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
you