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How to Get Rid Double Chins? 

Kybella™ vs Liposculpture Treatments

The double chin, or what is known medically as “submental fat”, is a common problem brought to the attention of cosmetic surgeons every day. In fact, a 2014 survey by the American Society for Dermatologic Surgery cited that 68% of respondents call a double chin their top concern in their practices.

The approval of the drug Kybella™ in May 2015 as a non-surgical injection specifically for this area has gotten many people with double chins to take notice. There are, however, other proven treatments that  have been around for a long time which also work very well.

Keep in mind that not all double chins are the same and many people who think they have double chins may actually just have conditions such as loose skin under the neck, banding from neck muscles (platysmal bands), or have large amounts of fat from being overweight.

who could benefit from kybella injection illustration
Many people are concerned about “double chins” and are considering Kybella™.
Half these people do not have chin fat or have other diagnoses.
only one can benefit from kybella injection illustration
Only one person shown here is candidate for Kybella™ treatment because she has a double chin with a limited amount of submental fat.

What is Kybella™ Treatment?

Kybella™ is a non-surgical injection designed specifically for the treatment of double chins caused by submental fat. Its active ingredient is deoxycholic acid which can reduce submental fat. Kybella is only FDA-approved injectable for fat present below the chin and is not for any other areas of the body.

submental fat example
This is the type of problem that can be treated with Kybella™

How does Kybella™ Work?

Kybella™ is injected into fat under the chin called submental fat and works by destroying subcutaneous fat cells. Once these fat cells are destroyed, they can no longer store or accumulate fat. Its active ingredient, deoxycholic acid, is also naturally produced by the body in the bile to help in fat absorption.

How many Kybella™ Treatment Do You Need?

Patients who undergo Kybella™ may need more than one treatment. While the exact number of treatments and injections are dependent on the way patients respond to the treatment, preliminary studies show that up to 6 treatments may be necessary, and up to 50 injections needed per treatment.

While a non-surgical solution certainly sounds more appealing, the amount of treatments and injections needed may make Kybella™ difficult for patients to maintain.

Where to Get Kybella Injection?

I advise that you book Kybella™ treatment only with doctors who are experienced with other facial procedures such as surgical facelifts, neck lifts, facial liposculpture, and non-surgical facial injections like Botox and Restylane. Cosmetic surgeons are able to give both non-surgical and surgical recommendations for the best results possible.

Is Kybella® a good procedure for double chins?

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’m Dr. Amiya Prasad I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon I’ve been in practice in Manhattan and Long Island for over 20 years 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 yaga 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 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 deoxycholic acid 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 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 prints one entering the skin with a needle is an invasive procedure subject to many of the same complications as surgery to 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

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 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 floating the excision 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 lifts may be performed without the need for more extensive surgery if there is a small amount of fat and skin laxity a non-surgical gel 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®

I hope you found this information helpful thank you for your question

Maintaining a Bit of Healthy Fat Beneath the Chin

A small layer of fat is healthy for the skin and provides a youthful look. Not all fat is bad. Patients and doctors must be conscious of maintaining a small layer of fat between the skin and soft tissue of the chin. Not only does this give youthful volume, but fat has stem cells needed for skin renewal and collagen generation.

Kybella Alternative: Liposculpture for Double Chins – Proven and Quick

While Kybella™ does hold a lot of promise when it comes to treating double chins, its effectiveness and ease of application have yet to be proven in the general public. Liposculpture is perceived to be an invasive procedure, but having a micro cannula not much larger than a needle for injection for submental fat removal is generally successful in only one session.

This is in comparison to numerous Kybella™ injections made during several treatment sessions. In the end, more time and more treatments are needed with Kybella™. Liposculpture to treat double chins is a tried, tested, typically one time treatment.

Results for facial liposculpture (facial lipo) are predictable, and patients do not have to wait for results to show before having another treatment session as results can be seen immediately.

submental liposuction before and after
Submental fat can be treated with facial liposculpture in under an hour in only one session.
submental liposuction before and after
Submental fat can be treated with facial liposculpture in under an hour in only one session.

Excess Submental Fat from being Overweight

Submental fat can collect in a larger volume in people who are overweight. People who have a larger volume of fat in general may have too much submental fat that can be effectively treated with Kybella™. The number of injections and repeat sessions will likely be frustrating for the patient and the physician. It’s likely that there will also be irregularities in the skin in between sessions due to the volume of fat present.

large volume fat under chin example
Considerable volume of fat due to being overweight should be reduced through diet and
exercise before any cosmetic treatment, including Kybella™ and liposuction/liposculpture

Overweight people may not be candidates for Kybella™ right away, but it doesn’t mean they cannot eventually become candidates. Reduction of submental chin fat should take place first by means of losing weight through proper diet and exercise.

When diet and exercise can no longer reduce remaining submental fat, then Kybella™ can be considered on the smaller volume.

Issues Not Related to Submental Fat

Some people may also mistake other issues for double chins such as excess, sagging skin.

Loose Skin Under the Neck

woman with loose neck skin
Loose neck skin is due the descent of skin due to facial aging, not submental fat.

Loose skin under the neck is due to the gradual sagging of facial skin due to aging, and also the weakening of the soft tissue layer under the skin that communicates with neck muscles called the SMAS (superficial musculo aponeurotic system). When the skin sags and SMAS weakens, the only solution to this is a facelift, or a face and neck lift.

Platysmal Banding

Platysmal bands refer to the neck muscles called the platysma that have pushed forward or become loose due to normal facial aging or surgery. This problem is best treated with a platysmaplasty to reduce the protrusion and appearance of these bands.

woman with platysmal band
Platysmal bands protrude from the neck due to normal facial aging.
A surgical procedure called a platysmaplasty can improve this appearance.

Minor Side Effects in Kybella™ Trials

Common side effects reported by a small minority of patients during Kybella™ clinical trials include: bruising, swelling, redness, nerve injury that caused temporary facial weakness, and pain. Most of these side effects are also reported in other facial injections such as filler application.

Double Chin Reduction NYC and Garden City, New York

To find the best treatment for your double chin problem, a proper physical evaluation is necessary. Contact us by filling out the contact form below, and we’ll get back to you. You may also reach us in Manhattan, New York City at (212) 265-8877. Or Garden City, Long Island at (516) 742-4636.

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