Doctors see surge in men seeking surgery-free double chin solution

Even though Scott Kaiser had a healthy diet and stayed active with regular cardio and weight lifting, he realized he was developing a double chin, something that also seemed to plague other men in his family.

Sure, he would indulge in a glass of wine or a slice of pizza on the weekends, but “it wasn’t worth giving up some of the fun stuff to lose the weight,” Kaiser, 50, said.

Five years ago, he met with plastic surgeon Dr. Michael Burgdorf to talk about liposuction. When Burgdorf told him about Kybella, a non-invasive fat dissolving treatment that wouldn’t require him to go into hiding for a few days, Kaiser was in.

“It sounded like a much better route without having downtime,” he said.

Men feel emasculated

Since Kybella first emerged on the market in 2015, experts say they have seen an increase in men between the ages of 30 and 70 opting for the treatment.

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In fact, 73 percent of people say they don’t like the extra fat under their chin and neck, according to a survey by the American Society of Dermatologic Surgery found.

Between 2000 and 2015, cosmetic minimally invasive procedures for men increased 69 percent, according to a report by the American Society of Plastic Surgeons. What’s more, men underwent more than 26,902 procedures of nonsurgical fat reduction in 2015, according to a report by The American Society for Aesthetic Plastic Surgery.

“Men associate masculinity with sort of a chiseled jawline, a wide lower face and the absence of a double chin,” Dr. Joseph A. Russo, a board-certified plastic surgeon in Newton, Massachusetts, said.

Once that area becomes softer, men tend to feel less masculine and confident. Although being overweight is one culprit, age or genetics can cause a double chin. The extra fat can also make people look overweight even if they’re lean and fit.

Experts say sometimes men’s wives or partners persuade them to get treatment.

“Men are a little more skittish about coming into the plastic surgeon and [Kybella] is a little more of an acceptable treatment,” Burgdorf, the founder and president of Music City Plastic Surgery in Nashville, Tennessee, said.

Before Kybella became available, doctors offered liposuction or a direct incision as options for double chin improvement, but both are invasive, carry more risks and side effects and include significant downtime.

Kybella is a more benign option, though it does involve injections and possible side effects. In clinical trials, 4.3 percent of participants experienced temporary nerve paralysis as a side effect.

If the solution is injected superficially, the hair follicles can be damaged and result in bald areas, or a skin sore that will heal. Numbness can last up to six weeks.

Some patients may also feel as though they have difficulty swallowing or even breathing after the treatment, but it’s a mental perception, not a physical side effect, Russo said.

What’s most attractive to men about Kybella is that there is little to no downtime before they can resume their normal activities.

“They want to come in, get it done and be back to work the next day,” Burgdorf said.

How does Kybella work?
Kybella is a synthetic form of deoxycholic acid, a naturally occurring bile salt found in the body that dissolves fat, then is absorbed and eliminated through urine.

Although it can help to tighten the skin, the goal of treatment is to reduce fat. The treatment is permanent so even if a patient gains weight, he can never make new fat cells in that area.

“Once they’re gone, they’re gone forever,” Russo said.

A typical treatment session last about 15 minutes and includes 25 to 50 small injections of the solution. Although it’s not painful, it’s uncomfortable.

“You have a warm feeling almost like you drank a shot of whiskey,” Burgdorf said.

While some doctors will use a local anesthetic or numbing cream, ice may be all that is needed.

After the treatment, welling will occur because the treatment creates an inflammatory response. Depending on the amount of fat, swelling can last for a couple of days or up to a month.

“It does actually look a little bit worse before it looks better because of the way the cells are destroyed,” Russo said.

After the treatment, patients should apply ice to reduce the swelling and take an over-the-counter pain reliever. They should also avoid shaving for at least two days to prevent the risk of infection. They may have to wait longer if they experience numbness.

Most patients undergo two to four treatments spaced out between 6 and 10 weeks to allow the swelling to resolve between appointments.

The cost of Kybella varies between $750 and $1,500 per treatment.

After Kaiser completed three treatments, he lost five pounds, friends and acquaintances started to take notice and he felt a boost of confidence on the dating scene.

“I would do it again in a heartbeat,” he said. “I look five years younger.”