Comparison

CoolSculpting vs Kybella

CoolSculpting needs fewer visits, less swelling, and works on the body too. Kybella is a course of chin injections. Both give a moderate change.
Written & medically reviewed by the Dermapedia team
At a Glance

CoolSculpting is the easier choice for most double chins. One or two sessions, no needles, and swelling you can hide. It is also the only one of the two used anywhere else on the body. Kybella is a course of injections, for under the chin only. It suits a small or oddly shaped pad that a cooling cup cannot grip, and it usually takes three sessions with real swelling after each one.

CoolSculpting
Also called cryolipolysis, CoolSculpting Elite, fat freezing, CoolMini
Kybella
Also called deoxycholic acid, ATX-101, Belkyra
The applicator sits on the treatment area and cools the fat beneath it. The skin surface is protected.
Kybella is injected under the chin in a grid of small amounts.

What happens

A chilled cup holds the fat

The applicator suctions the pad under your chin against a cold plate and holds it there. Your body clears the damaged fat cells over the following weeks.

Up to 50 tiny injections

The injector marks a grid on the skin and puts a small amount into the fat at each point. The medicine breaks open the fat cell walls.

Where it can be used

Chin and body

Under the chin, plus the belly, flanks, arms, back, bra area and thighs.

Under the chin only

It is not meant to be used on other areas, and the maker says so plainly.

How many visits

Usually one or two

Spaced four to eight weeks apart.

Usually three, sometimes up to six

At least a month apart. Most people who respond do so by the third session.

What you look like afterwards

Red and firm, not obvious

The area is numb and slightly swollen. Most people go straight back to work.

Visibly swollen for days

Swelling under the chin is expected and is the whole point of the treatment. It settles over one to two weeks. Bruising and numbness are common.

How long until you see it

Six to twelve weeks
After the second or third session
Both
Both work by damaging fat cells and letting the body clear them, so neither shows anything useful in the first few weeks.

The main downside

Fat can rarely grow instead

Paradoxical adipose hyperplasia: months later the treated area becomes firmer and larger rather than smaller. It affects about 0.22% of people, roughly 1 in 455, and liposuction corrects it.

Temporary nerve irritation

About 4% of people in the trials got an uneven smile for a while, because a nerve near the jaw was irritated. Every case settled on its own. Numbness lasting past a month was common.

Cost

Priced per cycle

Under the chin usually needs one or two cycles.

Priced per vial, and per session

The total depends on how many vials each session takes and how many sessions you have, so ask for the price of a whole course.

The at-home or drugstore version

Freezer wraps are a different thing

A gel pack starts cold and warms up while you wear it. The clinic device holds one steady temperature for the whole session, and that is the part that damages the fat cell.

Nothing you can buy is the same

Creams and chin straps do not reach the fat pad. Fat-dissolving kits sold online are not the same product and have no set strength.

Who each suits

Best for
A clear pad under the chin with firm skin over it, or the same problem on the body.
The mindset
One or two visits, then wait.
Best for
A small or awkward pad that an applicator cannot grip well.
The mindset
Several rounds, a swollen week each time, and a moderate result.
CoolSculpting applicator placed on a person's abdomen.
The applicator sits on the treatment area and cools the fat beneath it. The skin surface is protected.
Gloved hands injecting under a person's chin.
Kybella is injected under the chin in a grid of small amounts.

They damage fat cells in two different ways

CoolSculpting uses cold: Fat cells are more easily harmed by low temperatures than skin, nerve or muscle, which is why a cold plate can thin a fat pad without hurting the skin above it.

Kybella uses a detergent: Deoxycholic acid is a substance the body already makes to break down fat from food. Injected into a fat pad, it breaks open the cell walls.

Both then rely on the same clean-up: Your body carries the broken-down fat away over weeks, which is why neither one shows a result at the appointment.

What the result actually looks like

Both give a moderate change, not a new jawline: In the Kybella trials, about 68% of people improved by one grade on a scale of chin fullness, against about 21% given a placebo injection. Fewer than one in five improved by two grades.

CoolSculpting results are described the same way: A thinner pad, a slightly cleaner line under the jaw, and a difference you see in photographs rather than in the mirror.

Neither one gives a surgical result: If the picture in your head is a sharp jaw and a flat neck, that is liposuction or a neck lift.

Fullness under the chin is not always fat

Some of it is skin: Loose skin under the chin does not shrink with either treatment, and removing the fat propping it up can make it look looser.

Some of it is muscle: Prominent bands running down the front of the neck are muscle, and no fat treatment touches them.

Some of it is bone and posture: A small or set-back jaw makes the area look full even when there is very little fat there. A good consultation checks all of this before selling you either treatment.

Before you book

Ask whether your fullness is fat, skin, muscle or jaw shape, and ask them to show you.

Ask for the price of a full course, not one session or one cycle.

For Kybella, say in advance if you take a blood thinner, have a bleeding disorder, or have ever had trouble swallowing.

Ask to see before and after photos taken in the same light and the same head position.

Related

Questions people ask

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Which works better for a double chin, CoolSculpting or Kybella?
Both give a moderate change and neither gives a jawline. CoolSculpting usually needs fewer visits and causes less visible swelling, so it is the easier option for most people.
Can Kybella be used on my stomach?
It is meant for under the chin only, and the maker says use elsewhere is not recommended. CoolSculpting is the one used on the belly, flanks, arms, back and thighs.
How swollen will I be after Kybella?
Swollen enough that people notice. Swelling under the chin is expected, is part of how the treatment works, and settles over one to two weeks. Bruising and numbness are common too.
How many sessions does each one need?
Under the chin, CoolSculpting is usually one or two cycles spaced four to eight weeks apart. Kybella is usually three sessions, at least a month apart, and sometimes up to six.
Does either one tighten the skin under my chin?
No. Both remove fat and leave the skin as they found it. If the skin is already loose, taking the fat out can make it look slightly looser.
Is the fat gone for good?
The fat cells destroyed by either treatment do not come back. The ones left behind can still enlarge, so the result depends on your weight staying steady.