Kybella alternative; CoolMini or Mini FX? I can't do Kybella again because it gave me an asymmetrical smile. (Photos)

Question

I had 4 vials of Kybella 2 months ago under my chin, jawline, and jowl area. It made my jawline and chin worse than before I did the procedure. I have swelling that hasnt resolved and i have lost my natural contours of my face. I cant do Kybella again because it gave me an asymmetrical smile. I do not want lipo either. Do you recommend cool mini or mini fx for the safest alternative? I just want to go back to how i looked before this procedure.

Sheryl D. Clark, MD, FAAD · Answer

Dear tania_f:
The fat wrapped around the marginal mandibular nerve can be effected by Kybella, resulting in an altered smile. This side effect takes 2 weeks to more than two months to wear off, but is not permanent. If this has happened, it can be avoided in future treatments.
Firstly, the doctor must not inject any Kybella within 1.5 cm of the jawline. This will prevent this side effect in almost every patient. However, the doctor should be aware that tilting the head back pulls this nerve downward into the neck, making it harder to avoid while injecting. So, it is helpful to tip the entire patient back for the injections rather than only the head.
I have a nerve stimulator that can plot the course of the nerve for even greater assurance that it will not be affected. 
This side effect was seen infrequently during the initial trials with Kybella, but is rarely seen in practice.  It may be a little more likely if you have more than 2 vials, because when injecting three or 4 vials, you are treating the more lateral portions of the neck where the nerve sometimes courses more Inferiorly.  I myself have never seen this happen in the 100s of patients I have treated.
Nonetheless, if you choose not to have more Kybella, you can certainly have CoolMini treatments. I cannot recommend MiniFx.  Since you had a marginal mandibular nerve event previously, I would still want to plot the location of your nerve using the stimulator before treating you with any modality.
All the best,   Dr. Clark

Grant Stevens, MD · Answer

I would advise waiting until more of your swelling and symptoms have subsided before you do anything further.  You don't want to chase what's bothering you and end up making it worse in the long run.  You don't appear to have excess fat to treat under your chin and jawline.  Perhaps look in to Ultherapy or Thermage once the swelling has subsided.  Best of luck. Sorry to hear you are having to deal with the aftermath of your previous treatment.

Shamim Shakibai, MD · Answer

You would be a great candidate for CoolSculpting. The treatment would help rid of fat deposits under the chin and contour your jawline. It is a non-invasive procedure with no down time and for you I would recommend re-treatments to get maximum results. I would suggest seeking a certified CoolSculpting center near you and getting an in-depth consultation. Best of luck!

Kybella alternative; CoolMini or Mini FX? I can't do Kybella again because it gave me an asymmetrical smile. (Photos)

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Kybella alternative; CoolMini or Mini FX? I can't do Kybella again because it gave me an asymmetrical smile. (Photos)

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