Kybella vs chin liposuction vs CoolSculpting?

Question

Some people had the coolsculpting (cool mini) procedure done on there neck, and for a few weeks they told me they had a horrible side effects and bad experience? They told me they felt a very cold feeling like a ice cream brainfreeze feeling for a couple of weeks? Other people told me with the kybella treatment they had done on there neck, they had visible bruises on the neck area for a couple of weeks after having the kybella treatment done on there neck? Is this true too?

Calvin Jung, MD · Answer

Hi Kelly,
There is no real "right answer" to this question, all are appropriate methods to treat the area of interest.  Since there are no pictures posted, it would be hard to recommend one vs another.  
Kybella has the enzyme deoxycholic acid which causes fat cells to die and is removed by the body.  The pros: it is non surgical, one treatment can be completed in a timely manner.  The cons: patients get some swelling post procedure and depending on your tolerance it could range from slightly discomforting to painful.  Every patient response differently! Another downside to kybella is that it usually requires multiple treatments, approximately 6 weeks apart.  If you add up that healing period with swelling, and you had 2 treatments, well you are looking at about 12 wks before you will see your end result.
Chin Liposuction: with the advances liposuction the past 5 years, this is now a good product.  Most of the newer lipo techniques can be performed without general anesthesia.  The pros: you can actually see the fat cells being removed and sculpting of the jawline and submental area is very controlled and can be fine tuned to your jaw structure.  Of all the products procedures, this will give you the most defined and sculpted appearance. Also, you only have one recovery period, most double chins treated with other modalities will require more than one treatment.  If time is a concern, chin lipo may be the best option for you, you will see results almost immediately since the fat cells are removed.  You will wear a chin compression garment for a period or 4-6 weeks, for the first 2 days 24hrs a day followed by wearing it at night time for the remainder of the 6 wks.   The con: it is a minimally invasive procedure, for patients who have anxiety about "surgery" this may not be the best choice for them.  Chin lipo is likely the most expensive and time consuming of the 3 procedures you listed but you get what you paying for.

Cool Sculpting, in my experience using this machine I have not seen results that mandate this product in my current practice.  You are correct when you heard it feels like a "brain freeze".  I have personally tried it and did not feel comfortable during the procedure and did not see the results I expected.  The swelling post op was comparable to liposuction but without the same dramatic results.

Having said all that, I would discuss all your options with your provider and make an informed decision based on your needs and lifestyle.

Hope this helps!

Michael P. Morrissette, DDS, FACS · Answer

Both those side effects are possible with CoolSculpting and Kybella but they are not common. These are minimally invasive procedures but the results are not seen for several months. The most common side effect with submental liposuction is temporary numbness of the skin below the chin. If you are interested in immediate results, then submental liposuction is the best treatment for you.

Melissa Chiang, MD, FAAD · Answer

Since both procedures have minor side effects and relatively little downtime, I believe it makes more sense to choose the procedure, or combination of procedures, that will give you the best result.  Both Coolsculpting and Kybella diminish submental fat (see an experienced provider for an evaluation to make sure you are a good candidate). 
I think of cool sculpting as a debulking procedure.  In terms of bang for the buck, it gets rid of more fullness than Kybella.  However, the cool sculpting applicator does not fit every submental area.  
Kybella is an injectable and it can be customized for the area that is being treated, as well as patient preferences.  It tends to cause more discomfort and swelling, but this lasts on the order of days.
In my practice, we will often combine cool sculpting and kybella.  We debulk with cool sculpting and use kybella for the finishing touch.

Aldo Guerra, MD · Answer

Hi Kelly.We have had a really positive experience with Kybella and have not experienced any bruises lasting that long. However, many people these days take aspirin and other blood thinners which could affect the results of the procedure and increase the recovery period.Find someone who is well trained in the procedure and has plenty of experience for best results.Best, Dr. ALDO :)

Jason Emer, MD · Answer

Liposuction does the most improvement but there are non invasive options such as kybella or coolsculpting.  Please post photos and see an expert.  Best, Dr. Emer.

Kouros Azar, MD · Answer

Liposuction is the gold standard for fat removal. If you can afford the price and the downtime, it is going to deliver the fastest results. However, Kybella can be great for the right patient at eliminating that pocket of fat under the chin. My best advice would be for you to schedule a consultation with a board certified plastic surgeon who can examine you in person and discuss your options. Best of luck --

Alex Eshaghian, MD, PhD · Answer

Thank you for your question kelly.001. Kybella is the first and thus far only FDA approved
non-surgical injectable treatment for the double chin. I do not have experience with the Cool Sculpting mini so I cannot comment on that. With any injection there is a risk of bruising. The amount of bruising varies from patient to patient and is more common in those who take prescription or non-prescription blood thinners. In our office we treat bruises as early as the next day with a laser. This makes the bruise go away faster. Please consult with a doctor for specific recommendations. Good luck!

Michele S. Green, MD · Answer

I use both the Cool-mini and Kybella for the submental fat with great results for each.  If patients have a great deal of fat under the neck I often choose the cool-mini because of the size and the cost will be much less for the patients.  If the submental fat is a smaller amount I choose Kybella injections to treat the area.  The Cool-mini may give some temporary swelling or numbness.  Kybella will give a few days of swelling and sometimes bruising.  They are both extremely safe and effective ways to reduce fat non-surgically under the neck. Liposuction is invasive with a great deal of pain and down-time.  Please consult an expert in the aging neck for the best cosmetic results.  Best, Dr. Green

Sameer Bashey, MD · Answer

I have found that many people are not good candidates for coolsculpting of the chin. Oftentimes, the applicator does not fit correctly on the face. Sometimes, this can occur in 1 out of every 3 people. Usually, according to research there is about a 20% reduction in chin fat after coolsculpt but I have found this not to be true. Sometimes- months later- the results are barely noticeable. Coolsculpting can be painful during the procedure and some patients tend to complain of "nerve-related" pain for several weeks after the procedure. 
Kybella- is an injection based treatment. Several injections in each session to be exact. Although more expensive than coosculpt, it allows for better fat reduction (usually seen after the second session moreso than the first) and it allows the dermatologist to tailor the treatment for the patient rather than a cookie-cutter approach that coolsculpt uses (one applicator fits all). There is bruising after Kybella, and some people do get a "bull frog" chin but these are temporary and get better in the coming weeks. Thus, there is some downtime with Kybella. 
Liposuction of the chin is a more invasive procedure. I think for the right candidate it may be a good option but it is a surgery with downtime and you do have to wear a wrap for up to 2 weeks. Fluid collections may form (seromas) in the areas that fat has been removed. Also, a big assumption is that once the fat under the chin is removed- the actual skin overlying the fat will tighten up over the area over time. This does NOT happen in all people and sometimes the fat can be removed under the chin only to leave saggy neck/skin over hanging it (this requires a surgical correction).
Speak to both a dermatologist and plastic surgeon to get different approaches. I like Kybella and I think it works very well but an in-person consultation is the best to determine what your individual needs are.

Bruce E. Katz, MD · Answer

Thank you for your question. I don’t recommend CoolSculpting for treating the chin.  Kybella however is a great option to consider. It is an FDA-approved injectable medicine used to treat the fat underneath the chin. The injectable helps the body rid itself of fat cells that form under the chin (submental fat). One of the many benefits of Kybella is that it will actually destroy the fat cells. It is minimally invasive with no downtime. Please remember Kybella does not treat loose skin. It only used to remove fat. For more information, I would recommend getting an in person consultation with a board-certified dermatologist.

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