Skip to content Kybella is an FDA-approved injectable treatment that contains deoxycholic acid, a naturally occurring molecule in the body. It is used to reduce excess fat under the chin, also known as submental fat or a double chin.
Kybella works by destroying fat cells in the treated area. Deoxycholic acid breaks down the fat cell membrane, and the destroyed fat cells are then naturally eliminated by the body over time.
Kybella is specifically designed for reducing submental fat, making it an effective treatment for improving the appearance of a double chin.
The number of treatments varies depending on the individual’s anatomy and the desired results. Most people undergo a series of two to four treatments spaced about one month apart.
Results are typically visible within a few weeks to a month after each treatment, as the body gradually eliminates the destroyed fat cells.
Kybella is not a weight loss treatment. It is specifically designed to target and reduce localized fat deposits under the chin.
Discomfort is usually minimal. The healthcare professional may use a topical anesthetic or ice to numb the area before the injections.
Common side effects include swelling, bruising, pain, numbness, redness, and areas of hardness in the treatment area. Most side effects are temporary and resolve on their own.
Downtime is generally minimal. However, some swelling and bruising can occur, and individuals may choose to take it easy for a day or two after the procedure.
The results can be long-lasting, as the treated fat cells are permanently destroyed. However, maintaining a healthy lifestyle is essential to prevent new fat accumulation.
Good candidates are individuals with moderate to severe submental fat who want to improve the appearance of their double chin without undergoing surgery.
Kybella can be used as a standalone treatment or in combination with other cosmetic procedures, such as facial fillers or Botox, depending on individual goals.
Per vial: $450 / $400 CC
2-4 vials per session; 2-6 sessions needed.
The purpose of this consent form is to provide written information regarding the risks, benefits and alternatives of treatment with Kybella. This material serves as a supplement to the discussion you have with your Crawford Cosmetics provider. It’s important that you fully understand this material, so please read this information thoroughly. If you have any questions regarding the procedure, ask your Crawford Cosmetics provider prior to signing this consent form.
TREATMENT GOALS AND DESCRIPTION OF PROCEDURE Kybella (deoxycholic acid) injections are indicated for improvement in the appearance of moderate to severe fullness below the chin (submental fat) in adults. Kybella is a cytolytic drug, which when injected into tissue physically destroys the cell membrane causing lysis. Your provider will inject small 0.2 cc amounts of Kybella into the target area, using up to 50 injections during a single treatment. This procedure is not a treatment for obesity or a weight-loss solution. The treated area may develop swelling, tenderness, numbness or bruising in the days and weeks following treatment. These are normal reactions that typically resolve within days to weeks.
TREATMENT RESULTS Most patients are pleased with the results of their Kybella treatment. However, like any aesthetic procedure, there is no guarantee that you will be completely satisfied. There is no guarantee that the treated fat area will disappear completely, or that you will not require additional treatment to achieve the results you seek. Multiple treatments are usually needed to achieve a full effect, with a usual recommendation of 2-6 treatments, spaced about 4 weeks apart. The results of treatment are dependent on many factors including but not limited to: age, tissue conditions, and your general health and lifestyle conditions. Results may be visible as early as 3 weeks after your Kybella procedure, and you will experience the most dramatic results after 2-4 months. Your body will continue to naturally process the treated fat cells from your body for a few months after your procedure. Although highly unlikely, it is possible that you will not achieve any noticeable result from the procedure.
AFTERCARE INSTRUCTIONS Following your Kybella procedure, we’ll provide you with verbal and/or written aftercare instructions. These include, but may not be limited to the following: 1) You may resume normal activities immediately following the procedure; 2) Okay to apply ice and take Tylenol, NSAIDs, or oral arnica for post treatment discomfort; 3) You may experience temporary pain, redness, swelling, or bruising for up to 4-6 weeks; 4) You may experience temporary numbness in the treated area, which can last up to 6 weeks; 4) In rare cases, you may experience open sores, ulcers, drainage or damage around the injection site in which case you should notify your Crawford Cosmetics provider; 6) If at any time you suspect you’re having an unexpected side effect, adverse reaction or complication, contact us immediately, and obtain help in an appropriate medical setting (i.e. Crawford Cosmetics, your primary care provider, specialist, urgent care, or acute care facility). I will adhere to the aftercare instructions supplied to me during my visit.
POTENTIAL RISKS AND COMPLICATIONS Before undergoing this procedure, understanding the risks is essential. The following risks may occur, but there may be unforeseen risks and risks that are not included on this list. Some of these risks, if they occur, may necessitate hospitalization, and/or extended outpatient therapy. I understand that there are certain inherent and potential risks and side effects in any procedure, and in this specific instance such risks include but are not limited to: 1) Injection site reactions, including edema/swelling, hematoma/bruising, pain, numbness, erythema, induration, paresthesia, nodule formation, pruritus, and skin tightness; 2) Dysphagia, or difficulty swallowing; 3) Nerve injury, including marginal mandibular nerve injury which may temporarily paralyze muscles around the mouth area ; 4) Injury to nearby anatomic structures, such as lymph nodes, salivary glands and muscles; 5) Injection site alopecia; 6) Injection site ulceration and necrosis. In rare cases, surgical intervention may be required to address these problems.
PREGNANCY AND CONTRAINDICATED CONDITIONS I am not aware that I am pregnant. I am not trying to get pregnant. I am not lactating (nursing). I do not have any major illnesses which would prohibit me from receiving Kybella. I do not have multiple allergies or high sensitivity to medications, including lidocaine.). I have notified my Crawford Cosmetics provider of any previous or planned surgical procedures to the face, neck , chin or other area to be treated. I do not have any difficulty swallowing or any bleeding problems. I am not on anticoagulants or antiplatelet medications . I do not have any known sensitivity to Kybella. I do not have an infection in the treatment area.
ALTERNATIVE THERAPY I understand that this is an elective procedure with the goal of improved aesthetic appearance and that the main alternative to therapy is to observe and not receive any treatment. Other therapies for fat reduction might include cryolipolysis or surgical liposuction.
PAYMENT I understand that this service is not covered by insurance, and payment is my responsibility and is expected at the time of treatment.
RIGHT TO DISCONTINUE TREATMENT I understand that I have the right to discontinue treatment at any time during the procedure.
RELEASE OF LIABILITY I hereby indemnify Crawford Cosmetics, PLLC from any liability relating to the procedures that I have volunteered for. I understand that any treatment performed is between me and the doctor/healthcare provider who is treating me and I will direct all post-treatment questions or concerns to the treating clinician. Furthermore, I hereby indemnify the facility/meeting room/hotel where this treatment is being performed from any liability relating to the procedures that I have volunteered for.
CONSENT TO TREATMENT I hereby voluntarily consent to treatment with Kybella for the purpose of fat reduction in the submental area, or other planned area, as performed by my Crawford Cosmetics provider, and assistant technicians. I have read the above and understand it. I state that I read and write in English. I am not under the influence of drugs or alcohol. The treatment has been fully explained to me and my questions have been answered satisfactorily. I accept the risks and complications of this elective procedure and I understand that no guarantees are implied as to the outcome of the procedure. Please note this consent is valid for all future Kybella treatments I choose to receive from Crawford Cosmetics.
KYBELLA® is an FDA-approved injectable treatment for the permanent spot reduction of fat, deoxycholic acid, a naturally-occurring molecule in the body that aids in the breakdown and absorption of dietary fat. The procedure involves injections of standardized ingredients into the subcutaneous fatty layer below the surface of the skin. KYBELLA is a safe and effective treatment for reducing pockets of subcutaneous fat.
Schedule your Kybella appointment at least 2-4 weeks prior to a special event which you may be attending, such as a wedding or a vacation. Swelling does occur in the majority of people who receive Kybella injections, but this should subside within 4 weeks.
Be sure to have a good breakfast, including food and drink before your procedure. This will decrease the chances of lightheadedness during your treatment.
Avoid the use of Aspirin, NSAIDS, Ginko Biloba, Garlic Supplements, Green Tea, Flax Oil, Cod Liver Oil, Vitamins A and E, and essential fatty acids for up to 1 week pre injection as they will increase your risk of bruising.
Do not drink alcoholic beverages 24 hours before your treatment to avoid extra bruising.
You may take Arnica tablets 2-3 days prior to your injection to reduce the risk of bruising.
Do not use Kybella if you are pregnant or breastfeeding, are allergic to any of its ingredients, or have had any recent surgeries to the treatment area. Please inform your provider if you have any questions about this prior to the treatment.
Arrive with a clean face. Please do not wear makeup.
You may experience a mild amount of tenderness or stinging during and following injection.
Redness, swelling, firmness/ hardness and bruises are common post procedure occurrences, the sensation of burning/stinging that occurs with the procedure generally resolves within the first day. Soreness, swelling and firmness tend to gradually decrease 1-4 weeks following procedure.
No use of steroids or other anti-inflammatory medications (aspirin, Tylenol, Advil, Aleve etc.) for 48 hours following treatment, to reduce the risk of bruising.
Avoid exercising and eating salty foods for 48 hours following procedure, to reduce excess swelling.
You may sleep with your head propped up on a pillow or two for the first few days following procedure to aid in reduction of swelling.
Ice may be applied to the area to reduce discomfort, best to ice no longer than 2-5 minutes at a time to avoid freezing the tissues. May ice several times daily as needed.
You may take Tylenol for discomfort.
Use Arnica Montana gel/cream, as directed, to reduce the appearance of a bruise.
Remember to schedule your next appointment in 4-8 weeks. Kybella requires 2-6 sessions for optimal treatment.
For any questions or concerns please contact your Crawford Cosmetics provider. For serious side effects, such as symptoms of an allergic reaction, please call 911 or go to the nearest emergency room.
Our goal is to provide quality aesthetic treatments to all our clients in a timely manner. No-shows, late arrivals, and cancellations inconvenience not only our providers, but our other clients as well. Please be aware of our policy regarding missed appointments. Your appointments and well-being are very important to us. We understand that sometimes unexpected issues arise.
Our policy enforces a late cancellation fee for cancellations made with less than a 72-hour notice. It is important to understand that you will forfeit your deposit for any appointment cancelled inside the 72-hour cancellation window. If you no call/no show, in addition to forfeiting your deposit, you will be charged a fee of $100. We take No call/No shows very seriously. We make all efforts to avoid these fees for you by sending multiple texts and email reminders that allow ample time to cancel or reschedule your appt with us.
When you book your appointment, you are holding a space on our calendar that is no longer available to our other clients. To hold this appointment, we require a credit card on file, and partially refundable $75 deposit for appointments under 30 mins ($67.50 will be refunded), and $200 partially refundable deposit for appointments over 30 mins ($180 will be refunded). Shorter appointments with our estheticians require a smaller deposit and are partially refundable. Other appointment deposits many vary. The deposit will be applied toward the cost of your treatment and is partially refundable if you do not receive treatment at the time of your appointment. In order to be respectful of your fellow clients, please notify your Crawford Cosmetics provider as soon as you know you will not be able to make your appointment.
Please note, if you are more then 10 minutes late for your scheduled appointment, your appointment will be automatically cancelled, you will lose your deposit, and will be charged the additional no show fee of $100.
If cancellation is necessary, we require that you call, text, or cancel online at least 72 hours in advance. Appointments are in high demand, and your advanced notice will allow another client access to that appointment time. As we are closed over the weekend, if you have a Monday appointment, we require that you cancel the Wednesday before by 5pm. If you have a Tuesday appointment, we require that you cancel the Thursday before by 5pm at the latest. Appointments are in high demand, and your advanced notice will allow another client access to that appointment time.
If you need to cancel your appointment and are enrolled in text message reminders, you can reply “no” to the reminder text that you will receive 4 days prior to the appointment. Other options are: cancel online, call or text the scheduling line, Port Huron (248) 285-9876 or Royal Oak (248) 221-1895, during regular business hours, or text your Crawford Cosmetics provider. If necessary, please leave a detailed voicemail message and we will return your call as soon as possible. Please note, if you cancel your appointment through our automatic text message reminder or online, you must reach out to us for the refund, as is not returned automatically and remains on file unless a refund is requested.
A cancellation is considered late when the appointment is cancelled with less than 72 hours’ notice. A no-show is when a client misses an appointment without cancelling.
It is important to understand that you will forfeit your deposit for any appointment cancelled inside the 72hour cancellation window. If you no call/no show, in addition to forfeiting your deposit, you will be charged a fee of $100. These fees will automatically be applied to the credit card on file. If the credit card is rejected, any fee that is owed must be paid in full prior to booking any future appointments.
I confirm that I have read, understand and agree to the above policy.
Port Huron
Royal Oak
