I have had many patients recently coming in asking whether they need a mini-facelift or something non-invasive such as Kybella™. Both have their role and which one is right depends on each 
patient’s goals and anatomy.
Kybella™ is a new product from Allergan, the makers of Botox® and Juvederm®. Kybella™ is the first and only product to be FDA approved to treat sub-mental (under the chin) fat. It is composed of deoxycholic acid, a chemical that dissolves fat and is natural to our body (it is used in the GI tract to help digest fats). Kybella™ is injected over a series of sessions to improve the look of sub-mental fullness. Studies have shown excellent results with nearly 80 satisfaction and the results are long lasting. Treatments involve minimal discomfort and downtime is minimal, although patients may have some swelling for several days.
A facelift addresses fat deposits in the neck as well, typically via liposuction. In addition, a facelift will address excess skin and soft tissue along the jaw line and in the neck as well as platysmal (neck muscle) banding. While surgery does require more downtime, most patients are presentable with make-up by day 10. Discomfort, while more than with an injection, is typically far less than patients expect as the procedure does create some temporary numbness.
So the big advantages for Kybella™ is minimal downtime and no surgery. While Kybella™ may lead to some tissue tightening (we will have to see how much with long term studies). A facelift most definitely will address excess skin as well as tighten muscles.
In my view, Kybella™ is ideal for younger patients (early 40s and under) who have minimal skin excess and just focal sub-mental fat. Those patients who have excess skin or obvious platysmal bands will probably require a surgical approach to correct their issues.
All of this really depends on each patient’s anatomy, available time, and overall goals.