What treatment would get rid of these old lady jowls? (42 year old) Kybella? Lipo? Fillers? (Photo)

If your looking for a non surgical route for your jowls then consider dermal fillers to volumize the midface and cheeks. Most likely, 2 syringes of Restylane Lytton or Voluma. Kybella is probably the same as Coolsculpt so I would have to see you in person to be sure. 

Fat dissolving injections are very effective at reducing or even eliminating jowls. I use a compounded mix of deoxycholate and phosphatidylcholine monthly for a series of 3 to 5 sessions .Swelling in first week is usual and is required for it ro be effective but is not usually noticed by others .

 It is hard to tell without pictures. If it is fat, then Coolsculpting will help. You will need few treatments and end results will be visible after 3 months. If you have started with coolsculpting I advise you to stick with it. It is a great procedure. Kybella is great as well with removing submental fat. If you have sagging skin, then you will have to consider some treatment for skin tightening. If you want to contour your jowls, then you will have to look into dermal fillers after you are done with dissolving your fat, and tightening your skin. You may consider different lasers for skin tightening. Good luck!