1. Liposuction is a procedure used to remove extra fat under the skin and help shape the area around the chin and neck for a better contour. To give you an image, it’s like the doctor makes a tiny cut under the skin, puts in a small tube, and sucks out the unwanted fat. Liposuction typically requires only local anesthetic to numb the area. Patients are awake and sometime doze off during the procedure.

   Now, a common worry is, “Once the fat’s gone, will my skin sag?” It’s a valid concern. That’s why there’s something called Laser liposuction. With this method, you don’t just remove the fat. The laser actually melts the fat, and at the same time, it helps tighten your skin to prevent sagging. There’s also another technique called Renuvion liposuction that might be a better fit for some people than laser liposuction. To decide which method suits you best, a few things will be checked – the elasticity of your skin, how much fat needs to be taken out, and your age.

   Another common concern people have is, “Will the fat return after it’s been removed?” In reality, the fat that’s taken out during liposuction is gone for good. But people wonder if the fat cells that are still there, the ones that weren’t removed, could they grow bigger? Even if these remaining fat cells do get bigger, they won’t make your chin go back to how it was before liposuction. Your neck and chin will still look more contoured and defined than they were prior to the procedure.
2. Kybella is deoxycholic acid – an injectable treatment for a double chin. Deoxycholic acid is a substance the gallbladder uses to dissolve dietary fat. Injecting this chemical into the skin beneath the chin melts fat there that the body then reabsorbs. This nonsurgical approach requires several treatments spaced out over several weeks. Most people receive two or three treatments, but it can take up to six treatments, depending on the patient and the amount of excess fat in the treatment area.

   Although Kybella is an interesting concept, it has some real downsides. The injections are quite painful and people can also expect to have a swollen neck for about 10 days after each treatment session. Everyone who had this treatment was a little surprised that it’s not a fast, easy solution. Another concern is that even after two treatments, the fat under the chin hardly improved.

At the end of the day, people need to decide whether they’re willing to stick out the pain over several treatments and wait longer to see results or get the one time but permanent removal of the double chin fat.

In my medical practice, if a patient has previously had Kybella injections, I tend to advise against using liposuction as a follow-up treatment. The reason for this is due to how Kybella works. Kybella is a powerful substance that destroys not only fat cells but also other types of tissues it comes into contact with. This broad effect can lead to a side effect known as fibrotic scarring. This is a kind of scarring that results in the affected tissue becoming thick and tough. When fibrotic scarring occurs, it can make subsequent liposuction procedures challenging. Liposuction involves suctioning fat out of the body, which can be hard to perform effectively if the tissues are hardened and less flexible due to fibrotic scarring. In simpler terms, if you’ve had Kybella injections before, it might make any future liposuction treatments harder to perform and potentially less successful, due to the scarring that Kybella can cause. That’s why I usually recommend against combining these two treatments