At Wave Plastic Surgery
Kybella KybellaMobile


At Wave Plastic Surgery

Kybella in Los Angeles, Orange County and San Francisco

Kybella is a new FDA-approved treatment designed to remove fat from under the chin (i.e., a “double chin”) without surgery. The technique involves the injection of deoxycholic acid beneath the skin of the submental region, an area extending from the chin back to the angle of the jaw on either side. As we age and gradually gain more weight over time, this area becomes more and more convex (i.e., bulging) a change that is sometimes dramatically demonstrated by photographs taken from a profile view.

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Evaluation of Kybella

Los Angeles patients interested in Kybella are examined and evaluated by a board-certified plastic surgeon to determine whether they are good candidates for this treatment. Other possible causes of submental fullness (fat beneath the chin) include conditions such as cervical lymphadenopathy and thyromegaly. Contraindications to the injection of Kybella such as pre-existing dysphagia or the use of anticoagulant therapy, are carefully ruled out prior to administering the treatment.

In addition, because patients are evaluated initially by plastic surgeons, a careful assessment can be made as to whether treatment with Kybella can meet their aesthetic goals and expectations. Although Kybella is a significant addition to our quiver of nonsurgical rejuvenating treatments, it is not the answer to all aesthetic problems of the neck and submental region. It will not, for instance, be able to cure platysmal banding (the presence of a “turkey gobbler” on the neck), although injection of Kybella with Botox may improve the appearance of the neck. Nor can Kybella treat issues of skin laxity or redundancy, although, in some cases, pairing Kybella with non-invasive skin-tightening procedures may work well.

More importantly, because we are a plastic surgery practice, we are experts in the anatomy of the neck and submental region, including the course and location of significant blood vessels and nerves, muscles, salivary glands and lymph nodes. We are also knowledgeable in the surgical and aesthetic procedures available for these regions which patients may have undergone prior to seeking treatment with Kybella. By the same token, as plastic surgeons, we have the ability to choose one or a combination of noninvasive and surgical procedures that will most efficiently allow you to achieve your aesthetic goals.

Real Wave Patient. See more on our Before & After gallery!


We use a combination of topical anesthetic and ice packs to minimize patient discomfort during the injection of Kybella. Prior to injection, the planned treatment area is carefully marked, along with important nerves and blood vessels that must be avoided. A precise grid for the evenly spaced small volume subcutaneous injections is then drawn within the previously demarcated treatment area.  The injections themselves are performed by carefully drawing the skin and targeted submental fat up and away from the soft tissue beneath it.

We use extremely small needles to inject Kybella in order to precisely localize placement of the solution into the center of the subcutaneous submental fat pocket and to further minimize patient discomfort and swelling. After injection, we temporarily apply a snug adhesive dressing to further minimize any minor bruising or swelling.

Up to 10cc of Kybella (100mg) may be administered in this manner in a given treatment. We are scrupulous in our practice about only using fresh Kybella solution. Any unused solution is discarded at the end of each treatment.

The number of injections administered during each treatment, their placement, and the total number of treatments is precisely tailored to the specific topography of each patient’s unique distribution of submental fat, as well as his or her individual treatment goals. Patients can undergo up to six treatment sessions at intervals of one month to achieve maximal treatment of the submental region.

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