If it has not moved with weight loss, that is because the fat under your chin sits in its own pocket. Kybella® is injectable deoxycholic acid, a bile acid your body already makes to break down dietary fat, placed into that pocket so the fat is cleared over the following weeks.
Book a consultationFind out what it is
Kybella® is injectable deoxycholic acid, a bile acid that breaks apart fat-cell membranes. It is FDA-approved for the improvement in appearance of moderate to severe fullness under the chin in adults; any other area is off-label. Most plans run two to four sessions at least one month apart; the label permits up to six.
The appeal is that it ends: the fat cells the drug destroys are gone. Kybella® is deoxycholic acid, a bile acid your body already makes.
The FDA approved Kybella® in 2015 for the improvement in appearance of moderate to severe convexity or fullness associated with submental fat in adults, and that is the only approved area. Injection anywhere else on the body is an off-label use, which means the drug is the same but that particular use has not been through FDA review.
Deoxycholic acid dissolves the membrane of a fat cell on contact. Clearance takes weeks, so change lags the appointment by a month.
Protein-rich tissue resists it.
| Option | How it works | Typical sessions | Swelling and downtime | FDA status for fat under the chin | What it does not do |
|---|---|---|---|---|---|
| Kybella® (deoxycholic acid) | Injected into the fat pad, disrupting fat cell membranes | 2 to 4 observed in practice, 6 maximum on label | Visibly swollen 5 to 14 days per session | Approved for the improvement in appearance of moderate to severe submental fullness in adults | Tighten skin, or change how far the chin projects |
| Submental liposuction | Surgical removal of the fat pad through small incisions | One | Compression garment and bruising, usually 1 to 2 weeks | A surgical procedure, not a drug indication | Avoid anesthesia, incisions and a surgical recovery |
| Chin filler | Adds projection at the bone so the neck reads longer | One, reviewed at two weeks | Bruising 3 to 7 days | Specific fillers are approved for chin retrusion, none for submental fat | Remove any fat |
| Neuromodulator for platysmal bands | Relaxes the vertical neck muscles that pull downward | One, reviewed at two weeks | Little to none | Botox® Cosmetic is approved for platysma bands; other products and other neck uses are off-label | Change the fat pad at all |
They act on different tissues, so the question is which tissue is producing your fullness. Ranges are drawn from product labelling and from what is observed in practice.
Kybella® (deoxycholic acid injection) 10 mg/mL — The only FDA-approved injectable deoxycholic acid. Approved in 2015 for the improvement in appearance of moderate to severe convexity or fullness associated with submental fat in adults. Supplied in 2 mL vials, and a thick fat pad takes more than one vial per session.
Compounded topical anesthetic (lidocaine and tetracaine) — Compounded topicals are prepared by a pharmacy and are not FDA-approved products. The exact formulation used here is named at consultation.
Injectable lidocaine, with or without epinephrine — Local anesthetic is described in the Kybella® prescribing information as an option. It adds a few minutes and some tissue distortion, so it is planned before the grid is drawn rather than after.
Injection grid template and surgical marker — The mandibular border, the salivary glands and the lymph nodes are marked before the first needle, so the boundaries of the injection field are set while the tissue is still undisturbed.
Cold packs — Ice makes the first evening more comfortable. It does not shorten the underlying swelling curve, which follows the pace at which the tissue clears rather than the surface temperature.
The area is examined with you upright and swallowing. That is where fat, gland, skin and chin separate.
The grid is drawn at one centimeter spacing, with the mandibular border marked.
Each grid point receives 0.2 mL inside the fat pad, up to 50 injections.
Swelling clears first. The review sits at four to six weeks, profile re-photographed.
Swelling peaks on day two or three and shows 5 to 14 days.
Nothing shows on day ten. Swelling clears before fat loss is visible.
The first readable result is at four to six weeks.
Kybella® stings more than most injectables. Burning builds during the injections and for a few minutes afterwards, and the area is tender for several days. Swelling is the harder part to plan around.
Swelling is visible 5 to 14 days after each session, peaking at two to three days and worst after the first. In the pivotal trials, swelling was reported by 87 percent, bruising by 72 and numbness by 66.
Most patients need two to four sessions, at least one month apart, and the label permits up to six. In the REFINE-1 and REFINE-2 trials, roughly two thirds met the composite endpoint, against one in five on placebo.
Deoxycholic acid destroys the fat cells it contacts, and the label states that once the desired response is achieved, retreatment is not expected. The cells that remain can enlarge, so stable weight holds the result.
The cost depends on your treatment plan. Call (614) 425-1633 for current pricing and ask what consultation, treatment, and follow-up charges apply.
Under the chin is the only area the FDA approved for Kybella®, and it is the only area treated here. Injection anywhere else on the body is an off-label use, which means a provider may legally perform it but the FDA has not reviewed that particular use, and the published evidence behind it is thinner. The molecule is the same; it is the indication that has not been through approval. The U.S. Food and Drug Administration reviews each indication separately. If a different area is what is bothering you, say so at the consultation and the written plan will name what does address it.
Kybella® acts on fat, so where the fullness is not fat, the shape does not change. It can come from an enlarged submandibular gland, loose skin or platysmal bands. Injecting close to a salivary gland is cautioned against.
They suit different situations. Submental liposuction removes the fat pad in one surgical session under anesthesia, with incisions and a compression garment. Kybella® is staged over three to six months with no incisions.
The two serious risks are injury to the marginal mandibular nerve, which can cause a temporarily uneven smile, and difficulty swallowing. In the pivotal trials, difficulty swallowing was reported by 14 percent of treated patients against 2 percent on placebo, resolving over a median of about three days; nerve injury by 4 percent against 1 percent, resolving over a median of about six weeks. Every case in those trials resolved without treatment. Injection site ulceration and tissue damage have also been reported, usually with placement outside the fat pad. Call the direct number the same day if any of them appears, and we will look at it.
You can work the next day, though you will look swollen and people will notice. There is no dressing and no restriction on talking, eating or driving. Bruising, when it happens, usually lasts a week.
Kybella® is FDA-approved for the improvement in appearance of moderate to severe convexity or fullness associated with submental fat in adults. Treatment of any other area is an off-label use. Off-label use is legal and common, and it is named as such before consent.
Kybella® is a prescription medicine. It is administered here by a licensed provider after an in-person medical evaluation, and it is not suitable for everyone.
Individual results vary. Nothing on this page is a promise of a specific result, and treatment requires an in-person consultation and a medical eligibility review. Treatment is provided only where it is indicated.
They are unretouched, shot at fixed distance, angle and lighting, and they illustrate outcomes achieved rather than outcomes predicted.
Kybella® is a registered trademark of Allergan, Inc., an AbbVie company. Botox® Cosmetic is a registered trademark of Allergan, Inc. Rouge Aesthetics is an independent practice and is not affiliated with, endorsed by or sponsored by the trademark owners.
Rouge Aesthetics · 101 Mill Street, Suite 210, Gahanna, OH 43230 · (614) 425-1633
Individual results vary. This website provides general information and does not replace an individual consultation.