August 12, 2026 | Liposuction
Last month, a patient sat down, pulled up a photo from her phone and shared before and after. (“I will have three Kybellas,” she said). None of it guesswork, not the # of treatments, nor the price, nor friend #1 raving.
Something that caught her by surprise when I responded was telling her, “I have had Kybella myself.” I told her, “Yeah, it does work.”
What Kybella Does Well, and Where It Stops
Kybella is a product containing deoxycholic acid that is FDA-approved to reduce the fat beneath the chin in the submental area where fat naturally collects. In the right neck, the reduction it delivers is real and permanent. The deoxycholic acid causes dissolution of fat cells in the vicinity of injection, which are later absorbed by the body.
Kybella is effective only in eliminating subcutaneous fat in the submental region, beneath the chin. It does not address fatty deposits out along the sides of the neck. Furthermore, it has a limited depth and is not able to reach subplatysmal fat, below the neck muscles. And when you have excessive skin laxity, reducing fat beneath lax skin will just create a saggy neck.
Each method offers minimal results of only about 20% for that pocket, while CoolSculpting’s method (freezing then melting the fat) does not elevate results, so same limit. CoolSculpting is also not great for the neck either.
What the Operating Room Does Differently
In a liposuction procedure of the neck, approximately 80% of the surplus fat is removed. The complete area treated includes the lower edge of the chin extending downwards onto the neck. The process also incorporates treating the portion underneath the chin, as well as the sides of the neck where injections do not reach.
My technique uses three tiny incisions: one behind each ear and one just below the chin. In the same way, I insert the FaceTite device below the skin and use radiofrequency energy to tighten the envelope while suctioning out the fat, thus solving the loose skin problem that precludes so many people from having Kybella in the first place. For patients who really have the problem of platysmal banding and truly loose skin, a formal neck lift will indeed provide a better answer and I let the patient know this when it is.
Contouring is not so much about trimming down but sculpting that soft curve between neck and chin. Twenty percent out of one pocket rarely changes a jawline. Eighty percent across three zones does.
The Math That Changed Her Mind
Here is where she sat back in her chair. One session of a neck liposuction with FaceTite will cost around the same as 3 rounds of Kybella, and you need 3 to get the full benefit.
Same spending. A single appointment versus three spread out over months. Four times the fat removal, distributed across the whole neck instead of one central spot, with skin tightening built in. Our prices are listed openly on our fees page, and an exact quote comes only after we have seen you in person, because anatomy sets the plan.
Recovery is pretty honest, but also fast. Get a compression garment. There might be some puffiness/bruising, and most people look okay walking around in a week. Recovering from Kybella seems easier, going to normal activity the next day, but you cannot see the improvement for a while since you will be puffy and look full for a couple of weeks each session, three times.
Where I Learned to Think This Way
I trained in plastic surgery at the Mayo Clinic, and I teach as a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. In both institutions the teaching was the same: get the anatomy, then select your instrument. The other way around just never made sense.
That is why I continue to offer Kybella in our practice. An ideal candidate for Kybella is young, has great skin elasticity and has a relatively isolated, small and exclusively centered fatty pocket under the chin. The med spa nurses in our practice do an excellent job administering it. You can read the complete definition of the ideal patient on the Southwest Plastic Surgery side: what Kybella can and cannot do.
One More Thing About the Needle
Since I have personally been the patient here, I should close the loop on the experience. I assure you, the needles hurt more than either Botox or fillers. Afterwards your face is sufficiently swollen that you feel you have gained a double chin as you lose your original. But eventually the swelling goes down and the result you have achieved looks natural.
But a result that is real and a result that is right are not the same thing. Twenty percent of one pocket is the ceiling for the needle. For most of the necks that walk into my office, that ceiling is too low.
Why Choose Dr. Agullo
I am double board-certified, Mayo Clinic fellowship-trained and a Castle Connolly Top Doctor for 13 consecutive years. I have sculpted the perfect neck and jaw for 20 years, and I tell patients frankly which tool is best for their anatomy, even when it costs less.
Ready to Talk?
Come in with your Kybella questions. Leave with an honest map of your neck and the numbers for both paths.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. #StayBeautiful
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
Cross-links
- Med spa version on swplasticsurgery.com: “Kybella in El Paso: What the Fat-Dissolving Shot Can and Cannot Do” (link once live)
- Editorial version on drworldwide.com: “I Had Kybella Myself: A Surgeon’s Honest Read on the Fat-Dissolving Shot” (link once live)
