Are vertical wrinkles a side effect of Kybella?

I've had two kybella treatments (my most recent round was one month ago). Since my second round these wrinkles have been getting worse and obviously, I'm concerned. I'm 30 and have always been thin, healthy, no history of problems with my skin. I'm wondering if my skin will naturally tighten and bounce back with time or if my injections were administered incorrectly. I saw a board certified plastic surgeon. Can someone tell me of this is normal, expected or common? I don't feel like it is.

Doctor Answers 5

Are vertical wrinkles a side effect of Kybella?

Hello Leeannemarie,

There are really two possibilities taking place.  One is that you had bands of a muscle, called the platysma muscle, that has been exposed now that the fat is gone.  You can tell if this is the case by trying to pull the corners of your mouth down.  The muscle around the neck will then flex.  If the bands become more prominent, then what you have are exposed bands.  These can be treated with Botox or surgery.  The other possibility is that this is scarring deep to the skin.  I have not seen this with Kybella treatments, but the appearance almost looks like that.  If that is the case, then the bands can be improved with steroid injections to soft and relax the scar.  

What I would recommend is you follow up with your surgeon for evaluation.  There are treatment options available dpeneding on the cause.  Treatment that is sooner is better, especially if this is scarring.  

I hope this helps and good luck.   

The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Kybella and vertical lines

 Thank you for your question and for sharing your photos with us. Kybella does work to reduce the fatty tissue in the double chin region.  It can result in unmasking the underlying anatomy which can reveal small muscle bands in the center of the neck.  This can be softened with Botox.  If it is still soon after your last treatment, this could also be some fibrotic tissue that may soften over time.  A physical exam should be able to differentiate the two.  I would visit with your plastic surgeon for can assess you and then come up with options for you.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 38 reviews

Vertical lines after Kybella treatments

It appears you got a very good response to Kybella and have exposed underlying platysmal bands of the muscle that drapes the neck underneath the superficial fat.  If these worsen when you grimace and 'growl', they are definitely platysmal bands and should respond to Botox/Dysport injections.   If it is true superficial skin laxity due to loss of that much flat, we tend to look at either Ultherapy or Infini for additional tightening.

Steven Swengel, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

Wrinkles from Kybella

Kybella often tightens the skin in this area as well.  I would consider Botox in this area.  Thermage is also very effective in tightening this skin around the neck and jowls.  Best, Dr. Green

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


In the FDA study conducted for Kybella, there was a subset of patients that had excellent fat loss results in the area treated, but they also had exposure of platysmal bands, which they felt unfavorable.  The best way to tell if the lines you see are from the platysma, is to flex your platysmas muscles and see if the banding gets worse.  If these are from the platysma, it would be best to reconsult with your treating physician prior to your next injection.

Jesse E. Smith, MD, FACS
Dallas Facial Plastic Surgeon
4.8 out of 5 stars 26 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.