Kybella and Ulthera in same visit or wait to complete treatments and see results of Kybella then do Ulthera? (Photo)

I had WLS and am continuing to lose weight but I still have a double chin. Kybella and Uthera were recommended to me by a physician but I'd like to know if it would be more beneficial to have the Uthera done after the full effects of Kybella have taken shape. My doctor wants to do both in one appointment with the reasoning that it will help with loose skin as I continue to lose weight.

Doctor Answers 11

Combination With Kybella and Ulthera

 It is very common to have Kybella and Ultherapy on the same day. Kybella dissolves submental fat and Ultherapy will help tighten any sagging skin that may be left after the loss of volume. I generally do Ultherapy first on the same day as Kybella, and believe there may be a synergistic effect when combining both on the same day. Please see a board-certified dermatologist who has experience using Kybella and Ultherapy together.

San Diego Dermatologic Surgeon
5.0 out of 5 stars 86 reviews

Kybella and Ultherapy on the same day

Thank you for your question optimisticallyme. Kybella is the first and thus far only FDA-approved non-surgical treatment for the double chin. Every doctor is different. If you doctor is comfortable doing both on the same day, then it would be reasonable to follow his/her recommendation. Please consult with a doctor for specific recommendations. Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 4 reviews

Thermage or Ulthera and Kybella

I often do both Kybella and Thermage on the same patient since Kybella will remove the excess fat under the neck and Thermage will tighten the jowls and skin on the face and neck.  I would recommend having the Thermage first and then the Kybella.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 78 reviews

Kybella & Ulthera

Many surgeons perform these procedures together so there is nothing to worry about in that regard. If you do decide to get the Kybella first then just make sure that all of your swelling has completely dissipated before having the Ulthera.


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.9 out of 5 stars 34 reviews

Kybella and Ultherapy

This is very commonly done in my practice and I oftentimes will do the Ultherapy before the Kybella by 2 weeks.  They are treating two different areas as the Kybela is directly below the chin (submental region) and Ultherapy is tightening laterally.  The only reason to wait is so that the swelling from Kybella doesn't affect the treatment of Ultherapy.  The success of Ultherapy is highly dependent on tissue thickness, which swelling can impart a change in.

Seek the advice of a double board certified Facial Plastic and Reconstructive Surgeon.  They are the only true specialists in the face.

Roberto E. Garcia, MD, FACS
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Kybella and Ulthera for submental fullness

Kybella is a fat reduction treatment while Ultherapy is a skin tightening procedure. Combination treatment helps address both fat and skin laxity. The answer to your question would depend on how much skin laxity you have. The amount of skin laxity can only be determined with an in person evaluation. Based on the photo you have provided, you certainly appear to be a good candidate for Kybella. Same day treatment with Kybella and Ultherapy is not unreasonable. The Ultherapy should be performed prior to the Kybella injections if you are having same day treatment. 

Shaun Patel, MD
Miami Physician
5.0 out of 5 stars 58 reviews

One problem multiple solutions?

Hello optimisticallyme,

Thank you for your question and photo although in person evaluation and examination cannot be substituted for photos they were of help. The short answer is what you have been told by your doctor is true; you can have Ulthera and Kybella at the same appointment with the Ulthera being done first. The rationale given to you appeared also correct. Understand that the typical patient with Kybella will need 2-4 treatments roughly 6 six weeks apart to achieve optimal fat elimination. You also have surgical options available to help achieve your desired outcome. Best wishes. 

Paul Pietro, MD
Greenville Physician
5.0 out of 5 stars 3 reviews


Thank you for your question. Kybella is a very effective injectible drug that provides a dramatic reduction in submental fullness due to submental fat. While you may benefit from Kybella alone, an in-person examination would be necessary to determine your need for Ultherapy as well. Always consult with a board certified facial plastic surgeon.

Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 120 reviews

Kybella and Ultherapy compliment each other

Kybella will reduce fat in the double chin area and Ultherapy will help by tightening loose skin.  From your photo, you will likely benefit from the combination treatments.  They can be done on the same day but you will need to do Ultherapy before Kybella.   Also keep in mind that Ultherapy results continue to improve over the course of a year after a single treatment and Kybella may require 2-3 or more treatments given every 6-8 weeks  to reach a plateau.  If you are looking for a more rapid result that can also better highlight your jawline, consider ultrasound assisted tumescent liposuction (UATL) which has a similar effect with results that can be appreciated 3-6 weeks after the single treatment.  Be sure to meet with a board certified plastic surgeon who does all of these procedure to see what will work best and be most cost effective for you.

Best of Luck!

Steven Yarinsky, MD
Albany Plastic Surgeon
4.9 out of 5 stars 29 reviews

Kybella before skin tightening

Hi there. The conservative approach would be to do Kybella first. With Kybella, you will need between 2-4 treatments. Although Kybella itself does not tighten skin, patients do see some skin tightening effect after treatment-- this was seen in the initial studies but did not have an explanation. At the very least the skin is now traveling the 2 legs of the triangle rather than just the hypotenuse, and it may be as simple as that. I would recommend doing a full series of Kybella, and then if you still need to tighten your skin, research different modalities. I recommend Infini RF for skin tightening of the neck over Ulthera. 

Katherine Dee, MD
Seattle Physician
5.0 out of 5 stars 3 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.