Kybella (ATX-101) Injections vs Neck Liposuction for Double Chin

Young woman who had Kybella injections for her double chin

The newest fat dissolving injection, branded as Kybella (or ATX-101 in the pilot research study), is receiving quite a bit of press, but will it stand the test of time as a viable alternative to the gold standard procedure for refining the neck and jawline?

Keep reading to learn more about how the new injectable product compares to neck liposuction for treating the dreaded double chin and recontouring the neck and jawline in both men and women.

How does Kybella compare to Neck Liposuction?

The Advantages and Disadvantages of Kybella Injections

Kybella injections for neck fat

    1. ADVANTAGE: No downtime. There is no real downtime after an injectable treatment, but it is still advisable to take it easy and spend time icing after the treatment to avoid unnecessary bruising and swelling the following day.
    2. ADVANTAGE: No anesthesia. While no anesthesia is required for the treatment, it is advisable to have some form of topical or local anesthesia administered for maximal comfort.
    3. DISADVANTAGE: Injections will not correct sagging skin or neck bands. if you have vertical bands on your neck, or if the skin in the center is particularly saggy, Kybella injections are not the right treatment for you, and may actually make those issues worse. Sagging skin can only be corrected with some form of surgical or nonsurgical skin tightening, which will not happen with Kybella.
    4. DISADVANTAGE: Overdissolving possible. As with any injectable product, the final result can be a bit unpredictable depending on the skill of the injector, on your reaction to the product, and on the product dose. If fat is over dissolved in the neck, it can be quite difficult or impossible to fix, and this could lead to a prematurely aged appearance in the neck if the over-reduction of fat is severe.
    5. DISADVANTAGE: No significant risk reduction compared to liposuction. The risks of Kybella injections are very comparable to the risks of neck liposuction, including the more serious risks like injury to the facial nerve that controls the muscle motion of the lower face and mouth. In the pilot study for Kybella, the researchers reported a 4.3% risk of nerve injury that visibly affected smiling or other facial motions for up to several months. This risk is actually higher than the average risk of the same complication during neck liposuction procedures in the hands of a qualified plastic surgeon, but as practitioners become more experienced with Kybella, I’m sure this risk will decline.
    6. DISADVANTAGE: May make neck liposuction more difficult in the future. The long term effect of “dissolved” fat tissue is unclear, but it may promote scar tissue formation that may or may not make future procedures such as neck liposuction and neck lifting more difficult. If you end up having an unsatisfactory result from Kybella injections, it may be even more difficult to have a follow neck liposuction procedure than it would have been if you had done the liposuction first.
The Advantages and Disadvantages of Neck Liposuction
    1. ADVANTAGE: More dramatic result. Because the fat removal with neck liposuction is immediate and can be customized by your surgeon, the results can be quite dramatic.
    2. ADVANTAGE: More predictable result. Since your surgeon watches the fat reduction visually during the procedure, the treatment is more an immediate sculpting type of treatment with a more predictable result. You are not relying on the product’s reaction to produce the result; you are relying on your surgeon’s hands.
    3. ADVANTAGE: Nearly negligible downtime. Although it is recommended that most patients take a few days off work after neck lipo, almost everyone can easily manage this by having the procedure on a Thursday or Friday and using the weekend as automatic downtime. Many people can also work from home for a few days making the few days of downtime as close to negligible as possible.
    4. ADVANTAGE: Favorable risk profile. The risk of neck liposuction are no greater than the risks of Kybella injections, and some may even consider Kybella to be slightly more risky given the unusually high incidence of nerve injuries discussed above, and the possibility of noticeable inflammatory scarring if the product is injected too superficially into the skin.
    5. DISADVANTAGE: Twilight anesthesia recommended. While this is not a requirement to have neck lipo, it is recommended for the best overall experience. And if performed by a top quality anesthesiologist, the risk of this type of anesthesia is no greater than having a colonoscopy or wisdom tooth extraction. Twilight anesthesia is a very safe and extremely comfortable way to have almost any cosmetic procedure, and many would argue that the overall experience of neck lipo under twilight anesthesia is actually better than having 20-30 injections every month for 3-6 months.
    6. DISADVANTAGE: Higher cost. Since neck liposuction requires more equipment, more expertise, and more time, the cost is higher than Kybella injections, but the results usually match the additional cost.

While some might argue that the need for incisions with neck liposuction is a disadvantage, you must keep in mind that the incisions are only a few millimeters long and are hidden in inconspicuous spots behind the earlobes and under the chin where it is nearly impossible to notice the scars. It is also important to note that Kybella injections are not necessarily scar-free. Needle entry sites can sometimes leave dark marks on certain skin types, and any injections that are too superficial may also leave inflammatory scarring that can be even more noticeable than the strategically placed and very predictable scars required for neck liposuction. For these reasons, I chose not to list incisions or scarring as an advantage or a disadvantage for either treatment.

Is Kybella effective for both men and women?

Yes, Kybella can be used in men and women. Neck and jawline contouring is one of the few procedures that shares a common ground between the sexes. Everyone wants a tighter, stronger, sexier neck and jaw, so this is one procedure that definitely doesn’t discriminate.

When will Kybella be available?

As of the date of this writing, Kybella is not commercially available. The product recently received it’s FDA clearance and is tentatively slated for release to qualified plastic surgeons and dermatologists in the late summer of 2015. If you want to stay up to date with the release of this new exciting product, feel free to subscribe to our weekly newsletter by filling in your email address at the top right side of this page.

What other procedures can enhance the neck and jawline?

    1. Jawline Contouring with Radiesse. Injectable fillers designed to enhance bony contours like Radiesse can have a dramatic and long-lasting effect on the chin and jawline. Jowls and micro jowls can be hidden, sagging chins can be disguised, and jawlines can be lengthened. In men, jawlines can be made stronger and more angular. These types of procedures are injectable-only, just like Kybella, and can make a great addition to the treatment. Click here to learn more.
    2. Chin Implant. Chin implants are one of the most popular procedures to enhance the jawline for a variety of reasons. The procedure has a fairly quick recovery and favorable risk profile. There can be no visible scarring if the incision is placed inside the mouth. And the results are immediate, permanent, and very natural. Chin implants also come in a variety of shapes and sizes, so there are quite a few options for enhancing not only the chin, but the jawline as well. Click here to learn more.
    3. Neck Lift. A surgical neck lift will always be the gold standard for creating a long, youthful jawline, removing jowls and micro jowls, and sculpting a tight, slim neck in profile. This procedure involves more cost, risk and downtime, but the exceptional, long-lasting results are on par with the greater commitment. Click here to learn more.

Nicholas Vendemia, M.D.
Plastic Surgeon New York


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NOTICE: The information presented here is meant for entertainment and/or educational purposes only, and should never be considered as a statement(s) of fact, instructions, or medical advice. None of the celebrities or individuals discussed here have ever received treatment, surgery, medical advice, or evaluations from any author, physician, surgeon, or representative of this blog. No actual patients or clients are shown unless stated as such in the article.

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