Why Dr. Sobel Often Chooses Liposuction Over Kybella for Contouring the Neck

Kybella injections and liposuction are two popular cosmetic procedures to address submental fullness (or a “double chin”). But they have important differences, and it’s wise to understand some of them before your consultation. Below, triple board-certified cosmetic surgeon Dr. Alex Sobel compares Kybella double chin treatment with liposuction, and explores the pros and cons of each.

Kybella: How it works and its drawbacks

Kybella is an injectable medication that can permanently destroy fat cells and thus effectively reshape small areas of fat deposits. It is a non-surgical, minimally-invasive treatment that uses injections of deoxycholic acid, and it holds FDA approval for the treatment of the central neck just behind the chin. Kybella is particularly effective for those who have small to moderate amounts of diet- and exercise-resistant fat and good skin elasticity in this area. 

While Kybella can be effective for some patients, the results appear gradually, and only a small amount of fat can be addressed in each session. Here are some of the reasons that Kybella may not be the most efficient option.

Repeat treatments & inflammation

In general, patients require two to four treatment sessions with Kybella spaced four to six weeks apart to achieve optimal results. Each session involves multiple injections into the treated area, and patients typically experience swelling, bruising, and discomfort afterward. This post-treatment inflammation from Kybella, plus the need for repeat treatments, can limit its desirability as a treatment. 

Recovery time, side effects, & risks

Patients can usually quickly return to work and other daily activities, but you may experience some swelling, bruising, and discomfort. Even though Kybella is a quick in-office injectable procedure, the inflammation created by Kybella treatment can take a month or longer to subside. Consider that you will have to repeat the process two to four times to see desired results.

As Kybella is very effective at dissolving fat, it can also affect the fat coating of nerve sheets, leading to sensory or motor impairment (albeit generally temporary). This limits the use of Kybella to the central neck; unfortunately, treating the central neck without addressing the lateral (side) neck can lead to an unnatural appearance in some patients.

Cost

Kybella treatments can be costly, and the drug is not covered by health insurance. Thus the multiple treatment sessions and cost associated with large volumes of Kybella, this has led some patients and doctors to feel that the cost-benefit analysis makes liposuction a preferred alternative to Kybella. 

Liposuction: How it works and its benefits

Liposuction is a surgical procedure that removes submental fat through a small incision, using a suction device. It is usually performed under general anesthesia for large volumes, but can be performed under local anesthesia for smaller areas like the chin. While some downtime is required for recovery, patients can see dramatic, sculpted results after a single surgery. Thus, liposuction remains the treatment of choice for sculpting the neck area, and has many advantages compared with Kybella. 

Comparing side effects & risks

Cosmetic surgeons have been using liposuction safely for decades now, and methods for its safe use are well-established. Moreover, liposuction can be safely performed in prominent areas of the face and neck that are unforgiving when it comes to contour-irregularities that can result from non-surgical fat reduction treatment. 

Perhaps surprisingly, small-volume liposuction can be performed with less procedural and post-procedure discomfort than Kybella. Liposuction also causes less inflammation, as it involves a mechanical removal of fat, rather than relying on a bile salt to dissolve fat.

Still, remember that liposuction is surgery: there are potential risks associated with liposuction, such as bleeding, infection, and anesthesia complications. While complications are rare, to minimize these risks it’s important to choose an experienced surgeon with relevant medical board certification, an outstanding reputation, and extensive experience with liposuction.

Cost & treatments needed

Liposuction can provide dramatic, customized, and long-lasting results with a one-time procedure; as a result, it generally costs less than Kybella, which requires multiple treatments. Depending on the extent of the areas you wish to contour, liposuction will be performed under either local or general anesthesia and may take anywhere from one to three hours—if your concerns are only in the chin and neck area, then local anesthesia is typically the best option, and the procedure time will be brief.

Liposuction can provide dramatic results with a one-time procedure; as a result, it generally costs less than Kybella, which requires multiple treatments.

Recovery time comparison

After liposuction for a double chin, you will likely need to take a few days off work to recover, but patients can usually return to typical daily activities within a week or two. You should expect to experience some postoperative swelling, bruising, and discomfort, but this is easily managed with mild pain relievers. You will also wear a compression garment around your chin for some days to help reduce swelling. Still, liposuction typically has a shorter recovery time than Kybella. While there are risks associated with any surgery, the vast majority of liposuction procedures are successful with few complications.

Even though Kybella is an office-based injection procedure that can generally be performed the same day of your consultation, the inflammation created by the Kybella treatment can take a month or longer to subside, and the procedure must generally be repeated two to four times. On the other hand, liposuction is generally performed in a single treatment with far less inflammation and speedier return to social activities.

Talking with a cosmetic surgeon to develop a customized plan

Before undergoing any procedure, whether plastic surgery or minimally-invasive treatment, the first step is to have a face-to-face consultation with a cosmetic surgeon. During this consultation, your doctor should thoroughly assess your individual goals and create a customized plan that takes into account your unique anatomy, medical history, and desired results. In addition to chin contouring with Kybella or liposuction, you may wish to discuss other, related procedures: for example, a neck lift and/or facelift may greatly improve the contours of the chin and neck if you have sagging skin and age-related concerns beyond submental fullness.

Your provider should also answer your questions about anesthesia, surgical safety, and recovery, and provide a complete fee quote for the cost of the procedure, as well as counseling on financing options, ultimately allowing you to make a well-informed decision about the best treatment plan for your needs.

About Dr. Alex Sobel

Seattle cosmetic surgeon Dr. Alexander Sobel is a triple board certified surgeon and current president of the American Academy of Cosmetic Surgery (AACS). With a commitment to trust and compassion, Dr. Sobel not only delivers exceptional results, but also an unmatched patient experience from the consultation process to post-operative care. He will listen to you attentively in order to develop a customized plan that safely delivers your desired results. To schedule your consultation, call 425-453-9060 or contact our Seattle plastic surgery office online today.