Should I get Kybella® or CoolSculpting® for my double chin?

I get this question all the time in my office. So, what are the pros and cons of each?

Kybella® is deoxycholic acid, a bile acid from the gall bladder which is dumped into the intestine to emulsify and solubilize (breaks down) fats. It was approved for pharmaceutical use by the FDA in 2015 to treat fat in the submental area by injection. The treatment is administered using tiny injections throughout the area over 30-45 minutes and must be repeated monthly for 3-6 months. The biggest complaint is the embarrassing amount of swelling, redness and bruising (known as the bullfrog) as well as pain and numbness. The results take about 4-6 weeks to show up. Rarely the acid might affect a nerve in the jaw area which may cause an uneven smile or affect the ability to swallow. This usually resolves in 4-6 weeks. The total cost of the procedure is about $2100.

CoolSculpting® has been around since 2005 and was originally invented at Harvard after a Dr. noticed fat loss in the cheeks of kids who ate a lot of popsicles (popsicle panniculitis) It is hands down my favorite treatment for this area. The treatment applicator is placed on the chin for 45 minutes per side with some overlap in the center. The applicator gets super cold and freezes the fat cells (crypolysis) which causes cell death in 1-3 months. The treatment is a little uncomfortable due to positioning...your head has to stay still and the applicator can feel like it's sitting right on the Adam's apple. After 45 minutes there is a 2 minute massage of the area that is sometimes uncomfortable as well. Afterward you may have some redness, numbness or a couple pinpoint bruises, but nothing that anyone will notice-no bullfrog. Most people need a second treatment 2 months later for a total price tag of $2700.

Both treatments are effective and permanent, but CoolSculpting® requires fewer treatments and doesn't carry the risk of nerve damage or recovery time of Kybella®.