Is Kybella the Secret to Debulking Jowls?


Everyone is on a quest for razor-sharp jawlines accompanied by nonexistent jowls. Historically, surgery has been the go-to for eliminating bulky jowls. But as the world of injectables forges ahead, doctors are implementing noninvasive techniques that firm the area without an incision or stitch in sight. Enter Kybella, a popular fat-reducing injectable treatment now used to kiss jowls goodbye.

How Kybella Works in the Jowls

Jowls form from skin laxity and fat descent, causing a loss of definition in the jawline. Before using Kybella to delete jowl fat, a nonsurgical option for eliminating them didn’t exist. Of course, liposuction and a facelift work, but both come with downtime and scars. Now, Kybella is becoming a favored remedy for jowl reduction, with results transpiring in three to six months.

No matter where your dermatologist injects Kybella, it works the same way to eliminate fat. The secret sauce is a synthetic form of deoxycholic acid, a bile acid, that breaks apart and kills fat cells. Aventura, FL dermatologist Dr. Bertha Baum says injecting Kybella into the jowls is a great technique for destroying fat cells and eventually reducing the size of the area.

Montclair, NJ dermatologist Jeanine Downie, MD says treating the jowls with filler along the jawline won’t eliminate the jowls. And that’s where Kybella comes into play. Dr. Downie reveals she’s had great success using Kybella to create sleeker jawlines in both women and men.

Kybella permanently eradicates fat, so there’s no restoring eliminated fat, which is why most dermatologists take a conservative approach. “I would rather go slow and do more treatments than destroy too much fat,” notes Fresno, CA dermatologist Kathleen Behr, MD. For this reason, she starts with one-half to a full vial per treatment and retreats accordingly.

Still, some doctors consider Kybella somewhat risky. Dr. Downie cautions of rare temporary facial paralysis if the injections hit the marginal mandibular nerve. There’s also the possibility of a temporarily asymmetrical smile.

The Story on Swelling

Despite Kybella’s benefits, its downside is post-treatment swelling. In the chin area, swelling is more extreme, and there’s less when treating the jowls, although it will persist. “Swelling is the trade-off for a nonsurgical option with no cutting,” Dr. Behr says. “We want swelling—it means the product is working.”

So how much swelling transpires in the jowls? It’s similar to what you would experience with dental work. Dr. Baum says she hasn’t noticed much swelling in the jowls compared to what patients experience when treating submental fat. Visible swelling persists for the first few days post-treatment and then subsides. To help reduce puffiness, avoid excess salt, ice the area and take anti-inflammatory medications.

What Else You Need to Know

Not everyone who wants to inject away saggy jowls is a candidate—patient selection is paramount. Kybella works best for those with small- to medium-sized jowls. If there’s too much fat or loose skin, the treatment will not work. According to Dr. Baum, “skin laxity may increase once we remove fat in the area because there is less support. And Kybella doesn’t help with tightening or loose skin.” For those patients, a facelift or liposuction may be a better option.

Kybella does a good job of downsizing jowls on its own. However, combining it with injectables and skin-tightening treatments produces even better results. Dr. Downie first treats the jowls with Kybella and later uses Juvederm Voluma or Restylane Lyft to lift the upper part of the face. She also incorporates a skin-tightener, like Zaffiro or IntraGen, to address droopiness. “It’s a three-step process to achieve the sleek jawline people want,” Dr. Downie adds.

Dr. Behr follows a similar hybrid approach, pairing Kybella with filler or Ultherapy, threads, and even microcoring. She says combination treatments help to build the structure while shrinking the skin and fat for a natural result. But only some people need additional procedures. “In some younger patients, I can do just Kybella depending on their facial shape,” she explains.

If you’re expecting results akin to a lower facelift, Kybella won’t produce them. That’s because it only addresses fat and doesn’t remove loose skin or tighten the underlying tissue or muscles. Instead, Dr. Behr results are a subtle change with less bulkiness for a natural look.