New treatment for a double chin

double chin
Kybella – the injection to dissolve away your double chin!

As I discussed the other day here, the Kybella injection to dissolve under-chin fat and remove your double chin is coming out in June. Here’s a quick refresher of what it can do.


Kybella uses the chemical deoxycholic acid to dissolve fat. This isn’t a new chemical, it’s naturally produced in the body, but it is newly approved for this treatment. Obviously this sounds wonderful but let’s look at the numbers.






“The pooled results from both trials found that 68.2 percent of patients who got the drug saw at least a one-grade reduction in fat, compared with 20.5 percent of patients who got sham injections. Grading was determined by clinical examination and answers on a standardized form.


Sixteen percent of patients who received the real injections saw a reduction of two grades in under-chin fat. Only 1.5 percent of the placebo group saw that level of improvement.


M.R.I. scans also showed that under-chin volume had decreased more in treated patients than in ones who received placebos.”



In other words, the injection showed at least some improvement in 68.2% of patients, with no improvement in 31.8% of patients. While we would have preferred that the injection showed at least some improvement in a greater majority of patients, the benefits outweighed the risks.


The biggest downside to this treatment is that it requires around 50 injections into the neck for each session, with at least 2-3 sessions for full treatment. While I am a doctor, I don’t like needles, especially 50 of them!


So how much will it cost. There is much speculation but here’s what I think. Kybella comes in 2mL bottles but for a full single treatment, it will require five 2mL bottles. Let’s do the math: each individual injection is 0.2mL for a maximum treatment of 10mL per session. If each bottle is only 2mL, then that will require five bottles for full treatment. And that’s just one session. You’ll need up to 6 sessions, at least one month apart.


My guess is that the company will require a doctor to buy a full set, which will be five bottles (total of 10mL). But my guess would be wrong! Check out the image above (click on the image to enlarge). It shows that a set will only include four bottles! So that means for a full treatment during one session, a doctor will need to buy one set, plus another set so they can have the full five bottle treatment. Pretty smart forcing the doctor to purchase more than one set!


Sure the doctor can choose how many bottles to use on a patient but they’ll be committed to buying at least two sets. The set will probably cost the doctor $350 with a markup of 100% so the cost to the patient will be $700 for a full 10mL treatment. This pricing makes sense because it’s in line with the cost for other fillers on the market such as Juvederm and Radiesse.



A potentially easier treatment that may be down the road is CoolSculpting to the chin/neck area. CoolSculpting is already FDA approved for freezing fat for non-surgical fat reduction of the love handles, abdomen and thighs. This technology does not dissolve fat like Kybella but rather freezes fat. CoolSculpting, word has it, is working on an applicator to use on the neck as well.


While everyone would like to avoid surgery if possible, not everyone is a candidate for non-surgical treatments. If you have a good deal of fat, liposuction may be appropriate. Liposuction can help define the jawline by helping you lose fat in your face and aggressively remove fat from under the chin – all through a very small incision. Sure it’s invasive but can be defined as minimally invasive.


If you also have excess skin in addition to excess fat, a formal necklift is probably necessary. Depending on how much excess skin you have, there’s a necklift that requires incisions behind the ears to remove the skin but if you have some, but not a great deal of excess skin, you could do well with what I call a mini-necklift. A mini-necklift only requires one incision in the shadows of the neck, an area I call the crux of the neck which is where the undersurface of your chin meets the upper portion of your neck. It’s very well hidden and looks great for the right type of patient.


For pricing on Kybella, liposuction or other surgical and non-surgical methods of fat reduction, and to find a real plastic surgeon to perform your plastic surgery, click here.



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