Kybella
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Kybella vs Lipodissolve
Kybella is the pick if you want a known quantity. It is a lab-made deoxycholic acid, injected under the chin to break down a pad of fat. It has a set dose, a label and a counted list of side effects. Lipodissolve is the older practice it grew out of: a mixed-to-order shot of phosphatidylcholine and deoxycholate, approved by no regulator and backed by much smaller studies.
At a glance
| The difference | Kybella | Lipodissolve |
|---|---|---|
| Cost | Per vial, per session, out of pocket | Per session, and it varies by clinic |
Lipodissolve
A course of shots, recipe varies A mixture made up for the appointment. Lipodissolve is phosphatidylcholine (PC) and deoxycholate (DC), mixed by a compounding pharmacy and injected into the fat under the skin. There is no single recipe and no maker standing behind one. It is also called injection lipolysis.
Side by side
The differences that matter
What you actually do
Kybella
A course of shots under the chin
A prescription injection that breaks down fat under the chin. The active ingredient is deoxycholic acid, a lab-made copy of a substance your body already uses on fat. Your provider marks a grid on the skin and injects each square. Most people need 2 to 4 sessions, a month apart.
Lipodissolve
A course of shots, recipe varies
A mixture made up for the appointment. Lipodissolve is phosphatidylcholine (PC) and deoxycholate (DC), mixed by a compounding pharmacy and injected into the fat under the skin. There is no single recipe and no maker standing behind one. It is also called injection lipolysis.
How it works
Kybella
It breaks open fat cells
It works like a detergent. Kybella breaks open the wall of the fat cell. Tissue samples show fat cells breaking down within a day. Immune cells clear the debris over the next week, and the swelling mostly settles by day 28.
Lipodissolve
The same damage, from the DC in it
The same detergent damage, from the DC. Deoxycholate is the part doing the work in both treatments. A laboratory study found the PC product and deoxycholate alone damaged cells to a similar degree. It named deoxycholate the major active part. That is why Kybella has no PC in it.
What you can expect to see
Kybella
A moderate change over several rounds
Most people improved. In two trials of 1,022 people, 68% looked better to both their doctor and themselves, versus 21% on placebo.
Big changes were less common. 16% improved by two grades, versus 1.5% on placebo. Scans showed the fat under the chin shrank by at least 10% in 43% of treated people, versus 5%.
The result seems to hold. In a follow-up study, 82% still had their improvement 3 years later. But it only included people who had already responded, and the drug's maker paid for and ran it.
Lipodissolve
Small studies, and a small effect
The studies are small, and so was the effect. The largest trial under the chin enrolled 42 people. It called the improvement minimal, with or without the PC.
Adding PC made no measurable difference. A trial in 37 women treated one side with the mixture and the other with deoxycholate alone. Fat fell on both sides, with no real difference.
More photographs
Kybella
How long before you see anything
Kybella
Most respond within 2 to 4 sessions
Expect a few visits, at least a month apart. The label allows up to six sessions. In the trials, most people improved a grade within 2 to 4 sessions, and 59% went through all six.
Lipodissolve
No agreed schedule
There is no agreed schedule. Published protocols differ. Some used five treatments four weeks apart, others four treatments eight weeks apart.
The downside
Kybella
Swelling, bruising, pain, numbness
Swelling and bruising are the norm. Among 513 people treated in the trials: swelling 87%, bruising 72%, pain 70%, numbness 66%.
Some of it lasts past the first month. After 30 days, 42% still had numbness and 20% still had swelling. Firmness affected 23%.
Nerve injury happened in 4%. It shows up as an uneven smile or weakness in the face. Every case in the trials cleared up on its own, after 44 days on average.
Plan for some time off. In one study, 13% of people missed work after the first session, about a day.
Lipodissolve
Swelling, redness, pain, firmness
The studies report swelling, redness, pain and firmness. There is no side-effect table, because there is no standard recipe.
The reported list is longer. Plastic surgeons also list bruising, itching, pigment change and numbness, plus rarer problems such as abscesses, ulcers, nerve injury and infection.
Cost
Kybella
Per vial, per session, out of pocket
You pay per vial, per session, out of your own pocket. Budget for a course of 2 to 4 sessions rather than one visit.
Lipodissolve
Per session, and it varies by clinic
There is no standard product, so there is no standard price. It depends on the mixture the clinic makes up and how many sessions it plans.
Who tends to be happy with it
Kybella
- Best for — A defined pad of fat under the chin, with firm skin over it.
- The mindset — Several rounds, real swelling for a week or two, and a moderate result.
Lipodissolve
- Best for — Hard to answer honestly. The mixture varies, and professional bodies do not recommend routine use.
- The mindset — The strength, schedule and risk all come from the injector.
What the FDA has said
Lipodissolve
Lipodissolve has never been approved for anything. In 2010 the FDA sent seven warning letters over its marketing. Sellers had no support for claims of an outstanding safety record, or of better results than liposuction.
The fine print
Kybella
Kybella is synthetic deoxycholic acid at 10 mg/mL in a 2 mL single-patient vial. It was developed as ATX-101 by Kythera Biopharmaceuticals, later acquired by Allergan, and is now distributed by AbbVie. The FDA approved it on 29 April 2015 under NDA 206333. Label last revised October 2024.
The approved use is "improvement in the appearance of moderate to severe convexity or fullness associated with submental fat in adults." Use outside the submental region "has not been established and is not recommended." A session allows up to 50 injections of 0.2 mL, 1 cm apart, to a maximum of 10 mL. Sessions run at least a month apart, up to six.
Lipodissolve
There is no FDA-approved lipodissolve product for any body area, and no standard formulation. The FDA's consumer page, content current as of December 2023, names it among unapproved fat-dissolving injections.
Common questions
Questions Patients Ask
Is Kybella just lipodissolve with a brand name?
No, though they are related. Lipodissolve is a mixture of phosphatidylcholine and deoxycholate, mixed locally, with no FDA approval and no standard recipe. Kybella is man-made deoxycholic acid alone, at 10 mg/mL. It was approved on 29 April 2015 under NDA 206333, with a fixed dosing table and a side-effect table from 513 treated people. Kybella exists because lab work showed the deoxycholate was the part doing the work.
Why did lipodissolve get warning letters?
Because of what was being claimed for it. On 7 April 2010 the FDA sent seven letters, six to US medical spas and one to a Brazilian company. It cited unsupported claims that the products were safe and worked for removing fat, that they beat liposuction, and that they could treat male breast enlargement, lipomas and surgical deformities. The agency also said it had documented permanent scarring, skin deformation and deep painful knots under the skin at injection sites.
Is lipodissolve banned in the United States?
Not banned, but not approved either. There is no FDA-approved lipodissolve product, and FDA's current consumer page names it among unapproved fat-dissolving injections. The American Society of Plastic Surgeons' 2019 position is that mixing phosphatidylcholine and deoxycholate makes a new drug that is not approved for any purpose. That puts compounding it under sections 503A and 503B of the federal drug law, rather than in the category of off-label prescribing.
Does lipodissolve work at all?
The published studies suggest something happens, and that the deoxycholate is responsible for most of it. What they do not show is a large or reliable effect. The biggest submental trial, in 42 people, called the improvement minimal. The most-cited abdominal trial enrolled 13 people and 7 finished. The professional body's summary is that most uses rest on low-level evidence, with no standard recipe, dose or protocol.
Can I use Kybella somewhere other than under my chin?
That is off-label use, and the label says so unusually directly. Use outside the submental region "has not been established and is not recommended." Two systematic reviews of deoxycholic acid outside the chin found only about ten to eleven cosmetic studies between them. Almost all were uncontrolled case series and case reports. Both reviews concluded that the recommendations for off-label use are weak.
Which one has more downtime?
Kybella's downtime is the better documented of the two, not necessarily the shorter. Swelling affected 87% of people in the trials, with a median of around 10 to 11 days. Numbness affected 66%, with a median of 43 days. In a real-world series of 165 people, 13.3% missed work in the week after their first session. For lipodissolve there is no side-effect table for any recipe, so nobody can quote you a comparable figure.
Was lipodissolve ever tested against Kybella?
No. There is no published head-to-head trial of branded Kybella against a compounded phosphatidylcholine-deoxycholate mixture. The nearest comparisons are two randomised trials that tested deoxycholate alone against the mixture. Both found no meaningful difference. That is an argument about the recipe, not a comparison with the approved drug.
Safety to keep in mind
The FDA also listed harms it had heard about. Those were permanent scarring, skin deformation, and deep painful knots under the skin. It still lists lipodissolve as unapproved.