For the late Nora Ephron, the neck was the ultimate age revealer. “Our faces are lies and our necks are the truth,” she quipped in I Feel Bad About My Neck: And Other Thoughts on Being a Woman. But the jawline can be just as revealing. As we age and gain weight, or simply thanks to our genetic blueprint, the whole area loses the taut and chiseled quality synonymous with youth. 

“After skin texture and discoloration problems, and lines around the eyes, excess fat under the chin and neck is the third most common issue we see in cosmetic dermatology,” says DC-based dermatologist Tina Alster. And submental fullness, the clinical term for what is commonly known as a double chin, can pose a problem even for people who are slender and fit. “A lot of people, even when they lose weight, can’t get rid of that collection of fat under the chin,” says Montclair, New Jersey, dermatologist Jeanine Downie.

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Could the FDA’s approval this spring of Kybella, a treatment that helps eliminate submental fat with nary a scalpel or lipo wand, mark the end of the double chin? Kybella relies on fat-dissolving injections, and while questionable forms of the treatment have been around in the U.S. and abroad for years, Kybella’s point of difference is that it uses only pure synthetic deoxycholic acid. This substance occurs naturally in the body; it’s made in the liver and stored in the gallbladder to help metabolize the fat we eat. “Kybella is a synthetic, nonhuman derivative of that,” Beverly Hills cosmetic dermatologist Howard Lancer explains. “When you inject it in pure form into tissue, it’s designed to dissolve the fat stored below the skin’s surface.”

It can take a lot of injections—according to the FDA news release, an average of 20 per treatment and as many as 50, with patients requiring two to six treatments to achieve the desired result. “The actual number is probably not as important as the placement of those injections, because there are some critical issues in  treating the neck,” Alster says. Because the treatment is focused on an area close to glands and nerves, and because Kybella also destroys the cell envelope around the fat pocket, the parent company, Kythera, is being fastidious about training doctors to use it properly and releasing it only to a choice few. For patients who want to be among the first to receive the treatment, Alster recommends using only a well-trained doctor. “Don’t go to some spa to get Kybella,” she says.

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There’s also a risk of bruising and swelling, something that can happen with any form of injectable. Even so, there’s far less recovery time with Kybella than there can be with more invasive procedures, like liposuction. In fact, Downie has stopped performing lipo on the area altogether. “Submental fat can be very fibrous, which makes it stubborn and difficult to wand out with liposuction. But Kybella is something you are injecting and having the same effect,” she says. Still, it’s not for everyone. The optimal candidate has a metabolically resistant fat pocket beneath the chin. It may not be for people who are significantly overweight or who have saggy or hanging skin. And while the results are permanent (the fat is destroyed and processed through the body), they’re not immediate. “It took some time to see noticeable results,” says Mary Ellen, a woman in her fifties. “I did have swelling. but it wasn’t so bad that I couldn’t mask it with a scarf. I don’t have any regrets.”

Since Kybella now bears the FDA stamp of approval as a fat melter, it does raise the question: If it works for your chin, can it work for other equally stubborn pockets, like bra-strap fat? While the FDA and doctors involved in the clinical trials caution against using it on non-recommended areas, Alster, for one, predicts that we’ll be seeing a lot of off-label use. And, she adds, “I’m going to be tester number one.”

This article originally appeared in the September 2015 issue of Town & Country.

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