You are not a candidate for Kybella, nonsurgical neck fat reduction

Blog post - before after revision facelift neck muscle

Patients come to a facial plastic surgeon to improve the appearance of their eyes, neck, and skin. Most Washington DC plastic surgery patients, however, would like to avoid surgery if possible. The reluctance for surgery in some patients is multifactorial, which may include apprehension of recovery, discomfort, or looking “overdone”. As a result, non-surgical cosmetic procedures continue to increase in popularity.

Neck fat, a factor of submental fullness, is a common aesthetic concern for many. Excess neck fat may be present at an early age, but develops in everyone as we age. Neck fat reduction has traditionally only been limited to neck liposuction alone or as part of a face lift. Kybella® is a new option which gradually reduces neck fat with a series of injections in the office.

What is Kybella?

Kybella is a non-surgical treatment that dissolves neck fat. A series of injections under the chin gradually reduces fat over time. The number of required treatments to achieve desired results depends on the amount of excess fat present.

We reviewed Kybella, alternatively known as a “double chin shot”, in previous blog posts:

Who are not candidates for Kybella?

The appearance of the neck and jawline is multifactorial, and a double chin may not be from excess neck fat alone. Non-surgical treatment with Kybella to improve a double chin only addresses fat. It is not for bone, skin, muscle, or glands of the neck or jawline.  Double chin (i.e. submental fullness ) treatment options was reviewed previously.

Kybella does not tighten skin or lift muscle. Kybella does not augment, plump, or enhance like facial fillers. Lastly, Kybella does not relax neck wrinkles like Botox® or Dysport®.


Neck creases (vertical or horizontal), platysmal banding, and loose neck muscle can create an undesired neck. These patients typically do better with a surgical neck lift or Botox to relax neck wrinkles (ie. Nefertiti lift).

Blog post - before after revision facelift neck muscle

Before and after photograph revision facelift, liposuction, and chin implant.


Loose or sagging skin with laxity develops gradually with age. A facelift or neck lift is required to adequently lift the neck. Kybella should not be used as a “skin tightener”. Skin laxity treatment was reviewed in prior blog post, and best results for loose skin is typically with surgery.

Blog post - before after photo facelift neck lift skin laxity plastic surgery.001

Before and after photograph facelift and liposuction.


Microgenia (i.e weak chin bone) is frequently seen in a cosmetic facial surgeon’s office. These patients typically have had a double or soft chin since childhood that has only worsened with age. Chin augmentation surgery with an implant with neck liposuction is a more appropriate option for “best” cosmetic results.

Blog post - before after chin augmentation silicone implant neck lift

Before and after photographs of chin augmentation silicone implant (large) and neck liposuction.


Active neck infection or skin swelling is a contraindication for Kybella injections. Any inflammation or infection present should be managed first before considering Kybella.

Previous neck surgery

Patients who have had prior neck surgery, such as face lift, neck lift, or liposuction should be cautious about getting Kybella treatments. Scar tissue from prior surgery can affect the results of Kybella treatment.

A board-certified physician with experience in neck procedures should evaluate you to see if Kybella treatment can still be given. Prior neck surgery is not an absolute contraindication, just that it requires a more comprehensive evaluation before Kybella treatment.

Who is a candidate for Kybella?

The ideal candidate for Kybella is a person with excess neck fat under the chin, who wants to avoid surgery such as liposuction. This ideal candidate also realizes that Kybella treatment requires more time commitment before seeing results, unlike the faster change with surgery. Consultation with a facial plastic surgeon who performs a variety of neck procedures can help determine appropriate options for you.

Blog post - before after Kybella nonsurgical neck fat reduction double chin

Before and after photograph Kybella treatment, nonsurgical neck fat reduction.

Have you considered in improving you neck or jawline? Share your thoughts below.

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