Kybella, Cool Mini, or Chin Lipo? Which would be best for my situation? (photos)

Question

I'm 56 years old. Thanks to menopause, I gained almost 20 pounds and now have a lot of fat under my chin. The well-defined chin line that I used to have has disappeared! Losing the extra weight to reduce the chin fat is extremely difficult at this point. Which treatment would be best for my situation -- Cool Mini, Kybella, or liposuction? Which would be the easiest, least painful, and have the least amount of downtime? What sort of costs would be involved?

Jacqueline T. Cheng, MD · Answer

Hello, according to your photos it seems like liposuction would be the best treatment to
address your concern. Kybella and CoolSculpting will take many treatments and may not be
enough to address the amount of fat you wish to eliminate. Liposuction can be done relatively
quickly in only session and with relatively little downtime. It is difficult to say for sure however,
and you should consider scheduling an in person consultation with a board certified plastic
surgeon.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. Kybella is more effective than Cool Mini. Kybella also provides a shorter recovery time than liposuction. It is the only FDA approved non-surgical injectable to reduce the double chin due to submental fat and to contour the jawline. I suggest that you move forward and consult with a board certified facial plastic surgeon to learn more about cost, downtime, and recovery expectations.
Best wishes,

Sabrina Fabi, MD · Answer

Liposuction, CoolMini and Kybella are all effective means of permanently eliminating your double chin. Liposuction is the fastest: It takes just one treatment. However, you will have a few days of soreness and swelling. You may also have a small scar afterward. Kybella is minimally invasive, not very painful, takes 2 minutes and uses injections of deoxycholic acid to dissolve fat. You will need more than one treatment and will experience swelling for about one week after injection.CoolSculpting also takes 2 treatment sessions, each about 1 hour.  CoolSculpting is completely noninvasive, not painful under the chin and causes minimal swelling. It uses cryolipolysis – a patented technique that freezes fat cells – to permanently remove fat. It takes two months or more before your final results are visible with CoolSculpting or Kybella. Liposuction allows you to see your results immediately after the swelling goes down. Consulting a board-certified dermatologist that is an expert in all 3 options will let you ask more questions about these three highly effective fat-removal techniques so you can choose the one that's best for you.

George Bitar, MD · Answer

Thanks for the photos and questions, Linda.  Nothing substitutes for a thoughtful physical exam, and I would encourage you to get a formal consult.  All of the technologies and procedures that you mentioned are effective reducing fat in the neck, but really, as we age, not only can we deposit fat, but our skin changes and our muscle tone can change.  The question is whether you can meet your goals with fat removal and possibly some other technology to help tighten skin, e.g. ultherapy.  That can only be answered by assessing your neck in person.  If there are concerns about the quality of the skin, or the underlying muscles, then you may benefit most from a formal neck lift.  Best of luck as you consider your options.

Jason Emer, MD · Answer

I find that VASER liposuction in combination with ThermiRF are best for contouring the chin in those who are candidates and can be combined with a neck lift at the same time, depending on skin laxity. Kybella can be used as an alternative and needs to be combined with thermage/ultherapy/exilis or coolsculpting for good results. Cost will vary, I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Kenneth D. Steinsapir, MD · Answer

It is very likely to be less expensive than 6 sessions of Kybella.  Why do I say 6 sessions of Kybella?  That is because in the clinical study of Kybella done for its FDA approval, about 60% of patients required 6 sessions of Kybella and at that point only 60% of patients were satisfied.  Interesting that Allergan which owns Kybella just acquired Zeltiq, the company that makes the coolsculpting technology.  The coolscuplting is less dramatic than Kybella.  The thing is, is that liposuction of the neck and face is highly effective and very comfortable to have.

Daniel Barrett, MD · Answer

Dear Linda385,
If you are considering these procedure you should know that liposuction will require a small incision, it can be done in one hour but you will have to wear compression garment for at least 4 weeks. Regarding Kybella, it is less invasive, you will have no downtime, but it usually takes 2-4 treatments to show progress. Also, Kybella will cost more. Average cost depends on surgeon, type of procedure, type of anesthesia, city where the procedure is done, etc.
You should visit a board-certified plastic surgeon for a consultation.
Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery 
Member, Am. Society of Plastic Surgery

Kouros Azar, MD · Answer

Liposuction is the gold standard for fat removal. It also only requires one treatment versus Kybella which would require multiple treatments. However, you will have some down time for recovery with liposuction as well as anesthesia.

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question Linda385. Kybella is
the first and thus-far only FDA-approved non-surgical injectable treatment for
the double chin. Cool Sculpting and liposuction are other options. Comfort levels are good in all three treatments for most patients. Non-surgical treatments generally have shorter recovery time than surgical treatments but usually require a series of treatments. Price varies from office to office. Please click the link above for more information. Please
consult with a doctor for specific recommendations. Good luck!

Kevin Tehrani, MD, FACS · Answer

Thank you for your question and supporting photos.  You seem to be a good candidate for laser liposuction of the neck.  The excess fat in this area will be removed with this procedure and the skin will also be tightened.  A consultation would be necessary to give precise recommendations.

Kybella, Cool Mini, or Chin Lipo? Which would be best for my situation? (photos)

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