Say No to Kybella and Yes to Lipo with Dr. Tanya Judge

No to Kybella, Dr Tanya Judge, Dr. Tanya Judge, San Francisco Plastic Surgery, Lipo, KatWalkSF, Kat Ensign

DISCLAIMER: there are some graphic photos at the end of the post

say no to kybella

If you are a long-time reader over here you may remember that I had two kybella treatments with a different plastic surgeon down in Palo Alto over three years ago. The surgeon originally suggested that I get at least three to five treatments but after two extremely painful treatments with long painful recoveries, I put the brakes on the treatment and decided to walk away.

Flash forward to today and I am cruising around San Francisco with a weird fat pocket on my chin and a ton of scar tissue from the two kybella treatments in 2017. This has been something that has bothered me for YEARS and something that shows up in nearly every blog photo.

If you take away anything from this blog post please let it be that I HIGHLY suggest that you SAY NO TO KYBELLA.

my virtual consultation with Dr. Judge

I did not meet Dr. Judge in person until the day of my procedure.

We had a virtual consultation via zoom a couple of weeks before my appointment. I ended up taking the zoom call outside on my patio with natural light and no makeup to ensure that Dr. Judge got a real look at me and any problem areas I wanted to show her.

From the moment Dr. Judge jumped on the call I felt like I was chatting with an old girlfriend. She made me feel very comfortable and listened to all of my concerns and previous treatments over the years (botox, kybella, and filler).

I was most impressed with the way she went about explaining everything to me. Not only was she able to come up with a treatment plan I would have NEVER even thought of, but she was also able to educate me on each step of the plan.

At the end of the call, I felt well educated on the treatment plan, excited, and ready to go!

Based on what I shared with Dr. Judge during our virtual consultation I asked her to share how she came about my treatment plan:

Creating a treatment plan is definitely individualized for each patient.  For you, you described the areas of your concern: forehead wrinkles and expressed concern over the fullness of the area below your chin that had not responded well to Kybella after two rounds.  You also mentioned that you did not have a great experience with under eye fillers and desired correction of these areas.  Based on the failure of traditional injectable treatments for the fullness under your chin and the creases under your eye, I needed to create a plan that did NOT involve fillers or kybella.

Doing the same thing and expecting different results is insanity.  So a more permanent solution to correct the failed kybella and under-eye hollows, I opted for liposuction and fat transfer.  This was logically the best way to give you the results you desired with predictability.

how to prepare for the surgery

My surgery wasn’t until the late afternoon so I had plenty of time to take a shower and to remove all make-up, and jewelry. They told me to plan to wear something comfortable like sweatpants and flat shoes, so I wore sweatpants and flat shoes. I went straight to bed when I got home, so I wore clothes that I could comfortably sleep in and my favorite super-soft Spanx bra.

Dr. Judge had me snag Vitamin C and oral Arnica tablets before the surgery.

Vitamin C is necessary to build and rebuild collagen throughout the body. Vitamin C is also a powerful antioxidant that supports the immune response. I took 500mg twice-daily three days before my surgery. On the day after surgery, I began to take Vitamin C twice daily for the next two weeks.

Arnica is most commonly used for pain caused by osteoarthritis, sore throat, surgery, and other conditions. Arnica is also used for bleeding, bruising, swelling after surgery, and other conditions. I started the Arnica a week before surgery and will continue it a week after my surgery.

Dr. Judge also recommends a low salt and high protein diet. The goal is to be healthy and immune boosted in a natural way.  Balancing your body before and after surgery is the best way to expedite your recovery.

my exact treatment

I asked Dr. Judge to describe my exact treatment ->

We did botox to your forehead and glabella which softens the use of the muscles of the area and as a byproduct, the skin overlying smoothens out.

We also did liposuction of the submentum (that’s the area under the chin that gives a double chin look) and then took that fat and placed it under your eyes to fill out the tear troughs (that’s the creases under the eyes).

Liposuction is a controlled method of fat removal that can guarantee your results.  I can feel and see all the fat that is being removed so you can know for sure that the results we expect are what we will achieve.

Fat cells don’t replicate, so whatever we get rid of is gone…you cannot get that big in that area again unless you go on an all cheesecake diet (if only).  Therefore liposuction is an ideal method of predictable fat removal.

Then, since we had that fat, we can inject it into those creases under your eyes to fill out the hollowing that gives us an aged appearance.  50-80% of the fat cells that we put in a new location will survive, and those that do…are there for life.  So now we have utilized your own natural tissues to correct a defect of age to keep you looking youthful.  And this treatment has the longevity you were hoping for.

my recovery

1.1.2020 update:

I am about a week out from my surgery and feeling really good. My surgery was last Monday at 4 pm and was home by 6:30 pm. I went straight to bed Monday night and woke up feeling good Tuesday morning. I have been managing pain with hydrocodone, ice, and arnica (topical and oral). The swelling around my chin is NOTHING compared to what I looked like after my kybella treatment. The area under my eyes has gone from purple to a light yellow/green color now and is honestly not too bad.

I am going to see Dr. Judge tomorrow morning and will continue to update this post as I continue my recovery.

Scroll down for all the photos from the surgery at the end of this post.

recovery essentials

Gucci Pursuit Fake/Not Slide Sandal, KatWalkSF, Kat Ensign, Gucci Not Fake Slides, Gucci Not Fake, Arnica, Arnica Gel, Arnica Tablets

San Francisco plastic surgeon Dr Tanya Judge talking KatWalkSF through her liposuction procedure.

Dr. Judge prepping me for the surgery and explaining every step of the procedure to me.

San Francisco plastic surgeon Dr Tanya Judge preparing KatWalkSF for her liposuction procedure, no to kybella

Dr. Judge, KatWalkSF, Say no to kybella, Valium, Lipo, San Francisco Plastic Surgery

When the valium hit. I was awake for the entire in-office procedure.

Dr Judge, Liposuction, San Francisco Plastic Surgeon, Kat Ensign, KatWalkSF

No to Kybella, Dr Judge, Liposuction, San Francisco Plastic Surgeon, Kat Ensign, KatWalkSF

No to Kybella, Dr Judge, Liposuction, San Francisco Plastic Surgeon, Kat Ensign, KatWalkSF

After Liposuction Surgery

After the surgery checking out my new chin for the first time…slightly frazzled but feeling good.

More before and after photos to come.

I have a video of the entire procedure, but I am still too afraid to watch it!

Before and after photos here


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  1. I too did kybella and deeply regret it!!! Was painful and expensive and I never saw a difference!!
    Thank you for sharing!!

    What is the rough cost of this treatment?

  2. I actually was really pleased with my Kybella treatment – I had 2 treatments (I don’t recall how many vials) and not only did it give me a chisled under-chin area, but the skin completely retracted and I’m in my late 40s. Everyone is different though…

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