Dissatisfied with chin lipo - could Kybella be the answer? (Photos)

Question

2 years ago, I had submental laser lipo done by a board-certified PS. The initial results were just okay. 9 months later, he did a 2nd round of lipo to try to even out the left side of my neck/chin, which looked & felt much fatter than the right side. The wound wept for over 3 months & left a scar under my chin. The results weren’t much of an improvement. My PS suggested Kybella might be my best option for further Improvement. Does that make sense,are there other preferably non-surgical options?

Anil R. Shah, MD · Answer

Neck liposuction can result in asymmetries.  Focal areas can be improved with kybella, Facetite, neck liposuction, RF devices to the neck and laser treatments.  Seek the advice of a facial expert.  Best Dr. Shah

Jonathan Kulbersh, MD · Answer

Kybella is a wonderful at removing the excess fat under the chin and in the neck.  It is not good at tightening loose skin.  You appear to have loose skin that would need tightening to create the angulation and definition in the jawline. You would be better served with a lower facelift.  I hope this helps.

Steven Goldman, MD · Answer

The neck, and specifically the submental area under the chin, have many different treatment modalities that have to be properly selected and used appropriately to achieve a good result—but even subtle changes can be very rewarding for patients. Kybella and Coolsculpting can reduce fat but won’t tighten loose skin. Ulthera and other nonsurgical devices work well on the face but have difficulty taking up excess skin in the neck. FaceTite and other surgical technologies can tighten skin but produce subtle changes compared to surgery and can cause irregularities. A facelift/neck lift is the gold standard to treat jowls and excess neck skin. Recovery is generally quick, but this does involve surgery and requires an experienced surgeon. The optimal choice for any individual depends on their physical characteristics as well as their goals. A patient who wants a dramatic result won’t be happy with nonsurgical options if the have significantly loose skin, but nonsurgical treatments are a great option for properly selected patients. In your case, a small area of persistent fat after liposuction is best treated with Kybella. The neck is a complex topic. Good luck.

Daniel Levy, MD · Answer

Fishyface:Yes, if areas of fullness remain after lipo, Kybella is a great treatment to clean those up. It's effective, with minimal downtime and has less risk than getting further lipo.Good luck!

Sabrina Fabi, MD · Answer

If your double chin is caused by fat, then either Kybella or Zeltiq’s CoolSculpting CoolMini applicator could get rid of it. Kybella melts the fat with deoxycholic acid. CoolMini freezes it away.  Both treatments will take several sessions and months before you see final results. 
It is also quite possible that the double chin is either drooping skin without any fat or drooping skin with some fat. If the latter, adding in ThermiTight or Ultherapy could help. If the former, you might need Silhouette Thread Lifts in addition to skin tightening. If the fullness under your chin is deep fat or glands, these options won't help.
Because you weren’t happy with your liposuction results, I’d suggest finding another board-certified dermatologist to evaluate you, figure out what’s causing your droopy chin, and give you a second opinion.

Sheryl D. Clark, MD, FAAD · Answer

Dear fishyface:I have seen irregularities after liposuction to the neck. Kybella carefully planned for the areas with more fat helps to even out these irregularities. I would be happy to provide a complementary consultation tomorrow at our Kybella  Open House tomorrow from 5 to 7!All the best,  Dr. Clark

Elizabeth McRae, MD · Answer

Since we cannot see your presurgical pictures, it's difficult to say how much you have improved from your liposuction. It does appear that you have enough residual preplatysmal fat on your chin area to improve with two to three treatments with Kybella. Since you don't list your age, it's hard to determine how quickly your skin will tighten after the Kybella. Additional treatments that may be considered in combination with the Kybella for further refinement of your jawline include Trusculpt- the monopolar RF device by Cutera that has a special neck handpiece. We have seen very nice results under the chin and in the neck with this device and it feels very warm but painless. Another option if skin laxity is a concern is Ultherapy in this region for a tighter jawline.Results with Ultherapy are very good but it may take 2-3 treatments and it's a little uncomfortable at times.                       I hope you have excellent results whatever modality and doctor you choose! Blessings!

Robert Whitfield, MD · Answer

I would use body tight and liposuction to treat this problem provided you have enough residual fat.   The skin tightening effect from the Facetite will help improve the tone of the skin in this area.

Stanley Kovak, MD · Answer

Thank you for your question! Kybella may be a good option for you if we could determine, upon examination, that it is in fact excess fat below your chin. Coolsculpting is another potential non-surgical option for submental fat. Sometimes what appears to be excess fat is actually excess skin or the structure of your musculature. In that case, these would not be good treatment options for you. I recommend having another consultation with your provider, and if you are still unsure, get a second opinion. Best of luck to you!

J. Charles Finn, MD · Answer

Kybella is fine for a touch up, IF the problem is fat. I can't tell without a physical exam, but I would guess the problem is more muscle and skin. I think you would do better with a deep-plane facelift, and I would consider adding a chin implant for best results. Good luck!

Dissatisfied with chin lipo - could Kybella be the answer? (Photos)

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