KYbella.
FDA-approved deoxycholic acid injection that permanently reduces fat under the chin. Honest about timeline and significant 7–14 day swelling — plan around social events.
A naturally occurring acid, precisely placed.
Kybella is the brand name for deoxycholic acid — a molecule that occurs naturally in the body to help break down dietary fat. When deoxycholic acid is injected directly into the submental fat compartment (the pocket of fat under the chin), it disrupts the membranes of fat cells, causing them to release their contents. The body then clears those destroyed cells through its normal inflammatory and lymphatic response over the following weeks.
Once a fat cell is destroyed, it cannot store fat again. That makes Kybella results permanent for the cells treated. New weight gain can still create new fat in the area (or elsewhere), but the cells we destroy stay destroyed.
FDA-approved for submental fat (the under-chin area) — the only FDA-approved indication. Treatment is a series of 2 to 6 sessions spaced 4 to 8 weeks apart. Each session takes 15 to 30 minutes; recovery from each session takes 1 to 2 weeks of meaningful swelling. Patients plan around social events.
Allergan-trained injection, planned cadence.
Kybella at Reviv Med Spa in Millbrae is administered by our Medical Director Dr. Gayle Misle, MD, and our Aesthetic Nurse Megan Sosnick, RN — both with extensive training in deoxycholic acid injection technique. Allergan, the manufacturer, requires specific provider training for Kybella; both Dr. Misle and Megan have completed this training.
- Kybella by Allergan Aesthetics
- Deoxycholic acid; the only FDA-approved indication is submental fat reduction.
The actual injection process: consultation to assess submental fat (palpation, photos, lateral and frontal views) and to screen whether the fullness is fat (Kybella territory) versus laxity or glandular (different approach). A treatment template — a grid of injection points marked on the skin — determines spacing and dose distribution. Topical numbing applied 20 to 30 minutes beforehand. Series of small subcutaneous injections across the marked grid; brief stinging during active injection (4 to 5 out of 10). Ice packs immediately after to reduce initial swelling. Photo and follow-up; we schedule the next session at 4 to 8 weeks once swelling has resolved.
Honest framing on downtime. Kybella swells significantly. Days 2 to 4 are the worst — patients often describe a "bullfrog" appearance under the chin. By week 2 most swelling has resolved. Bruising is common. Plan sessions during quiet periods, not before weddings or major events. When we recommend pairing. Patients with significant skin laxity may need NuEra Tight RF skin tightening to address residual lax skin after fat reduction. We discuss this at consultation.
Three areas, one indication.
Submental fat is the FDA-approved indication and the area we treat with confidence. The other listings are downstream effects of treating that one compartment.
Submental fat
Under-chin fullness — the FDA-approved indication and the area we treat with confidence.
Jawline contour
Refined definition along the lower face once the submental fat is reduced.
Profile definition
A cleaner cervicomental angle on the lateral profile.
Fullness, contour, and the angle.
Submental fullness ("double chin")
Subcutaneous fat under the chin that has not responded to weight or fitness changes.
Jawline definition
A clearer transition between jaw and neck once the fat compartment is reduced.
Profile and cervicomental angle
The lateral angle from chin to neck — sharpened as fullness reduces.
Pairing with skin tightening
For patients with significant skin laxity, pairing Kybella with NuEra Tight RF supports the underlying skin response.
Profile Jawline Chin Definition Contour Permanent Targeted Submental Profile Jawline Chin Definition Contour Permanent Targeted Submental Profile Jawline Chin Definition Contour Permanent Targeted What to know, in four lines.
- 01
Kybella destroys fat cells permanently. Once a fat cell is destroyed, it cannot store fat again — that makes the result durable for the cells we treat.
- 02
Swelling is significant for 7 to 14 days after each session. Plan around social events; do not schedule a session a week before a wedding.
- 03
FDA approval is for submental fat only. We are conservative on off-label use for areas where mistakes carry significant cosmetic risk.
- 04
Pricing is per vial. Most first-treatments use 2 to 4 vials per session, across 2 to 6 sessions spaced 4 to 8 weeks apart.
From day zero, to a settled profile.
Treatment day. Topical numbing, then a grid of small injections under the chin. 30–45 min appointment. Visible swelling is expected — plan to head straight home, not to a public meeting.
Peak swelling and firmness under the chin. Some patients describe a "frog" or "fullness" look — this is the inflammatory response, not the result. Cold compresses help. Avoid heavy exercise for 48 hours.
Swelling resolves and the treated area settles. You can begin to read the change in profile. Sensation returns to normal across this window.
Next session if more reduction is wanted. Most patients complete 2 to 6 sessions total spaced 4 to 8 weeks apart. The fat reduction is permanent — those cells are gone.
What it actually costs.
Kybella at Reviv is priced per vial, with most first-treatments using 2 to 4 vials per session. Number of sessions depends on the volume of submental fat and your goal — and the volume of fat and your goal we quote in writing at consultation, before any treatment begins.
Who it's for — and who it isn't.
- Adults with persistent submental fullness that has not responded to diet and exercise
- Patients with good skin elasticity and modest-to-moderate submental fat
- Patients comfortable with a 7- to 14-day swelling window and willing to plan around it
- Patients seeking a non-surgical alternative to submental liposuction
- Pregnant or breastfeeding patients
- Active infection at the treatment area or bleeding disorders
- Patients with significant skin laxity that would benefit more from a surgical approach
- Patients with prior surgery in the submental area that altered the anatomy
Your Kybella team.
Dr. Gayle Misle, MD
Founder of Reviv Med Spa & Laser Treatment. Allergan-trained for Kybella; leads our injectable program with a conservative, planned-cadence approach.
Megan Sosnick, RN
Aesthetic Nurse and Practice Manager. Allergan-trained for Kybella. Runs your initial consultation, places injections alongside Dr. Misle, and manages session planning around your schedule.
Real Reviv patients. No retouching.
Six to twelve weeks after the final session. Same lighting, same pose, same camera. Tap any pair to read the case study — sessions, vials, recovery details.
Individual results vary. All photos are real Reviv patients, shared with consent. Lighting and pose are matched, no retouching.
Conservative dosing first.
Kybella sessions at Reviv start with a careful map of the submental fat pad. We dose conservatively on the first visit and reassess at four to six weeks before adding a second session. Most patients need two to four total.
What people say about Reviv.
The whole team takes their time. No upselling, no pressure — just a thoughtful plan and beautiful results. The space itself feels like a sanctuary.
I've tried four other med spas in the Bay Area. Reviv is the only one where I feel genuinely listened to. Worth the drive from the city.
Conservative, honest, and skilled. They told me I didn't need half of what I was considering — and the things they did do were perfect.
No Kybella-tagged reviews yet — these are recent reviews from across our practice.
Read all reviewsFrequently asked.
How does Kybella work?
Kybella is the brand name for deoxycholic acid — a naturally occurring molecule the body produces to break down dietary fat. When injected directly into a fat compartment, it disrupts the membranes of fat cells, causing them to release their contents. The destroyed cells are then cleared by the body's natural inflammatory response over the following weeks. Once a fat cell is destroyed it cannot store fat again, so the result is permanent for those cells.
How many sessions do I need?
Most patients need 2 to 6 sessions for full result, spaced 4 to 8 weeks apart. The amount of fat in the submental area determines how many sessions and how many vials per session. Smaller pockets resolve in 2 to 3 sessions; thicker submental fat needs more.
How much does Kybella cost?
Kybella is priced per vial. Most first-treatments use 2 to 4 vials per session across 2 to 6 sessions. Final cost depends on the volume of submental fat and your goal — quoted in writing at consultation, before any treatment begins.
Does Kybella hurt?
There is a brief stinging or burning sensation as Kybella is injected — most patients rate the in-treatment sensation 4 to 5 out of 10. The discomfort lasts about 5 to 10 minutes during the active injection phase. Topical numbing is applied beforehand, and many providers add ice packs. The sensation diminishes immediately after.
How bad is the swelling really?
Honestly significant. Swelling peaks 1 to 3 days post-injection and lasts about 7 to 14 days. Patients often describe the look as a "bullfrog" or noticeably puffy under-chin appearance. Most plan around social events: do not schedule a Kybella session a week before a wedding. Bruising is also common. By week 2 to 3 swelling is mostly resolved; by week 4 you can usually assess interim result.
Will my chin sag after the fat goes away?
Skin elasticity matters. Patients with good skin quality and modest submental fat see clean, refined jaw definition. Patients with significant skin laxity may have residual sag — this is why we sometimes pair Kybella with skin tightening (NuEra Tight RF) to improve the underlying skin response. We assess at consultation.
When will I see results?
Initial reduction visible 4 to 6 weeks after each session. Full result of a series visible 4 to 6 weeks after the final session. Most patients see clear definition improvement at session 3 baseline.
Can Kybella be used elsewhere on the body?
FDA approval is for submental fat (under the chin) only. Off-label use of Kybella for jowls, buccal fat, bra-fat, and other small fat pockets exists in some practices. We are conservative on off-label use for areas where mistakes carry significant cosmetic risk — we will discuss any off-label consideration carefully and only proceed in clearly appropriate cases.
Are there side effects?
Common: significant swelling (1 to 2 weeks), bruising, mild numbness in the treated area (typically resolves over weeks), tenderness. Less common: hardness or lumps under the skin (typically self-resolve over weeks; massage helps). Rare but serious: marginal mandibular nerve injury (asymmetric smile) — almost always self-resolves over weeks; difficulty swallowing (transient). We use careful injection technique and a defined treatment template to minimize each.
Who should not get Kybella?
Patients who are pregnant or breastfeeding, who have active infection at the treatment area, who have bleeding disorders, who have prior surgery in the submental area that altered anatomy. Patients with significant submental fullness should also be evaluated for whether the fullness is fat (Kybella territory) or laxity/glandular issues (different approach). We screen carefully at consultation.
Patients come to us from across the peninsula.
Reviv Med Spa is at 31 S El Camino Real in Millbrae, California — easy to reach from across the Bay Area peninsula. Patients come to us from Burlingame, San Mateo, Hillsborough, San Bruno, Foster City, and the broader peninsula including Atherton, Belmont, Brisbane, Daly City, Half Moon Bay, Menlo Park, Pacifica, Palo Alto, Portola Valley, Redwood City, San Carlos, and South San Francisco. Off the 101, just south of SFO. Free parking on site.