Kybella for jowls? (Photo)

Question

I understand it's not FDA approved for Jowls. See photos - do you think small injections of kybella would breakdown the excess fat near Jowls. It's genetics. They will continue to droop as I age. I am a 34 y/o male in good health. But you can't stop genetics. Thanks.

Sabrina Fabi, MD · Answer

I was an investigator in the original Kybella trials and thus have been using it for several years. In our center, we have begun injecting Kybella to treat jowls and have a great deal of success in this area. You are correct – this is an off-label use. It takes a great deal of skill and knowledge of anatomy to dissolve jowl fat using Kybella. An inexperienced injector could accidentally cause inflammation to the nerve. Consulting a board-certified dermatologist who has proven experience with using Kybella will give you the best results.

Bruce E. Katz, MD · Answer

Thank you for your photos. Kybella is an FDA approved, injectable product that can be used to help your body to rid itself of fat cells that form under the chin (submental fat). I would not recommend it for the jowls. Please make sure you get an in person consultation with a board-certified dermatologist.

Kouros Azar, MD · Answer

Some surgeons do use Kybella "off label" for treating the jowls. You would have to find someone very experienced. Another route would be using filler to increase volume in the mid-face thus changing the contour of the jowls. Consult with a board certified plastic surgeon to discuss options.

Onir Spiegel, DDS, PhD · Answer

Dear RS friend, 
Thank you for sharing your picture. A better option for you would be to fill the area with fillers.  A great option for this specific area would be something like Juvederm Ultra or Ultra Plus or Volbella.  From the Restylane line there is Lyft and Defyne which could be great options.  KyBella is probably not a great option for this area.  Hope this helps, Dr. ONIR

Zein E. Obagi, MD · Answer

Kybella can be used for jowls and many doctors do it as off label. The jowl area can be tricky to treat with Kybella and requires a more pinch/grab/rotate technique before injection. The marginal mandibular nerve is superficial in the jowl area which means it can get irritated with Kybella. This is not permanent but the irritation can cause an asymmetric smile for about 2 months or so. The jowls can be further improved with voluma to the pre-jowl mandible.

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question and for submitting your photos.  You are correct - Kybella has not yet been tested for safety in the jowls in comprehensive scientific studies, and so it's use here would be considered "off label."  That said, many injectors are now using Kybella in the jowls with excellent results.  This is a somewhat higher risk injection, as the marginal mandibular nerve, which controls the movement of the lower lip, runs in this area and is at a higher risk of injury with jowl injections.  I would recommend seeing a cosmetic dermatologist or plastic surgeon with extensive experience in Kybella injections to discuss your concerns.  Best of luck!

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question mocktwisting. I understand your concern. Kybella is the first and
thus-far only FDA-approved non-surgical injectable treatment for the double
chin. It is not cleared for treatment in the jowls. This is because there is a nerve in the area. If this nerve is damaged it can lead to a temporary asymmetric smile. That being said some doctors do place Kybella in the jowls. To treat jowls I prefer to lift the mid face using fillers such as Voluma. Please
consult with a doctor for specific recommendations. Good luck!

Michele S. Green, MD · Answer

Since Kybella is not FDA approved for jowls, you can not determine how the fat will be dissolved or know if you will have nerve damage. I would suggest you looking into something safer for skin tightening like Thermage or fillers.  Best, Dr. Green

David A. Sieber, MD, FACS · Answer

Thanks for the great question. The great thing about Kybella is that it is indiscriminate about destroying fat. The bad thing about Kybella is also that it is indiscriminate about destroying fat. Any time Kybella is injected in another location outside of the submental area, it is considered off label use. Drugs like Botox are commonly used off label for other uses. That being said, Kybella will work to dissolve the fat in your jowl area. The danger in that area is that there is a nerve which controls part of the movement of your mouth. When injecting in this area it is very important that it is being done by someone who is very familiar with the facial anatomy so as to reduce your risk of nerve injury. I hope this helps and best of luck!~Dr. Sieber

Regina M. Fearmonti, MD · Answer

Thanks for posting this common question.  In my experience, I do not feel jowls are an ideal place for injection.  If you've had the treatment prior in the submental region, you will notice your physician marked out some key landmarks in the neck--areas rich in nerve and blood supply should be avoided for safety concerns. There is some burning on injection, followed by swelling over the next few days that follow; that is the process of chemical lipolysis, or fat dissolution.  It should not be injected around the nerve/blood vessel-rich region of the jowls, and not without imaging.  Surgery is always an answer.  Other image-based modalities (Ultherapy has some data--still some risk in my opinion) are also being applied.  Hope that helps?

Kybella for jowls? (Photo)

Answers (12)

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