Thank you for your question!
You’re asking if Kybella can reduce some fat under the chin with the hope that you
would get a very taut skin as you see in film.
And certainly the question is whether or not that can be achieved with Kybella.
Well I can certainly give you my perspective on this modality.
I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic and
reconstructive surgeon.
I have been in practice for over 20 years in Manhattan and Long Island and helping people
improve their facial appearance particularly sharpening jaw line and reducing fat under
the chin, etc. has been an important part of my practice which is focused a lot on facial
aging.
Now that being said, in the absence of a photo, I would have to give you just basically my
process in how I consider the role of fat reduction and what modality to use to help
patients maximize this desire for a more crisp looking jawline.
So to begin with, first we have to determine is there truly excess fat.
I think that with the introduction of Kybella, it has restored or renewed interest in this
perception that under the chin, everything that is undesirable is the equivalent of excess
fat and that simply is not true.
The appearance under the chin is based on a variety of factors and let’s go over several
of them.
One of them is the jawline in terms of the position of a bone under the chin called the
hyoid bone.
When the hyoid bone is low, it makes the distance between the chin and the neck, what defines
the angle, short.
So the jawline can sometimes look less defined because there’s shorter angle between the
chin and the neck.
There is skin tension and whether or not there is relative laxity of the skin.
There’s skin thickness and in terms of the overall facial anatomy, what does the fat
or volume under the skin contribute and of course, the overall important question is
there loose or excess skin.
So if you think about it, there are a lot of variables that contribute to the appearance
of under the chin and jawline area.
So when I examine someone, I first start by looking at their skin quality, skin tone and
their anatomy and ask them what are they really looking for.
If they’re saying they just want to have this tight look, well we have to understand
that fat isn’t completely the enemy.
A certain amount of fat under the skin provides a youthful quality of the skin.
Many years ago, before lasers were around to help tighten skin, it was kind of an idea
amongst our colleagues that if you suction aggressively the fat, the skin will retract
and contract.
And although these made for some very nice before and after results, a lot of times,
there was too much fat removed and the skin actually looked irregular, rippled, aged.
And we learned of course that you have to leave a certain thin layer of fat under the
skin in order to have a natural look.
If you think about it, a younger person looks youthful for a variety of reasons amongst
which is this nice layer of fat under the skin.
So before you move forward with anything, you have to have a proper evaluation.
For example, if we see a patient who feels like they need a little bit of fat removed
or they need lipo done under the chin, very often I will lift the skin for them and show
them it’s more than extra fat.
Many times, in fact it’s not extra fat.
When the skin is redraped, then they see that the skin and everything looks better and they’re
actually more of a candidate of facelift.
So, with Kybella being around, Kybella being a chemical called deoxycholic acid which is
a bioacid that basically digests fat which is FDA cleared for under the chin use but
of course doctors can use it for “off label”.
However, this a little bit of hesitancy amongst a lot of my colleagues who have more experience
using this material because there’s a fair amount of inflammation that results.
So I often have to ask myself in the perspective of just that specific area, under the chin
and possibly the jawline, we have options such as liposuction which can be done with
a syringe and reduce and improve the jawline and that can be done with one setting.
We can use non-surgical fat reduction using laser where the skin is actually heated in
a way that allows the laser to penetrate through the skin and reduce the fat and cause skin
tightening and that’s with or without superficial ablation which means we actually have a solution
where with the laser, we can improve both the fat and tighten the skin.
It just makes me wonder where exactly does Kybella fit in all of this.
It might be that the practitioner who offers Kybella may not have the opportunity to do
the other modalities.
Also, Kybella does require multiple treatments and that is something else that one should
factor in.
That being said, I advise that you meet with qualified, experienced surgeons who can offer
you both the non-surgical, the minimally invasive and the surgical options so you can see what
can be accomplished.
To speak about the movie or film look of a jawline, you have to understand that a lot
of times, actors and models are chosen because of the advantages they have genetically where
they have a naturally crisp strong jawline which films very well.
Many times also, actors will lose weight to further accentuate that angularity so they
look good on film.
So we have to understand that we want to try to aspire to look our best but we can’t
look necessarily the same.
We have to look the best we can for yourself.
So again, meet with a doctor who can guide you and go over the options.
Get a proper examination and learn and make a decision based on the options provided to
you.
So I hope that was helpful, I wish you the best of luck and thank you for your question!