What to Know About Kybella, the Double-Chin Treatment

  • Kybella is a nonsurgical procedure to treat double chins.
  • It takes six to eight weeks for results to take effect.
  • Kybella can also be used to treat excess fat in areas like the armpits and bra rolls.

No matter your age, your lifestyle, or how "good" your skin is, double chins can be a fact of life. The range of what a double chin looks like runs the spectrum — from a slight jowl to more obvious fat pocket surrounding the face. Regardless, having one is nothing to be ashamed of — and it definitely doesn't mean you're unhealthy or overweight.

There's also nothing wrong with wanting to get rid of excess fat — it's your body, and you should do what feels right. If you're not into having surgery, your doctor will likely recommend Kybella, a nonsurgical injection that dissolves fat cells. With that said, it's important to embark on your Kybella journey with realistic expectations.

We turned to Lara Devgan, MD, MPH, FACS, a board-certified plastic surgeon based in New York City, to learn everything you want to know about Kybella — from cost to pain level to results.

What Is Kybella?

Simply put, Kybella is a nonsurgical injection that dissolves fat. The FDA approved it in 2015 for the treatment of the submental region, meaning the area between your chin and neck.

The main ingredient in the injection is deoxycholic acid, a naturally occurring substance in your body that helps with emulsification and fat absorption. When injected into the body, the deoxycholic acid permanently dissolves fat in the subcutaneous tissue.

"It's injected into the subcutaneous tissue directly into fatty deposits," Dr. Devgan says. "Through an acid-based reaction, it literally degrades fat cells or adipose cells. And that causes a transient stinging for about two minutes, and then, over the course of six to eight weeks, the lysed fat cells, or the burst fat cells, will get cleared by the body that results in the slimmer overall contour."

How Much Does Kybella Cost?

Like any other cosmetic procedure, the cost will depend on the number of vials used and how much the practice charges per vial, where you're located (big cities tend to have higher price tags), and the provider expertise (note: with a procedure like this, you'll always want to see a board-certified dermatologist or plastic surgeon).

Dr. Devgan says that on average, a Kybella treatment can range anywhere from $2,000 to $8,000.

What's the Difference Between Kybella and Other Options For Treating Excess Fat?

The main reason to get Kybella over other options is to avoid surgery. "I think of plastic-surgical interventions as a ladder," Dr. Devgan says. "Kybella is the bottom rung on the ladder, because it is going to give you a nonsurgical approach to dissolving fat in the area. I would say submental liposuction is one step above, because it will give you removal of fat with some modest skin tightening. Then the highest rung on the ladder is a surgical neck lift, which is going to give you a removal of fat, very nice skin tightening, and also removal of excess or loose skin."

With that in mind, it's important to be realistic about the results you can achieve with Kybella — ie they may not be as dramatic as what you would get with liposuction or a neck lift.

Dr. Devgan calls submental liposuction the gold standard, since it "allows you to thoroughly, in one short, minimally invasive operation, remove the entire amount of unwanted excess fat," she explains. "It allows you to get difficult-to-access places . . . which are hard to treat with Kybella. Submental liposuction also gives you a modest skin tightening that can improve the contour in that area." However, since liposuction is a surgical procedure, there's more downtime and aftercare to factor in.

Certain lasers are another route for treating this area. However, most lasers use high heat to tighten skin and burst fat cells, which can cause pretty significant discomfort and isn't as precise.

Who Is a Good Candidate For Kybella?

Dr. Devgan says that the best candidate for Kybella is a patient with a modest amount of submental fullness who prefers a nonsurgical approach. They should also keep in mind what Kybella does and doesn't treat: Kybella treats fat pockets, not skin laxity (excess or loose skin), which is an important distinction to make. Start by talking to your doctor about the best approach. "Your surgeon will evaluate the area to determine the extent to which you have excess fat versus lax skin or both and talk to you about your options, depending on your unique anatomic characteristics and your desired outcome," Dr. Devgan says.

Perhaps even more important than the procedure itself is the patient's attitude. Dr. Devgan says that a great candidate is someone who understands the limitations of Kybella and has realistic expectations. While Kybella does literally work — as Dr. Devgan notes, "you can microscopically see it lysing fat cells" — it's important to remember that Kybella gives you a dose-dependent effect.

"If you have a great yield of fullness and you do a very small amount of Kybella, it may feel like a drop in the bucket," Dr. Devgan says. "Some aesthetic judgment is needed, and it's the provider's responsibility to give the patient good advice about what is going to be a good experience for them. Either they should come back multiple times or, if that's not something that's practical or budget friendly, they should maybe consider another option — like liposuction."

What Is the Procedure Like?

Once you've consulted with your doctor and determined that you're a good candidate for Kybella, the actual injection process is very straightforward and easy for most patients. "The area in the submental region is assessed, and often it's marked to delineate anatomic boundaries and treatment regions," Dr. Devgan says. "Then it's sterilized." She says that while topical numbing cream will sometimes be applied, it's usually not necessary.

The injection itself takes about 30 seconds. "When the injection is over, there can be a transient stinging that lasts for about two minutes," Dr. Devgan says. "Sometimes patients describe this as a bee-sting sensation. It's often relieved with some ice. Typically, by the time you leave the doctor's office, that sensation will have resolved."

It takes about six to eight weeks for Kybella to go to work degrading those fat cells. If, after that time period, you're still feeling like there's more fat to be melted, you can go back for more treatments. It's common for people to have around three treatments of Kybella before they get the results they want. There isn't a limit (other than cost) to the amount of Kybella you can get.

What's the Downtime and Aftercare For Kybella?

Dr. Devgan says that it's normal for patients to see some redness after the injections, and it's possible to have swelling or bruising in that area for a few days or weeks. Around one in 20 patients will develop what Dr. Devgan describes as "bullfrog swelling," which is more common in male patients with beards or patients who consume a large amount of alcohol or regularly take blood thinners.

Are the Results Permanent?

Did you know that you're born with a set number of fat cells? (We didn't.) Once those fat cells are destroyed, they never come back. With that said, "not every single fat cell is going to be destroyed in a given area that's treated," Dr. Devgan says, so technically, remaining fat cells that haven't been treated could expand in the future.

So is it permanent? Yes and no.

Can Kybella Treat Other Areas of the Body?

While Kybella is only FDA-approved for treatment of the submental region, Dr. Devgan says it does have some off-label uses. "I've had a lot of success using Kybella in the arms, the inner thighs, the bra rolls, the abdomen, the banana rolls, and the outer thighs," she says.