Unhappy with under eye bags, small lips, and double chin. Advice on what you would do for my face with filler? (photos)

Question

Also how many injections of kybella would be recommended for my case?

Joel Schlessinger, MD · Answer

Kybella is a good alternative to liposuction while CoolSculpting is good in certain situations as well.  You would be best to see a dermatologist to see if these are options for you and they can feel the area and see if your anatomy is better for one or the other.  Good luck!

Jonathan Kulbersh, MD · Answer

Under eye bags can be permanently corrected with surgery or temporarily camouflaged with fillers.There are great non-surgical options to fill in under eye depressions and hollowness. Using dermal fillers, a liquid eyelift can be performed. A dermal filler such as Restylane would be placed in the cheek and tear trough to hide the depression or bag underneath your eye.
Surgery would require a fat-repositioning lower lid blepharoplasty. In this surgical procedure, fat from the eye area is moved into the tear trough depression filling the actual depression. Both Kybella or neck liposuction are good options and will improve the double chin.  Chin filler or implants can improve projection. It depends on your lifestyle and personality which would be better for you. 
Kybella is best for patients that:
1)  Do not want surgery 
2)  Are not surgical candidates 
3)  Not willing to wear a compression dressing around the face for 1 week 
4)  Patient-  The results of Kybella will take months
Kybella take 1-3 treatments every 6 weeks.  Patient will develop swelling and possible bruising after each injection that may last a few days.  The benefit of Kybella is each treatment is quick and completed in the office.
Neck Liposuction is best for patients that:
1)  Want a single treatment 
2)  One recovery time-  Downtime for neck liposuction require wearing a wrap around face for 1 week. 3)  Less painful 
4)  Quicker results 
5)  Cost is a concern
Neck liposuction is a quick surgical procedure that can be complete while the patient is awake.  It cost around the same price a Kybella and can be less in patients with heavier necks.  The single recovery of neck liposuction may be a better option for some patients.
I hope this helps.

Jason Emer, MD · Answer

A combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. For under the chin, a combination approach is needed to get the most improvement with non-invasive options like Kybella. I recommend Kybella with thermage, ultherapy, exilis. VASER liposuction in combination with ThermiRF is an alternative for contouring the chin, if you're a candidate. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Kenneth D. Steinsapir, MD · Answer

You could be very happy with under eye filler treatment.  Just keep in mind that it is a fussy service.  You need to find an injector who is expert at fussy with this type of treatment.  The right filler makes a huge difference.  The so-called smooth fillers are all wrong for this location. These fillers are characterized by their physical viscoelastic nature: Low G prime and high tan delta.  The effect of this combination is a product that does not hold where it is placed.  That t is actually the opposite of what is needed here.  You need a high G prime and low tan delta product.  In my opinion, the best product for this location is Restylane.  Kybella will never accomplish what you need.  Don't waste your time and money with this goofy product.  What those funny ads don't tell you, is that despite all the pain, swelling and bruising, each Kybella treatment does very little.  In the study that FDA approval for Kybella was based on, 60% of participants needed all 6 treatments and in the end, 40% were disappointed with the treatment.  I recommend lower face/neck liposuction.  This treatment can be done under light intravenous sedation, swelling and bruising is minimal and most return to work after about 4 days.

John K. Wakelin III, MD, FACS · Answer

I think that facial injectibles would likely offer you some excellent improvement in the areas that bother you.  I can't say for sure without examining you, but a filler like Voluma may help the area under your eyes.  Volume can be added to your lips with a filler like Juvederm or Vollure.  Kybella would likely be an excellent option to consider as well for the area under your chin.  Perhaps 3 treatments with Kybella would get you optimal improvement.  A consultation would be the best way to determine the right plan for you.  Good luck!

Harry Glassman, MD · Answer

Kybella injections at monthly intervals for 2-3 months to dissolve the fat in your neck. Belotero injections to fill the tear trough below the “bags” under your eyes (although a lower blepharoplasty would be a more permanent solution albeit surgery). Your lips are relatively thin and in our experience Juvederm Vollure works well to increase their fullness without creating an artificial forward unwanted projection.

Laura Riehm, MD · Answer

Thanks for your question and posting pictures.  I agree with some of the previous physicians that we could recommend Kybella.  The FDA recently approved the SculpSure laser for treating submental fat (double chins).  It is a quick 25 minute treatment.  In the FDA study, the participants had 100% satisfaction after 1 or 2 treatments.  If you look at the Kybella FDA studies, there is high satisfaction after an average of 6 treatments.  I did SculpSure recently and it was only mildly uncomfortable.  I have no noticeable swelling.  With Kybella, you will have noticeable swelling for 1-4 weeks.  Best of luck.

William Yates, MD · Answer

Hello, Rainsapphre1.For your lips and under eye bags I will recommend that you get an expert injector to use Restylane Silk. It gives a smooth beautiful fill making those bags disappear and it also helps shape the lips to your desired look. The double chin is something we successfully work out with Kybella. A series of injections will take about 30 minutes to be done and then just wait a couple of weeks for the results to show. Most patients benefit from a second round of Kybella to get to the look they want.Best of lucks

Justin Harper, MD - Account Suspended · Answer

Hi  Rainsapphre1, It would be great to see you to assess you better. offhand maybe 3 Kybella treatments, also Restylane Refyne for undereye hollows and Voluma for chin augmentation. Unsure about Botox for the jaws,All the best, Justin Harper, M.D.

Unhappy with under eye bags, small lips, and double chin. Advice on what you would do for my face with filler? (photos)

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