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Submental fat? Making the right treatment choice

Article-Submental fat? Making the right treatment choice

In a recent CST poll, doctors weighed in on their opinions of the best method of treating the submental region for fat deposition. The results were as follows:

44% CoolMini

30% Kybella

26% Neither

Although a small, casual poll is not ultimately interpretive it does provide some data of contemporary treatment and thoughts.

The CoolMini from CoolSculpting and Kybella represent new treatments (although mesotherapy has been used for decades) and both of these treatments are just now tricklilng into mainstream practice. Because they are both novel treatments, I would imagine that the same poll conducted a  year from now will show even greater numbers, assuming these treatments make noticeable differences.

What is interesting about this poll is the 26% “neither” choice. This could reflect the fact that CoolSculpting Mini and Kybella are new, but more so, probably represents input from doctors that employ liposuction in this area.  Submental liposuction in the correct patient choice remains one of the most simple, affordable and dramatic treatments for submental and cervical liposculpting. I am a Kybella trainer and think the technology is exciting and my friends that perform cyroliposysis say it works well. Both of these treatments require multiple and expensive treatments, whereas submental liposuction is a 20-minute, single procedure and can be performed on awake patients. Liposuction is a time-tested, evidence-based, predictable procedure that can be performed in a single setting.

Related: Kybella pricing: Do you know how to charge?

Some patients may undergo four Kybella treatments spaced over four months and cost almost $5,000, whereas submental liposuction can be performed in 20 minutes for less than half that fee. The fact is that contemporary cosmetic surgery patients and the specialty itself has more minimally invasive options than ever before, and some patients just don’t want surgery. The Coolsculpting Mini and Kybella are perfect alternatives for these patients.

NEXT: How Do You Choose?


How Do You Choose?

The biggest single factor in the success of any of these three therapies is choosing the right patient. The best results are on younger patients with isolated submental fat deposits without skin excess. Patients with fat and skin laxity may actually look worse after fat reduction as it accentuates the skin excess. I see many before and after pictures from conservative submental therapies that are effective for fat reduction, but the skin excess is unacceptable.  

Related: Can Kybella be used to treat fat in areas other than the submental space?

My practice is largely surgical and I perform several facelifts per week. My patients expect more and will not tolerate residual skin excess. On the other hand, I have friends that do not do surgery and their patients may be happy with a smaller change.

Like all therapies, choosing safe procedures with repeatable results and happy patients is the best treatment. The exact therapy will differ from practice to practice and in the hands of surgeons and nonsurgeons. There are many ways to skin the cat! There is no doubt that more and more conservative therapies will emerge and be refined over time. To me, this is one of the exciting things about the ever changing practice of cosmetic surgery.

Dr. Niamtu

Joe Niamtu, III, DMD, is well known in international cosmetic facial surgery circles as surgeon, teacher and author and is regarded as a key opinion leader by academics and clinicians worldwide. He lectures internationally on cosmetic facial surgery and has taught on six continents around the world. Dr. Niamtu has written six textbooks, contributed 31 chapters to other textbooks, and has authored hundreds of publications on various cosmetic facial surgery topics. Dr. Niamtu is a fellow of the American Academy of Cosmetic Surgery and the American Society for Lasers in Medicine and Surgery, and is board certified by the American Board of Oral and Maxillofacial Surgery. 

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