Thank you for your question and for sharing your photograph dm9876. I understand your concern. Kybella is the first and thus-far only FDA-approved non-surgical injectable treatment for the double chin. The double chin can be formed by various factors including age, weight gain, and genetics.The active ingredient in Kybella (deoxycholic acid) is used by the body to digest the dietary fat. When injected into the double chin it will dissolve the fat and it is eliminated by the body naturally over time. The pivotal studies demonstrated that most people require two to four treatments, sometimes up to six treatments. The pivotal studies used two vials per treatment, which is what I use for my patients. Some doctors use more or less than this amount, which is fine. The more product is used the more swelling can be expected after the treatment. Although some people see results after a single treatment, for my patients I recommend starting with at least two treatments because many people do not see a significant improvement after only one treatment. Each vial contains 2 mL of product and 0.2 mL aliquots are used for each injection per the manufacturer’s guidelines; therefore, one vial would be enough for 10 injections using this method.Although in the pivotal studies treatments were performed at four week intervals, I find that performing treatments at twelve week intervals provides for better results. This may be due to an increased amount of time for healing of the skin, allowing nodules to dissolve and swelling to completely subside. Therefore, I recommend that patients start with one treatment, followed by a second treatment three months later, and return three months after that to assess initial results. At that point, more treatments may be performed if further enhancement is desired. Patience is important.With any injection, there is a risk for pain, bleeding, bruising, redness, tenderness, swelling, and infection, We take special precautions to minimize these risks. We numb the skin prior to the treatment and apply cold air to maximize our patients' comfort. We treat bruises with a laser as early as the next day. Bruises usually resolve by two weeks and after a laser treatment they usually resolve in one to three days, although it still can take up to two weeks for full resolution. Most people feel a burning sensation for about 15 minutes after the treatment. This is addressed by placing cold compresses on the area which we provide in our office.The most common concern for our patients after a treatment is swelling, which occurs 100% of the time and I feel that this is an indication that the treatment is working. I tell my patients to expect swelling for one to two weeks. Some people describe it as looking like a pelican or bullfrog. Therefore, patients prepare for this by scheduling their treatments at times where they are not planning any special events where they want to look their best. Some people will wear a turtleneck or scarf during this time to hide the swelling. For my patients, I recommend applying cold compresses such as ice packs to the area to reduce the swelling. We provide cold compresses which can be frozen and re-used which attach to a wrap that goes around the neck and crown of the head. Also sleeping on an extra pillow if not uncomfortable will help to reduce the swelling.For those scheduling treatments around events, the swelling is the biggest concern. Therefore if a patient knows how much swelling he had from a previous treatment, he can expect a similar amount of swelling if the same amount of product is used. This recovery time can be used as a guideline to schedule treatments around events. For example if swelling took two to three days after a treatment for my patient, I would recommend that he schedule a subsequent treatment at least this many days before an important event, preferably one week prior to the event just in case there is more swelling. That being said, as mentioned above I find that my patients get better results when the intervals between treatments are extended up to three months rather than four weeks.Those interested in Kybella treatments for the double chin are usually also interested in improving jawline definition. While Kybella, Cool Sculpting Mini, and liposuction all improve jawline definition, there are other treatments that can be performed to further improve the jawline definition. Fillers such as Voluma can be placed on the jawline or in the chin. This will sharpen the jawline. Such fillers can also be placed in the upper cheeks to restore lost volume to the mid-face. This provides the structural support for the face that is slowly lost over time. As a result, this will pull up on the lower face to improve the jawline definition. Simultaneously it will restore the youthful apple of the cheek and address nasolabial folds (the wrinkles that go from the sides of the nose to the corners of the mouth), marionette lines (the wrinkles that go from the corners of the mouth to the jawline), and jowls. Skin tightening treatments such as fractional CO2 laser resurfacing can stimulate the skin to form its own natural, new, fresh, and healthy collagen. This will tighten the skin and pull the lower face upward. Finally, Botox can be placed in the platysma muscle in the neck which pulls down on the lower face. When this muscle is relaxed it will lead to a subtle lift of the jawline further improving the definition. Combinations of such treatments yield improved results.Please consult with a doctor for specific recommendations. Good luck!