Well, look at that…the annoying fat pad hanging below the chin – aka the “double chin.” Double chins become prominent when excess neck and lower face fat lessens the profile of the chin and jawline. Sometimes it seems as if there's no amount of dieting and exercise to get rid of the fatty tissue and excess skin in that area.

Although, non-surgical treatments have some drawbacks, you’re usually presented with a couple options. In this case, it’ll be Kybella® treatments and neck-lift surgery (sometimes even chin liposuction).

The best choice between these procedures depends on several factors.

What Exactly is Kybella?

This fat melting injectable treatment is the first of its kind. It's purpose is to help take away the excess fat located underneath the chin. Kybella® was approved by the FDA in April 2015. Its key ingredient is known as deoxycholic acid, which is a type of natural salt found in the human gall that is produced by the liver that aids in the destruction and digestion of fat cells.

Basically, Kybella breaks down the membrane lining of the fat cells, which spills the contents and removes the body’s immune cells.

Even though Kybella® does work, it’s not always presented right and sometimes patients have unrealistic expectations. This treatment isn't a no-downtime alternative to a neck lift. After each treatment there is swelling and tenderness, but it's a non-surgical alternative, which carries different results and fewer risks.

This treatment is a good option when patients have good skin elasticity, need a minimal amount of fat removed and jawline contouring. (Learn more about this in A Comprehensive Guide to Jawline Reduction Surgery.)

It's also an alternative for those who don’t want surgery. But if more than two injections of this treatment are needed, it can be more expensive than surgery. It isn’t a good option for patients who have loose, excess skin, more fat and the ‘authentic’ double chin. Plus, Kybella® shouldn’t be classified as the attractive marketing term known as the “non-surgical neck lift.”

The result of these treatments can provide a subtle restoration with a more attractive and natural profile after just a few weeks. When the non-invasive treatment is finished, it is up to you to maintain the results. This goes for surgical procedures as well.

The Neck-Lift

The neck-lift is the best option for patients with loose, excess skin and for those wanting complete skin rejuvenation in that area. It tightens the skin and underlying muscles, while also contouring the jawline. This procedure is usually includes liposuction (and used in combination with other surgical options for complete facial rejuvenation such as a face-lift). (30 somethings are getting face-lifts, learn more about it in A Face-Lift at 30? It's Trending and Smashing the Stigmas.)

A neck-lift is usually performed with incisions made under the chin and behind the ear.

The platysma muscles located underneath the chin are then tightened and sewn together. Then the re-positioned skin and tissue are sutured and the incisions are closed. After surgery, there will be bruising, while also feeling tight and numb in the surgical area. The bruising should go away in about 4-5 days, but the tight, numb feeling may take several months to resolve.

Liposuction alone is used if only contouring and fat-removal is needed. Furthermore, Kybella® and liposuction don’t target loose skin in any such way.

Treatment Vs. Surgery

According to AAFPRS (2017), Kybella® injections were the least popular minimally invasive treatment performed by plastic surgeons. In 2017, the most recent statistics from the American Society of Plastic Surgeons (ASPS) shows that out of the 15.7 million minimally invasive cosmetic procedures performed in the U.S., 62,587 were Kybella® treatments. Then, out of around 1.79 million surgical procedures performed, 246,354 were liposuction and 53,028 were neck-lifts.

Non-surgical treatments provide more subtle results and usually require more than one treatment. For optimal results, non-surgical treatments such as Kybella® usually require a specific candidate that has more facial elasticity and firmer skin.

Even though, procedures such as a neck-lift carry more risks, they can provide a more enhanced appearance with ‘constant’ results that are predictable and long-lasting.

While Kybella treatment and neck-lift surgery have different results and benefits, but what should matter most is understanding which one is right for you.