55 year old. I had two treatments of Kybella and not noticing any difference. (Photo)

Question

I had Kybella done twice. Once in late December 2016 and the other in late February 2017. I'm at 16 weeks after the first and 8 weeks after the second. Both treatments were 2 vials each and I think 6 needles full of Kybella at each treatment. I would like to mention before the Kybella treatments I had two Mini Coolsculping and also did not see any improvement so feeling a little light at $3400 and a bit depressed. That's a lot of money to me for zero results. Thanks!

Kenneth D. Steinsapir, MD · Answer

I personally have concluded that Kybella is not a very good value for most individuals.  Doctors who don't perform liposuction like Kybella and cool sculpting because it gives them the opportunity to offer more invasive services.  The reality is that these services are over promised and over sold in my opinion.  And they are expensive.  In the initial clinical studies of Kybella leading to FDA approval, approximately 60% of study participants requires all 6 Kybella treatments over 6 months.  At the end of that time, only about 60% of participants were satisfied with their results.  That is a very expensive alternative to a neck liposuction which is really a minimally invasive treatment.  One liposuction with minimal swelling and comfortable recovery produces a result that is much more dramatic than what most will experience with Kybella or Coolscuplting.  Stop wasting your money and look into neck liposuction and please review Kybella on sites like this so other consumers can get a real idea of what this service is actually like.  The commercials are amusing but the treatment does not live up to the hype in my opinion.

Ron Shelton, MD · Answer

If I examine a patient and determine that they have hanging muscle bands that are bringing their neck down and that they don't have a fat collection, then I don't recommend CoolSculpting or Kybella. However, if there is fat in the neck, usually two to three CoolMini treatments(CoolSculpting) or 3- 5 treatments with Kybella using 2 to 4our vials can reduce the fat. There are some patients that do have fat more underneath the muscle layer than above the muscle layer and they won't respond as well to Kybella.

Jason Emer, MD · Answer

the issue here is that you are a candidate for a neck/face surgical lift, kybella will do very little.Options include for skin tightening:
thermage radiofrequency
ultherapy high intensity ultrasound
PDO nova threads for lifting
sculptra injections for collagen production
btl exilis ultra, venus legacy, and thermi250 for constant collagen stimulation
facelift/necklift with fat grafting/fillers

Michael P. Morrissette, DDS, FACS · Answer

Based on your photos, you are not an ideal candidate for Kybella treatment. It appears that you have 2 layers of fat above and below the muscle that require a more invasive treatment. I would recommend submental liposuction to address the fat located beneath the skin and a platysmaplasty with removal of fat below the muscle to address this second layer of fat. Unfortunately, Kybella nor Cool-sculpting can remove fat beneath the muscle.

Heidi A. Waldorf, MD · Answer

The first question is whether you had improvement in the fat, but can't recognize it because of skin laxity (sagging).  Cool mini and Kybella don't worsen skin laxity - and often improve it - but if a patient has a lot of sagging, another different treatment may be necessary for tissue tightening.  Reviewing the before and after photos with your treating physician should help you with that.A second consideration is whether the treatments themselves were optimal or if you've had enough treatments to assess your results.  Two vials of kybella is not a lot.  In the kybella study, most of my patients had 3 or 4 vials per treatment and 4 treatments.  In practice, many physicians try to limit the amount of swelling the patient will get after kybella by reducing the amount injected with each treatment.  Also,  even with sufficient kybella injected, depending upon the amount of fat when you started, you may need several sessions.Although it is unusual not to see results from coolmini or kybella, it is not impossible.  There is a subset of patients whose fat is less susceptible to these noninvasive options. These patients are thought to have very fibrous fat -- similar to the fat in a lipoma.  Unfortunately, there is no way of knowing that in advance.  If that is the case here then you may want to consider a surgical alternative.I hope this answer was helpful. Best wishes.

Michele S. Green, MD · Answer

Based on your photos it appears that you have a great deal of skin laxity.  You may need a surgical treatment to have a better result.  It is difficult to say from the photo if you have any fat or too much skin laxity. Please consult an expert in Kybella for an evaluation. You may benefit more from Thermage for skin tightening.  Best, Dr. Green

Kouros Azar, MD · Answer

I an sorry that you aren't happy with your results. In all honesty, based on your photos, I don't think that you are a great candidate for Kybella. You would do better with liposuction and/or a surgical neck lift.

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question ocmama. I am sorry to hear about your situation. Kybella
is the first and thus-far only FDA-approved non-surgical injectable treatment
for the double chin. When did you have the Cool Sculpting treatments and do you have photographs before. The pivotal studies demonstrated that up to 6 treatments may be required. It is important to understand this before starting any treatments. I have found that some patients see minimal improvement after one or two treatments but see further improvement after more treatments. Most people require 2-4 treatments, sometimes up to 6. I recommend spacing the treatments every three months as I have seen better results this way. Please
consult with a doctor for specific recommendations. Good luck!

Davin Lim, MBBS, FACD - Account Suspended · Answer

Have you got the original photos? Nothing beats a live consultation where we can touch, pinch, feel, and move your skin. Looking at these photos I am not surprised that 2 by 2 vials of Kybella- Belkyra did not shift the fat. This maybe loose skin. Surgical options provide the most reliable method of treating this. If little fat is left, then non surgical Ulthrapy - Thermage- Thread lifts etc... may work, but I would lean on the side of a surgical intervention. Dr Davin Lim. Brisbane. Australia.

Val Lambros, MD, FACS (retired) · Answer

kybella isn't entirely predictable and isn't a good deal for most people. On the other hand it's not really for excess skin, it's for excess fat and it not clear from the pictures whether what remains on our neck  is skin or fat. Not to second guess your doctor, but 55 year old ladies with necks like yours usually need more than just a fat removal, they need skin removed with a necklift or facelift. Sorry, there just isn't any other way to make necks like yours  much better.

55 year old. I had two treatments of Kybella and not noticing any difference. (Photo)

Answers (10)

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