice more improvement with more treatments. Please
consult with a doctor for specific recommendations. Good luck!

Hardik Soni, MD · Answer

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!

Jill C. Fichtel, MD · Answer

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.

Kouros Azar, MD · Answer

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. Kindly,Kouros Azar

Bruce E. Katz, MD · Answer

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

William Marshall Guy, MD · Answer

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.

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

Answers (15)

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