Deoxycholic Acid
Also known as Kybella, Belkyra
Dissolves fat under the chin without surgery. Effective, but the treatment course is genuinely unpleasant.
US $600–1,200 per session, typically 2–4 sessions.
How it works
A synthetic version of a bile acid that disrupts adipocyte cell membranes, causing permanent destruction of fat cells in the injected area. The debris is cleared by macrophages over several weeks.
How it's used
Two to four sessions spaced roughly a month apart, each involving 20–50 injections into the submental fat. Only appropriate for genuine subcutaneous fat with good skin elasticity — it does nothing for skin laxity or platysmal banding.
Trade-offs
In favour
- Permanent fat cell destruction
- No surgery, anaesthetic or incisions
- Good option for a modest double chin
- No compression garment
Against
- Severe swelling for up to two weeks after each session
- Multiple sessions required
- Can cost as much as liposuction by the end
- Only suitable for small volumes
Risks and side effects
- Dramatic swelling — a visibly enlarged "bullfrog" appearance for 1–2 weeks
- Marginal mandibular nerve injury causing an uneven smile — usually temporary
- Injection site pain, numbness and firmness
- Skin ulceration if injected too superficially
- Dysphagia
Recovery
Days 1–14: significant swelling, tenderness and firmness under the chin. Most people take a few days off social commitments. Weeks 2–6: swelling resolves and contour emerges.
How good is the evidence?
Randomised controlled trial evidence supported its regulatory approval for submental fat.
Sources
Sources point to guideline bodies and literature searches rather than single papers, so they stay accurate as the evidence moves.