Would Kybella on jowl area work for me (22 years old)? (photos)

Question

I want to get rid of the fat on my lower face. I’ve gotten buccal fat removal and pdo threads. The buccal fat removal worked well but not on the right area, and the pdo threads did not work at all. Especially with the downtime, pdo threads were not worth it to me. I want to try kybella but see w lot of mixed reviews. I plan on doing Morpheus after the kybella. What are your thoughts?

Jason Emer, MD · Answer

kybella makes the jowls sag. try threads or facetite. fillers to jawline

For a more defined jawline to strengthen your profile (and help prevent the dreaded jawline "jowl" sagging), we use injectable fillers like Revanesse Versa - a filler known to limit swelling and give subtle, soft enhancements - or Radiesse. Using a cannula to limit pain and swelling, we inject on the bone in strategic points to get more lift and shaping, resulting in a more contoured lower face and defined, structured jawline. I would suggest getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Nima Shemirani, MD · Answer

Hi @meafer!  I recommend Morpheus 8.  Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin 
tightening and lifting.

Daniel Barrett, MD · Answer

Dear meafer,
Kybella typically takes 3 to 5 treatments to work. This is why I've stopped carrying Kybella in my office. I recommend neck liposuction more often then any injectable procedure for the neck now. It provides superior results gives me more control over the area than any injectable. It also costs about the same as what you paid for your first kybella session. The liposuction can be done under local while awake in the office and recovery is about the same as kybella.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Marc Polacco, MD · Answer

Thank you for your question. Kybella is essentially an enzyme which breaks apart fat cells, and I have used it for patients who want just a little less jowl protrusion. However, it often takes several treatments to see a noticeable result, and the injections can cause a good deal of swelling. So really the choice comes down to your expectations. It will work, but it may not be worth the cost. As always, a detailed discussion with your surgeon will be the most helpful moving forward. I hope that helps!

Michael P. Morrissette, DDS, FACS · Answer

The area of the lower face can be made slimmer with facial liposuction. I prefer to use a small flat cannula and a tiny incision is made in the earlobe crease. The entire lower face can be treated by this approach. Kybella runs the risk of nerve injury.

Kenneth D. Steinsapir, MD · Answer

Kybella (deoxycholic acid) is uninvestigated and not FDA approved for the area you are concerned with. That means that anyone injecting you in this area is basically conduction an experiment on you. Kybella is approved from treatment of submental fat. That is fullness in the neck below the chin (double chin area). Kybellar causes terrible inflammation. That inflammation kills the fat. The inflammation is associated with severe swelling and terrible pain. It can injury permanently motor nerves that travel through the treatment area. If that happened in the area you are asking for treatment, you would look like you had a stroke. I also do not recommend focal liposuction for the area that bothers you. I do wonder if you have had lip and perioral fillers. These products are often runny and over time, these can drift outside the lip area. They often accumulate in this area just outside the mouth. They do respond to hyaluronidase treatment. I am attaching a video on this. I caution you to be carefully in your treatment choices.

Darryl J. Blinski, MD · Answer

Very diluted KyBella injections with 1-stitch facelift (side burn incision with 1-3 muscle lifting sutures would help. Expect fee in $5,000+ ranges.

Mats Hagstrom, MD (license on probation) · Answer

I suggest that you consider slowing down your pursuit of removing facial fat to change your facial contour.

Your facial contour is primarily determined by bone structure not The soft tissue envelope.

With age people lose facial volume and removing fat at a young age including buccal fat removal will set you up for undesirable premature aging in the future.

Fat removal whether done physically with Liposuction or through chemical fat destruction is permanent and irreversible.

The marginal mandibular nerve runs right through the jowls in the main area of concern. That branch of the facial nerve innervates the muscles around your mouth. In order for nerves to function they require a fatty covering called the Mylan sheath. Fat removal whether done by liposuction or chemical fat destruction put you at risk for developing facial nerve paralysis.

In Alargan‘s clinical trials of doing Kybella in the submental area only 120 patients developed facial nerve paralysis.  while it’s typically temporary it is a highly undesirable outcome that mimics looking like you’ve had a stroke.

My recommendation is that you get a thorough facial assessment regarding bone structure first and foremost so you have a very clear understanding of why your facial contour looks the way it does.

Go easy on treatments that are permanent and irreversible.

Whenever possible try to treat the primary underlying problem and not look for secondary solutions like fat removal.

Best,

Mats Hagstrom MD

James Fernau, MD, FACS - Account Suspended · Answer

Hi there, and thanks for your question. I highly recommend Kybella to remove fat especially around the jowl area. My patients have a very high satisfactory rating when using Kybella in the face. Synthetic deoxycholic acid is the ingredient used in Kybella, which is a naturally occurring molecule in the body that aids in the breakdown and absorption of fat. When injected into fat, Kybella destroys fat cells, resulting in a noticeable reduction in fullness on the face. Please see a board-certified physician for your consultation.

Sincerely,
James Fernau, MD, FACS Aesthetic Surgery 
CERTIFIED: American Board of Plastic Surgery CERTIFIED: American Board of Otolaryngology/Head & Neck Surgery Member: American Society of Plastic Surgery (ASPS) American Society of Aesthetic Plastic Surgery (ASAPS) International Society of Aesthetic Plastic Surgery (ISAPS) American Academy of Facial Plastic Reconstructive Surgery (AAFPRS) American Academy of Otolaryngology/Head & Neck Surgery (AAOHNS) American Society for Laser Medicine and Surgery (ASLMS) The Rhinoplasty Society

Would Kybella on jowl area work for me (22 years old)? (photos)

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