How do I rid possible If it is scar tissue under chin? Massage? Will more Kybella help or is chin liposuction my only option?

Great question. The answer to this question is individualized to your specific anatomy and desired results. Kybella works great to permanently dissolve submental fat. Patients typically need 3 treatments with Kybella that are spread 4-6 weeks apart. After the injections, the treated area can be swollen for 1-2 weeks. After the swelling goes down, the fat will start to dissolve, and the results will show. Chin liposuction is going to be better for someone who has a diffuse band of fat around the face. After the surgery patients must wear a face band to help hold the chin area tight. This band needs to be worn as much as possible for the first two weeks. Swelling after surgery can last for 6 weeks, but the results are going to be more dramatic. The surgery, unlike Kybella, is a one and done procedure. Go to a Board Certified Plastic Surgeon who can help guide into the right direction. Best of luck!
In Good Health,

Dr. Ellen Mahony

I think Kybella might help in this situation.  CoolSculpting can be associated with paradoxical lipodystrophy where is has the opposite effect.  Liposuction might make the scar tissue worse.

Thank you for your question! If you are hoping to avoid chin liposuction, another round of Kybella may help the area. Kybella only dissolves fat so it would only work if the hard areas are residual fatty deposits. If it truly is only scar tissue, then your next best treatment would be liposuction or direct excision (Removal) of the scar tissue using a tiny incision underneath your chin. Best of luck!

It's hard to comment on your case without evaluating you in person. That being said, additional Kybella treatments may help particularly if the lumps are residual fat deposits. If it is in fact scar tissue, then surgery maybe your best option. I recommend you schedule an in person consultation with a local aesthetic physician.

If you are hoping to avoid chin liposuction, another round of Kybella may help the area. Kybella only dissolves fat so it would only work if the hard areas are residual fatty deposits. If it truly is only scar tissue, then your next best treatment would be liposuction or direct excision (Removal) of the scar tissue using a tiny incision underneath your chin. Hope this helps!Johnson C. Lee, MD
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

As someone who has administered Kybella (and its original formulation of mesolipotherapy since 2007) and CoolSculpting since about 2009, I have had much experience with both.  Neither causes scar.
They both selectively kill fat (Kybella does so by chemically dissolving it, and CoolSculpting does so by thermally freezing it "to death"), but neither carries the (dead) fat away.  They both depend on your body's own immune system to carry the dead fat away.  In most people, this process takes 3-5 months....but in some (unlucky) individuals it can take a few years for all the dead fat to be ingested and carried away.  In the meantime, one can feel "nodules," which are collections of dead fat cells.  Per some peer-reviewed medical journal articles, D-linked Beta Glucan, (the best one I know is one called Beta Force, made by Southpointe of Columbia, SC), is believed to theoretically hasten this process via stimulating the activity of our immune system macrophages....the cells responsible for ingesting the dead fat and taking it away.  It is known that massaging these nodule can help hasten their dissappearance, too, presumably by encouraging circulation to the area, which carries the macrophages.
A rare side effect of CoolSculpting is "paradoxical hyperplasia."  In this, for reasons that do not make logical sense to us, the patient's treated area develops a thickened, firmer mass(es), which may need surgical excision.  Again, this is RARE, but is mentioned in the CoolSculpting literature online.

They can try steroids which in small doses can help. Liposuction can also help. The scarring after Kybella is real and not often talked about. It actually makes the liposuction more difficult. The real question for you is whether there is scarring or leftover fat. For this you need an in person consultation. 

It is important understand that there are 2 compartments of fat in the neck, above and below the platysma muscle.  A thorough examination is going to be required to make a determination about how best to proceed.  Liposuction can only remove the fatty deposits above the platysma muscle, while a surgical neck lift is required to remove the fatty deposits underneath the platysma muscle.  A platysma plasty is also required if fat removal has been performed underneath the platysma.  For patients less than 50 years of age, no skin removal is required.   For many examples, please see the link and the video below