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Liposuction Surgery vs. Kybella – Which is the Best?

"I'm talking a little bit more about Kybella today. I'm getting so many questions and phone calls as one of the principal investigators on the FDA trial, and I actually went to the FDA and testified with the company because the drug does what it says it is promoted to do.

It destroys the fat cells in the area injected. It has many potential applications but the actual FDA indication is under the chin and the so-called neck fat. In a series of treatment injections, where you would come in typically monthly, we can take even the fattest of and really improve the contour dramatically with no surgery at all, which brings up a common question that I’m getting asked.

"Is it better to do neck liposuction surgery under the skin, or is it better to do the Kybella?

There's not really a right answer if one is better than the other. They are really a contrast for someone that is interested in non-surgical options and would rather see a gradual improvement, Kybella is certainly going to be a good option.

I don’t want anyone to think that there won’t be any swelling or recovery because there is actually with Kybella. After the treatment, people get modest swelling.

In most cases, and in contrast to what I’m seeing on the Internet where they are saying that people are swollen as bull frogs, where they have that "bull frog" look. That was very rare in our experience of over 300 treatments only a couple of patients had that, so that will really be the exception rather than the rule, and it’s definitely related to how much fat there is, and how much drug is given.

It's probably also related to how much lipid or the contents of the fat cells is spilled in to the tissues which creates a very intense inflammatory response, and thus the swelling. I also think that will be mitigated largely by the use of a head wrap or compression garment that we will be using that will be quite easy to take on and off, you can still shower and do all the normal things. We want to reduce that swelling but it is not free of swelling or free of any kind of recovery time.

So in contrast to other things that I’m hearing, you can get injections and have no recovery time as opposed to surgery where there is recovery, its actually not true, there is some swelling, so you can be prepared for that. In general, it can be limited and it’s directly correlated with how much is used.

In contrast, liposuction on the neck is a great procedure, it takes only an hour or so, there's very minimal recovery to it. It’s the tiny little incision under the chin and one behind each ear. The cannulas, or little tubes, a stainless steel tubes that are used have small ports on the side, the tip is blunt so there is no traumatic effect from the cannula or minimal traumatic effect to the cannula.

The fat is evacuated, not all of it, but the bulk of it. What's most effective about liposuction is not just the fat removal but the fact that there are little tiny channels or tunnels that are created underneath the skin that actually crisscross one another underneath, and the body really doesn't like empty space, so there's a natural contraction process to the skin underneath the chin and neck area. This is true really in any of the liposuction cases and why we also use compression garments after submental liposuction.

The beauty of the submental liposuction is that there's usually minimal swelling or moderate probably the fat is all gone, it's neutral. If there is a little bit of swelling, it’s offset by the fat removal so you look about the same after the treatment or even a little better than you did before, the swelling is nominal in that regard.

Most patients get very little bruising with submental liposuction. They do need to wear the head compression garment as much as they can in the first week, and I have them wear at night only in the second week. So really, it becomes a choice not of which is better or which one you can choose, it really becomes more of a lifestyle choice.

If you have a few days where you can wear a compression garment, and you want a one-time long term result, submental liposuction probably is your better choice.

If you're busy and on the go, and you want a smaller improvement and a few treatments to get you to the same place or very close to where submental liposuction can get you, Kybella might be a better treatment.

If you have any other questions about Kybella, submental liposuction or treatment of fat in general, don’t hesitate to visit my website at or our video and you can post pictures and questions on there, we can have further dialogue.

As always, it’s my pleasure to answer your questions and I look forward to hearing from you. This is Dr. Corey Maas on "Looking Your Best.""
