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Kybella has recently been FDA-approved for treatment of sub–mental (under the chin) fat. Kybella (deoxycholic acid) is a naturally occurring bile salt that dissolves fat. It is injected under the skin to rid patients of fat located under the chin. While this is a new FDA approved treatment, many physicians are waiting to be trained properly, myself included, and results remain to be seen. However, this treatment may be a promising option for those resistant to surgical intervention (i.e. liposuction or face/necklift).

Submental (under the chin) fat has become more of a concerning issue for people. and part of the problem (or perceived problem) is the growing popularity of cell phones, Skype, and FaceTime! Seeing yourself close up on a video screen, or caught in pictures while texting, or even the more popular “Selfies” are bringing to light a problem not previously seen. This bulging seen under the chin has people searching out options for correction. Kybella may be an additional option.Kybella can be provided with a series of tiny injections targeted specifically to areas of unwanted fat. Up to fifty injections can be performed in a single setting and can be spaced apart by approximately a month to six weeks. The average amount of treatments ranges from four to six sessions.

The main side effects – seen in the trials needed to obtain FDA approval -included pain, swelling (which might be significant), and nerve damage. Although not specifically seen in these trials, the concern for skin necrosis from superficial injections remains a real possibility. Let’s get more specific into these side effects.


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As Kybella is a dissolver of fat, it dissolves in a non-specific fashion; it can’t tell which is good or bad fat to attack. So the fat that surrounds nerves as normal insulation and protection can be dissolved if injected too closely to this area. This could lead to temporary or permanent nerve dysfunction. Swelling occurs under the chin after each injection. Reports say significant swelling can occur. I don’t know yet what is meant by significant, as this is a subjective term. So comparing Kybella to liposuction of this area brings up a few concerns. Mainly the swelling but also pain and unpredictability.

Repeated injections are required for Kybella (versus a single episode needed for liposuction to achieve similar results). Now to be fair, we often don’t see the full results of liposuction for three to six months. However, the swelling resolution is pretty quick in the first month. It takes the next few months for the final results to take shape, but those are subtle changes that occur.

With Kybella, the repeated swelling experienced after each successive series injections might be problematic for patients. Pain is another concern. With a single surgical procedure, liposuction patients experience mild pain one time. With Kybella, pain is experienced with each injection and each series of injections. In my work, I can achieve predictable results with liposuction. Since I don’t have the experience with Kybella yet, I am not as confident that I can obtain predictable results. However, as I am trained and become more familiar with Kybella, I may change my stance on this and, in fact, become more confident achieving the desired results.

Overall, the FDA-approval of Kybella gives surgeons another option for treating the common problem of below the chin fat. I think it will allow patients to experience relief of this increasingly popular concern without surgical intervention. Will it take over liposuction as the mainstay of treatment in this area? The race is literally neck and neck!


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