Is Kybella a good treatment for double chin?
There’s been a lot of excitement about the product Kybella after introduction to the market in 2015.
Allergan, the company behind Kybella, obtained FDA approval for the non-surgical dissolution or dissolving of fact under the chin also known as a double chin or medically referred to as submental fat.
There was often a lot of buzz for any new non-surgical treatment as an alternative to surgery.
So is Kybella a more effective and convenient treatment for people looking to address their double chin in comparison to a surgical procedure.
I’ll discuss how I looked at Kybella as an option in my practice.
I have been treating the double chin or submental fat area throughout my career using different methods of liposuction or facial liposculpture as well as non-surgical long pulsed 1064 YAG laser.
Although I’m trained and practiced as a surgeon I routinely integrate non-surgical procedures in my practice to help my patients in the best way I can.
I’ve always pursued my training and ongoing education by integrating information and experience from multiple specialties to do what matters most, helping my patients in the safest most predictable and beneficial way.
Being in practice for so long I’ve witnessed such hypocritical self-interest and inter specialty rivalry that has resulted in an erosion of the general public’s trust in the medical profession.
Every physicians single mission should simply be to put the patient’s best interest above everything.
So let’s take a look at Kybella.
The active ingredient in Kybella is a chemical called deoxycholic acid. It naturally exists in your bile, which is stored in your gallbladder and is used for the digestion of fat.
It makes sense that the same chemical for fat digestion in your intestines can be used for fat dissolving under the skin.
People who want to improve the appearance of double chin are understandably excited about being able to have their double chin improve without surgery.
Table of Contents
Before and After Kybella Double Chin Treatment
The Challenges of Using Kybella
The catch is that Kybella can take up to six treatment sessions to achieve the desired result, which means you have to have multiple injections over multiple sessions.
These injections typically cause swelling as well as skin discoloration for extended periods of time. The ability to control the amount of fat being dissolved is difficult with Kybella, since a liquid injected under your skin can spread to areas where you don’t want it to go.
This is a problem because a certain layer of fat directly below your skin is beneficial for healthy as well as youthful looking skin.
As mentioned earlier, my objective is to help my patients by recommending procedures, which are safe, highly predictable and allow for quick recovery.
Many people are afraid of the word surgery and many non surgeons as well as non physicians unethically take advantage of this fear for their own financial benefit.
I’ve helped many patients who are apprehensive about surgery come to understand some basic principles.
1. Entering the skin with a needle is an invasive procedure subject to many of the same complications as surgery.
2. A surgical procedure performed under general anesthesia can be safer and more predictable than a non-surgical alternative by using local anesthesia.
In my practice I routinely reduce fat under the chin and jowls with local anesthesia and LITE IV sedation, as per the patient’s preference.
I’m able to sculpt the fat, which means being able to protect the skin and allow the retention of the healthy layer of fat needed for smooth looking skin.
The procedure takes little time to perform and the benefits are appreciated in real time.
The patients can go back to work within a few days and they don’t typically need any additional sessions.
Misconceptions of Kybella’s Effectiveness
The highly aggressive marketing of Kybella by both the company and the practitioners hoping to profit from another cosmetic retail service has resulted in everyone concerned about the appearance of their neck to think that Kybella is the way to go.
There are some limits to both facial liposculpture and Kybella.
If you are significantly overweight, for example, it’s important to understand through a proper evaluation how much of the appearance of the under chin and neck area is related to fat that is accessible and how much fat is in the deeper tissue, which is not accessible.
Optimally, a treatment like facial liposculpture is done for stubborn fat not diminishing in spite of you being close to your ideal body weight.
How to Treat Loose Neck Skin
Loose skin under the neck is not due to fat, but from skin and soft tissue sagging associated with age or from significant weight loss.
Generally this needs to be addressed by some type of lifting procedure or removal of redundant skin.
For example, if the loose skin is due to aging, then a neck lifting procedure may be appropriate. For people with moderate skin laxity, a minimally invasive suture suspension neck lift may be performed without the need for more extensive surgery.
If there is a small amount of fat and skin laxity, a non-surgical jowl lift procedure, such as a long pulsed ND-YAG laser treatment can both reduce fat and contract the skin to create better jawline definition.
Another issue, which is not addressed by facial liposculpture and Kybella, is the appearance of platysmal bands.
The platysma muscle starts at the base of the neck and runs up to the sides of the neck all the way to the chin.
Lattissima bands can be addressed with the neurotoxins such as botulinum toxins in Botox, Dysport, Xeomin and Jeuveau.
If there is also significant skin laxity, then a neck lift is also an option.
The appearance of excess volume under the chin can also be caused by the natural anatomy of having a low hyoid bone.
The hyoid bone is responsible for the angle between the chin and the neck. A low hyoid bone can create the perception of having a double chin.
Loose skin under the chin can also be associated with the deficiency in the bone structure, which can be caused by genetics, aging or a combination of the two.
I perform a procedure called Structural Volumizing where I place long-lasting hyaluronic acid fillers, such as Juvederm Ultra Plus and Juvederm Voluma in a way which is comparable to the placement of facial implants.
By enhancing the bone structure of the cheeks, the chin and jaw angle and neck skin, the elevated neck skin and the facial proportions can look significantly better.
While having a non-surgical treatment to improve the appearance of a double chin may be attractive, it’s important to recognize that there are many different anatomic issues which can all be described as a double chin.
This means that a proper examination by a doctor without any bias is the first step to your understanding what treatment strategy is best for you.
If you have fat under the chin and you are in a healthy weight range with good skin tone, the question is which is a better option: Kybella or facial liposculpture.
In my opinion, I am serving my patients better by performing facial liposculpture with local anesthesia rather than having them come in for multiple sessions with less predictability and more total recovery time using Kybella.
By Dr. Amiya Prasad, a Board-certified cosmetic surgeon.