What Is Injection Lipolysis?
Injection lipolysis is a nonsurgical procedure in which a series of injections under the skin breaks down fat cells near the injection sites. The name comes from "lipo" (fat) and "lysis" (breakdown).
In the United States, deoxycholic acid injection (brand name Kybella, plus an FDA-approved generic) is the only approved fat-dissolving injectable. It is approved only to improve moderate to severe fullness from fat under the chin, often called a double chin, in adults. The FDA recommends against using it anywhere else on the body.
Other fat-dissolving products sold online, such as Lipodissolve, Aqualyx and Kabelline, are not FDA approved. The FDA has received reports of permanent scars, serious infections and painful knots after these injections.
Injection Lipolysis at a Glance
| Also called | Fat-dissolving injections |
|---|---|
| What it treats | Moderate to severe fullness from fat under the chin (submental fat) in adults |
| Approved drug | Deoxycholic acid injection (Kybella and a generic) |
| How it works | Destroys fat cell membranes, so the cells break apart |
| How it's given | Up to 50 small injections under the chin per session, by a health care provider |
| Sessions | Usually 2, spaced 6 to 8 weeks apart (up to 6 allowed) |
| How long it lasts | Destroyed fat cells don't come back |
| Side effects | Swelling, bruising, pain and numbness. Usually no downtime. |
| FDA status | Approved in 2015 for fat under the chin only |
How Does Injection Lipolysis Work?
Injection lipolysis works by placing a drug directly into the fat layer under the skin, where it breaks fat cells apart. Deoxycholic acid physically destroys the fat cell's membrane, causing the cell to burst. The drug is similar to bile acid, which helps the body digest fat.
You keep the same number of fat cells whether you gain or lose weight. The cells expand with weight gain and shrink with weight loss. Because injection lipolysis destroys some fat cells, those cells are gone for good, though the remaining cells can still grow.
Who Is Injection Lipolysis For?
Injection lipolysis is for adults with a small pocket of chin fat that remains despite diet and exercise, and whose weight is normal for their height. The trials behind FDA approval enrolled healthy adults aged 19 to 65 with a BMI of 40 or less.
Your provider should first rule out other causes of chin fullness, such as an enlarged thyroid or swollen lymph nodes. Loose skin can lead to a less pleasing result.
What to Expect Before, During and After Injection Lipolysis
An injection lipolysis session is a series of small injections under the chin, and most people return to everyday activities right after.
- Before: share your health history and medicines, including blood thinners.
- During: ice or numbing medicine such as lidocaine may be used. The provider marks a grid and gives tiny injections spaced 1 cm apart.
- After: swelling, bruising and discomfort are common, and the area may feel firm or lumpy for a while. Some people are extremely swollen for up to 2 weeks.
Injection Lipolysis Results
Injection lipolysis results appear gradually, with the full effect usually 3 to 4 months after the last treatment. Results are subtler than with liposuction.
- In the REFINE-1 trial, 70.0% of treated adults had at least a 1-grade improvement in chin fat on both clinician and patient ratings 12 weeks after the last treatment, versus 18.6% on placebo.
- Among trial patients who improved, 82.4% of those treated with deoxycholic acid kept their improvement at 3 years, versus 65.0% on placebo.
Risks and Side Effects of Injection Lipolysis
Most injection lipolysis side effects occur at the injection site and are temporary, but serious problems can happen. In trials of 513 treated adults, the most common were swelling (87%), bruising (72%), pain (70%) and numbness (66%).
- Nerve injury: an uneven smile or facial weakness in 4%. All trial cases resolved without treatment.
- Trouble swallowing: 2%, resolving after a median of 3 days
- Skin problems: hair loss at the injection site, ulcers, tissue death (necrosis) and infection
- Nodules or masses: lumps that may not go away. In September 2026, the FDA added a label warning after identifying 117 cases of unresolved nodules or masses.
Use outside the chin has caused blurred or reduced vision and muscle or nerve injury.
Who Shouldn't Have Injection Lipolysis?
Injection lipolysis should not be given to anyone with an infection in the treatment area. Avoid it or use caution with:
- Current or past trouble swallowing (avoid)
- Bleeding problems, or taking antiplatelet or anticoagulant medicines
- Past surgery or cosmetic treatment of the chin area
- Children and teens (not recommended)
- Pregnancy or breastfeeding (not adequately studied)
Injection Lipolysis vs. Liposuction and Cryolipolysis
Injection lipolysis dissolves fat under the chin with injections, while liposuction is surgery that suctions fat out and cryolipolysis uses a device to freeze fat.
| Injection lipolysis | Tumescent liposuction | Cryolipolysis | |
|---|---|---|---|
| Method | Injected drug | Incision and suction tube | Cooling device |
| Areas | Under the chin | Almost any area | Belly, flanks, thighs, chin, upper arms and more |
| Sessions or setting | Usually 2 sessions | Office surgery while awake | Usually 2 sessions |
| Downtime | Usually none | A few days at home | Usually none |
| Full results | 3 to 4 months | Months | 3 to 6 months |
| Size of change | Subtle | More dramatic | Subtle |
Injection Lipolysis at GENEVA
At GENEVA Primary Care & Med Spa in Alpharetta, GA, a provider can evaluate whether injection lipolysis fits your concern about fullness under the chin and review your health history and medicines. Based on that evaluation, your provider will recommend treatment at GENEVA or a referral to a specialist.
If weight is part of your goal, ask about medical weight loss, or raise the concern at a primary care visit. GENEVA serves patients from Alpharetta, Johns Creek, Milton, Roswell and Cumming.
Related Terms
- Facial Contouring
- Non-Surgical Chin Augmentation
- Body Composition Analysis
- Body Mass Index (BMI)
- Cellulite
- GLP-1 Receptor Agonist
Injection Lipolysis FAQs
Is injection lipolysis safe?
Injection lipolysis with FDA-approved deoxycholic acid is generally well tolerated when a health care provider injects it under the chin, but side effects are common. In trials of 513 treated adults, 87% had swelling and 70% had pain, effects a meta-analysis found were mostly temporary. Nerve injury causing an uneven smile occurred in 4%, and all trial cases resolved without treatment. Avoid unapproved products sold online, which have been reported to cause scars, serious infections and painful knots.
Can injection lipolysis be used on the stomach, thighs or arms?
No, injection lipolysis is not FDA approved for the stomach, thighs, arms or back. Deoxycholic acid is approved only for fat under the chin in adults, and the FDA recommends against other uses. Since 2015, the FDA has identified 129 adverse event cases from use outside the chin, including vision problems and nerve injury. Products marketed online for body fat are unapproved. For other areas, ask about FDA-approved fat-reduction devices or liposuction.
How many injection lipolysis treatments are needed?
Most people need about 2 injection lipolysis sessions, spaced 6 to 8 weeks apart, according to the American Academy of Dermatology. The FDA label allows up to 6 sessions, at least 1 month apart. In the REFINE-1 trial, 55% of treated adults had at least a 1-grade improvement in chin fat after 2 treatments and 75% after 4. Your provider re-evaluates you a few weeks to a month after the first treatment.
Are injection lipolysis results permanent?
Yes, the fat cells destroyed by injection lipolysis are gone permanently, although the remaining fat cells can still grow. You keep the same number of fat cells as your weight changes, and those cells expand with weight gain. In a follow-up of trial patients who improved, 82.4% of those treated with deoxycholic acid kept their improvement at 3 years, compared with 65.0% on placebo. If you gain weight, you'll still see less fat in the treated area.
How long does swelling last after injection lipolysis?
Swelling is the most common side effect of injection lipolysis, and some people are extremely swollen for as long as 2 weeks. In clinical trials, 87% of treated adults had swelling, and it lasted more than 30 days in 20%. Numbness lasted more than 30 days in 42%. Most people can still go about normal activities. Contact your provider promptly about trouble swallowing, an uneven smile or an open sore.
What is the difference between injection lipolysis and liposuction?
Injection lipolysis destroys fat with injections and no incision, while liposuction is surgery that suctions fat out through a thin tube. Liposuction gives more dramatic results and can reshape many areas, but most people need a few days at home to recover. Injection lipolysis is approved only for fat under the chin, gives subtle results that peak 3 to 4 months after the last session, and usually has no downtime. Liposuction is not meant for weight loss.
Can a primary care provider help with injection lipolysis?
Yes, a primary care provider can evaluate whether injection lipolysis makes sense for you and check for other causes of fullness under the chin, such as an enlarged thyroid or swollen lymph nodes. At GENEVA in Alpharetta, a provider reviews your health history, medicines and goals, then recommends treatment at GENEVA or a referral to a specialist. Mention any trouble swallowing, bleeding problems, blood thinners or past chin procedures, because each affects safety.