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Kybella is one of the most popular cosmetic treatments, for men and women, at the NYC based office of board-certified dermatologist, Dr. Michele Green. Introduced by Allergan, the company that produces Botox and Juvederm, Kybella is the only FDA approved injectable which is used to target fat cells under the chin and dissolve them. Many patients, both men and women, are bothered by submental fullness, also known as submental fat or a “double chin.” Even with a healthy diet and regular exercise routine, if fat has accumulated under the chin, it can be very difficult to contour the neck and jawline without the help of a cosmetic procedure. Many of us feel self-conscious about the accumulation of submental fat, which can make us appear heavier or older. Previously, the only available cosmetic procedure to address the stubborn fat cells under the chin was liposuction, a highly invasive treatment performed by plastic surgeons with significant recovery time. With the FDA approval of Kybella in 2015, Dr. Green’s patients now have a safe and effective non-invasive method of fat reduction with no downtime.

Kybella has become an extremely popular cosmetic injection to dissolve not only submental fat cells, the double chin, but fat cells in other areas of your body, including bra fat and abdominal fat. Ever since Kybella was first approved, Dr. Green has been using the product on stubborn fat pockets in several areas of the body to great success. Fat cells can easily accumulate in areas such as the abdomen, banana roll, bra fat, and knees and be very stubborn areas to treat without invasive liposuction procedures. However, with Kybella injections, no incisions are needed and with almost no recovery time involved.

Dr. Green was one of the first New York physicians to incorporate Kybella into her boutique Upper East side, Manhattan, private dermatology office. With over 25 years of experience, Dr. Green is an expert in minimally invasive cosmetic procedures, including Botox, Juvederm, laser treatments, dermal fillers, and Kybella injections. She performs these expert injections daily in her New York City cosmetic dermatology practice. Dr. Green ensures that all patients experience top quality of care and has been consistently voted one of the best doctors in New York City by Super Doctors, Castle Conolly, The New York Times, and New York Magazine.

How to get rid of your double chin

Submental fullness, also known as a double chin, occurs when fat cells accumulate under the chin. This fullness under the chin can lead to a less defined jawline that can emphasize the appearance of sagging and heavy jowls. Luckily, Kybella is a non-invasive treatment to eliminate the double chin and contour the jawline. Kybella is composed of a synthetic form of the naturally occurring deoxycholic acid, which is a chemical found in your gut that dissolves fat. When used in the Kybella injectable treatment, deoxycholic acid dissolves the fat cells in the treatment area in order to reduce stubborn pockets of fat under the chin. Once the deoxycholic acid breaks down the membrane of the fat cells, the body’s natural metabolizing processes take over to eliminate the fat, which leaves patients with a slimmer, more contoured look to the chin and jawline.

Who is a good candidate for Kybella treatment?

Patients who are good candidates for Kybella injections are the patients who are bothered by their “double chin”. The first consideration to see if you are a good candidate is the degree of submental fat, which is the amount of fat under the neck. If there is an excess of fat under the chin, this larger amount of fat can be reduced with Coolsculpting first. The Coolmini is a special Coolsculpting adaptor, which is specifically designed to treat the neck area. Coolsculpting will decrease the fat in the area of the neck, or any area treated, by 25% per treatment. A second treatment of Coolmini in the same area, can reduce the fat cells by over 40%. Once the amount of submental fat has been reduced, Dr. Green will inject Kybella into the submental area and treat the remaining fat cells permanently under the chin.

The perfect candidate for Kybella treatment is someone with a moderate amount of submental fat. A study in 2015, conducted by the American Society for Dermatologic Surgery (ASDS), found that 67 percent of patients were bothered by their submental fat, the fat under their neck. Many patents do not want to have an invasive procedure, like liposuction, and prefer the accessibility of a noninvasive procedure to correct this chin fat and treat the double chin.

If a patient has skin or skin laxity (loose skin), in the neck or submental fullness in the chin area, then Kybella injections alone may not be sufficient. A combination approach may be best with Thermage for skin tightening, or a non surgical neck lift to give you the desired cosmetic results. Kybella treatment may also be combined with Botox injections of the neck cords and other cosmetic treatments such as Fraxel laser, Vivace, or microneedling, to help improve the skin texture of the neck and face.

What is the process for Kybella treatment?

The process of Kybella treatment for the double chin is straightforward and effective. An in-person consultation is necessary to evaluate the neck, chin, and jowls area. Photographs are taken for your personal patient record to document your treatment results. If you are a good candidate for Kybella injections, a topical numbing cream is applied 45-60 minutes prior to your treatment, to the site of injections. After the area is numb, the site is cleaned with alcohol and prepared for Kybella treatment.

A grid is placed to mark the the treatment site of the submental area and Kybella injections are placed uniformly into the area of the fat cells. In order for the fat cells to dissolve, the deoxycholic acid will have an enzymatic reaction at the site of the injection. In this manner, the Kybella injections will cause the area to swell as the area is being treated.  Kybella swelling is actually an indication of the process working and is an expected side effect of Kybella treatment.

kybella grid

Does Kybella have side effects?

The side effects that are involved with Kybella treatments are all temporary. The following are common side effects from Kybella injections:

  • Swelling – occurs commonly at the treatment area from Kybella injection
  • Bruising – localized bruising can occur at the injection site. Dr. Green recommends patients to avoid any blood thinners, including aspirin, ibuprofen, fish oil, or vitamin E, or supplements for one week before their Kybella treatment.
  • Pain at the localized site of injection
  • Burning or redness at the treatment area
  • Nodule or hard skin at the treatment area
  • Numbness at the site of injection
  • Nausea

Rarer side effects which have been described are:

  • Throat or mouth pain
  • Hair loss in men at the treatment area
  • Skin tissue damage (necrosis)
  • Infection or sores at the site of injection
  • difficulty swallowing or eating
  • Submandibular nerve irritation – when If the injection is not placed in the appropriate anatomic location the submandibular nerve may be irritated and a temporary droop may occur.

How long does Kybella swelling last?

Every patent is unique but the downtime, characterized by swelling, typically lasts about five to seven days. The swelling typically lasts up to one week, and is characteristically the most noticeable after the first treatment session, when there is the largest amount of fat cells which need to be dissolved. The swelling, which is an expected inflammatory reaction, can also vary based on the amount of Kybella injected into the treatment area. Each subsequent Kybella treatment will cause less inflammation, and in turn less swelling.

Why does Kybella cause swelling?

The swelling from Kybella injections are a result of the enzymatic reaction whereby the active ingredient in Kybella, deoxycholic acid, dissolves the fat and this reaction in turn causes swelling and inflammation. This swelling is an expected and necessary part of the Kybella treatment process. Typically the swelling is moderate and lasts less than one week. Rarely, the swelling can be quite significant with a “bullfrog” appearance and can take up to a month to resolve.

How many treatment sessions are needed for Kybella?

In order to achieve the best cosmetic results, most patients will require multiple Kybella injection treatment sessions. Typically, it takes three to four sessions to eliminate the appearance of mild to moderate fat pockets in the submental area. For other areas of the body where fat accumulation is more severe, patients may require up to six sessions. With multiple treatments necessary, sessions will take place four to six weeks apart. The number of sessions and the space between sessions vary based off of the individual results of each patient, which Dr. Green will take into account when creating a treatment plan and schedule.

male 45 54 thermage kybella before after 1 1 MGwatermark

Kybella and thermage, before and after

How to reduce Kybella swelling fast?

When patients ask how to lessen Kybella swelling, there are a number of ways to help resolve the post-Kybella swelling more quickly.

  • Cetirzine – Some patients benefit from taking the over the counter antihistamine, Cetirzline, one day before and one day after the Kybella injections. The antihistamine can help mitigate some effects of this localized swelling
  • Ice cold compresses – Cold compresses should be applied to the treatment area to reduce swelling. Ice should not be applied directly to the skin, to avoid a burn to the skin.
  • Sleeping upright – It is helpful to sleep upright with two pillows to help reduce swelling.
  • Salt intake – Salt intake should be reduced to avoid any additional swelling.
  • Chin/Neck wrap – Some dermatologists recommend a chinstrap to help with swelling while the patient sleeps.
  • Lymphatic massage of the treatment area
  • Medrol dose pack – oral steroids can help mitigate swelling or inflammation from Kybella injections.

Does ice help Kybella swelling?

Ice can definitely help treat the side effects of swelling from Kybella injections. The swelling is an associated and expected part of the procedure. However, applying ice packs to the treated area for the first day will minimize the degree of swelling in the treated area.

How much is Kybella in NYC?

Kybella treatments are approximately $1500 per area session in NYC when performed by an expert injector, like Dr. Michele Green. There is a huge patient satisfaction with Kybella injections in permanently treating these fat cells and removing the double chin.

How bad is Kybella swelling?

Predicting the degree of Kybella swelling in each individual patient is not possible. Some patients have very little swelling and resolves in a number of days and other patients can have considerable swelling and take more than a week to resolve. In general, the worst swelling is typically from the first treatment of Kybella and lasts about 5 days. Dr. Green recommends not having Kybella injections, like any cosmetic injectable, immediately before a special event or party since swelling or bruising can occur.

How long should I wait between each Kybella treatment?

It is best to wait 4 to 6 weeks between each Kybella treatment and always wait until all of the swelling or symptoms have resolved before your next treatment.

How many vials of Kybella are needed to treat the double chin?

When treating mild to moderate submental fat, also known as a double chin, most patients require two vials of Kybella per treatment session. The number of treatment sessions and the exact number of vials necessary for each patient is determined by Dr. Green based off of each individual’s aesthetic goals and needs. If the pocket of submental fat is particularly full, Dr. Green may recommend the use of the CoolMini to “debulk” the area of fat before using the Kybella injections. After your initial consultation with Dr. Green, she will provide you with more information about your individualized treatment plan.

How long after Kybella will I see results?

After each Kybella treatment, there will be a reduction of fat in the treated area with up to 25% of the fat cells eliminated with each injection of Kybella. With each subsequent treatment, the results continue to improve. Most patients will achieve their optimal results after three to four treatment sessions, however each patient is unique and results may vary from person to person. Dr. Green provides individualized treatment plans for each patient to reach their aesthetic goals and may combine Kybella injections with other treatments, such as Thermage for skin tightening or dermal injections in order to achieve the best results. Patients who have a great deal of submental fat might benefit from having CoolSculpting in the neck first to “debunk” the area, followed by Kybella injections to dissolve the remaining fat cells.

ah 33 kybella before after right MGWatermark

Male kybella patient before and after

Does Kybella really work? Is it permanent?

Yes. Kybella is a permanent procedure and was approved by the U.S. Food and Drug Administration (FDA) in 2015. There is a huge patient satisfaction rated associated with Kybella injections. The number of treatment sessions depends on the amount of submental fat in the area. Since most patients prefer not to have invasive plastic surgery, the rise of non-invasive cosmetic treatments, which as Botox, Juvederm, Restylane, Microneedling, laser hair removal, Thermage FLX, and Coolsculpting, continues to increase each year. With the rise of social media, zoom, and instagram, patents want to look their best, both in person and in “selfies”. This is just one more reason why Kybella injections have become even more popular.

Who is a good candidate for Kybella injections?

An in person consultation is necessary to evaluate the area of the jowls, neck, and submental fat. It is important to differentiate this submental fat from genetic fat or weight-related fat. Age, skin turgor, elasticity, weight, and sagging, are all important parameters to be evaluated and reviewed before Kybella injections. Additional medical information will be reviewed with Dr. Green during your consultation and can be researched in my kybella.

How long does it take for Kybella swelling go down?

Many patients wonder, when does Kybella swelling go down? While the answer may vary from patient to patient, most find that the swelling from Kybella injections lessen after 5 to 7 days. Further, for most patients, the swelling that occurs after the injection becomes less severe after each subsequent treatment session, as there is less fat to be dissolved. Patients can reduce the swelling following the injections by using a cold compress, sleeping upright, massaging the lymphatic area where injection occurred, or using a chin or neck wrap while sleeping.

What are the long term side effects of Kybella?

Kybella injections are a safe and effective treatment with minimal side effects, which include swelling, bruising at or near the injection site, and mild soreness. These side effects typically resolve themselves within a week following the treatment. There is a very rare risk of more long-term side effects, including hair loss around the injection site. Four percent of subjects in the clinical trial had temporary marginal mandibular nerve injury, which presented as an asymmetrical smile or facial weakness, which all resolved spontaneously. Two percent of patients in the original study exhibited dysphagia, which all resolved on their own.

Can Kybella cause permanent damage?

No. While Kybella side effects are typically mild, the risks of developing more severe side effects increases when you seek treatment from an inexperienced injector. One of the potential side effects of Kybella is temporary nerve damage to the submandibular nerve, which can result in an asymmetrical smile or facial weakness. Inexperienced injectors are more likely to hit the nerve accidentally during injection. That is why it is best to seek treatment from a board-certified, expert cosmetic dermatologist, such as Dr. Green in NYC.

Does fat come back after Kybella?

Kybella is a permanent solution to submental fat accumulation as long as you maintain your weight after your Kybella injections. The treatment works to permanently eliminate fat cells at the injection site, however, if a patient gains weight, fat cells may once again begin to accumulate under the chin.

Why choose Dr. Green for your Kybella treatment?

It is best to consult with a board certified cosmetic dermatologist, like Dr. Michele Green, who is a specialist in cosmetic injections, like Kybella injections. Dr. Green was one of the first NYC physicians to provide Kybella injections, in her Upper East side New York office, for the permanent treatment of fat cells and the double chin. Dr. Green will determine if you are a good candidate for Kybella and provide the best permanent fat reduction from Kybella injections. She will review the proper skincare, other laser and injectable treatments, and devise a unique treatment plan for you.

Kybella, 1 treatment, 1 month post treatment

What procedures can be combined with Kybella to improve the neck contour?

Often Dr. Green combines skin tightening lasers, such as BBL, Vivace, and Thermage with Kybella injections. Thermage will tighten the skin around the jowls and neck while Kybella permanently destroys the fat cells. For patients with an excess amount of fat, Coolmini will be used first as a Coolsculpting treatment to reduce the fat in the neck. Botox, Juvederm, Restylane, Sculptra, and Fraxel laser treatments can all be performed with Kybella injections.

How do I get started with Kybella injections?

An expert in minimally invasive cosmetic treatments, Dr. Green will help with the best facial treatments, cosmetic injections, microneedling, noninvasive fat removal and body contouring procedures. Ever since Kybella became FDA approved in 2015, Dr. Green has been treating patients with Kybella injections with fabulous results. If you are looking to contour your jawline and reduce the appearance of submental fat, Kybella injections may be the best treatment for you. Dr. Michele Green has over 25 years of experience in cosmetic injections and is consistently voted as one of the best dermatologists in New York. Find out more about Kybella injections and say goodbye to your “double chin” by contact board certified dermatologist Dr. Michele S. Green to schedule an appointment or call our office at 212 535 3088 today.

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