This is a great question.  In my opinion there are three main things that contribute to jowls:

  • Loss of volume in the upper face, and that can be shifting or loss of fat pads, bone and skin.  If it makes a big difference to your jowls to lift up your face back towards your ears and eyes, then volume loss may be the main issue, or …a contributing issue.  Then Kybella may not be your best option;
  • Loss of skin tone and elasticity due to sun damage and age.  If you have very little “spring back” when you pinch your facial skin, and use the same test as above (pulling up and back), then using Kybella may not be your best option;
  • Last but not least, if your fat pads have really shifted and you have a clear fat pad sitting just above your jawbone where your jowl is, then yes…..Kybella may be a great option for you.  This is an FDA off-label use, so experts only please.

Things to ask your dermatologist:

  1. How many vials are they using at each treatment typically.  And how many treatments on average to achieve the results your seeing?
  2. Have they had any cases of nerve injury, and how long did they take to resolve?  Kybella can cause nerve injury, but it’s usually temporary.
  3. How much swelling (it DOES cause swelling) and downtime to expect?
  4. Costs?

Just to summarize the above, if your problem is more volume, then replacing volume first with fillers, makes sense to me and may solve multiple problems.  If your problem is poor skin quality and laxness, then deep radiofrequency like Profound, plus a CO2 laser to repair the collagen and epidermis (outer layer of skin).  Profound is particularly good at increasing elasticity (snap back).  And then lastly, to address fat pads which may have shifted.  Some of our patients have a degree of all three problems.

Hope this helps,

Dr. Brandith Irwin


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