The long-term effect of Kybella use is fat reduction. That is the desired goal, and in properly selected patients the results are excellent. Our neck ages with both excess skin, fat, and muscle. Kybella addresses the fatty portion of that equation, there is some skin tightening that happens with it, but that is not dramatic when compared to surgical options, for instance. Satisfaction completely boils down to patient selection. Make sure you have an injector very familiar with the product and its abilities and outcomes.To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.Cameron Chesnut#realself500 Physician