Kybella, Lipo or CoolSculpting? (Photo)

"A formal evaluation would be needed to determine what's best. Many of my patients try to avoid surgery, so we perform a non-surgical chin augmentation treatment with injectable fillers. Fillers like Radiesse, Voluma, BellaFill as well as Sculptra are injected into the area, improving the overall appearance of the lower face and balancing the jaw and lip harmony. We use cannula injections to meticulously contour and project the chin, soften the chin along the jawline and improve the chin crease.

Implants are still a great option once you are 100% positive that you are ready for a permanent enhancement.​ I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert; our practice is located right here in Los Angeles. Best, Dr. Emer"

Dear steinbah,
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

For your weak chin area, I would recommend fillers over an implant. This will also improve your submental area (under your chin). Many types of fillers can be dissolved, so you do not need to think of it as a permanent implant. I agree that a permanent implant is not the best solution. One of the main reasons is because there are risks to inject filler when an implant is present. Therefore, as you age, this creates limitations of solutions for other age-related concerns you will likely experience later in life as you age through menopause. I've had several clients who have had surgical implants in areas such as cheeks and chin. They looked good at at time they were completed, however, years later, as changes happen to our bones, fat tissue, collagen, elastin etc, we develop areas of concern on the face that can be easily improved with filler, assuming there isn't a permanent implant.

Kybella injections would help to thin your neck and jowls/jawline, and promote skin tightening. I think a chin implant would be a separate issue and would wait until you saw what the Kybella did for you; and try filler injections in the chin to see how you like it prior to considering an implant.

 The Photographs demonstrate two problems which include a recessive chin profile and fat deposits in the neck. Liposuction is the most effective way to remove the fat in the neck, not Kybella or coolsculpting.  To improve the recessive chin profile, a chin implant is going to be required. This will offer more structural support for the soft tissues in the neck, in addition to giving better facial balance and portions from the side profile. Chin implants are manufactured in a large array of thicknesses, sizes, and shapes, which is best determined at time of the examination. Both procedures can be performed simultaneously under local or general anesthesia.

We’re not willing to get a chin implant a sliding Genioplasty is the correct treatment.You don’t have a lot of fat to remove so don’t expect that to make too much difference especially when the primary problem is skeletal.Of the three modalities for fat removal only Liposuction is one I would recommend.Best, Mats Hagstrom MD

When the underlying bone support is reduced, the soft tissue drape changes and the laxity of tissue appears more obvious. A genioplasty (no implant) would help 'stretch out' the contour under the chin and improve the jawline esthetics. Liposuction may help but one has to consider the elasticity of the skin.