Evaluate the safety and efficacy of subcutaneous fat layer reduction in the submental area using multiple therapeutic tools.

The Zeltiq CoolSculpting System and the sequential use of the injectable drug Kybella for non-invasive and then minimally invasive fat reduction in the submental area will be evaluated during the study.

Inclusion Criteria

• Male or female subjects > 22 years of age and < 65 years of age.
• Women of childbearing potential must have a negative urine pregnancy test result at screening and agree to practice adequate contraception.
• CR-SMFRS grade of 4 (extreme) as determined by the evaluating investigator at screening.
• Dissatisfaction with the submental area expressed by the subject as a rating of 0, 1 or 2 using the Subject Self Rating Scale (SSRS) as determined at Screening visit.
• History of stable body weight confirmed by the subject, for at least 6 months prior to the first treatment session.
• Subject agrees to maintain his/her weight (i.e., within 5%) by not making any major changes in their diet or exercise routine during the course of the study.
• Subject agrees to forgo any treatment or behavior (e.g., unshaven facial hair) during the subject's participation in the study that may affect the assessments of the submental area.
• Subject is medically able to undergo the administration of KYBELLA® determined after review of the subject's medical history for which the evaluating investigator identifies no clinically significant abnormality.
• Subject has read and signed the study written informed consent form.

Exclusion Criteria

• Body Mass Index ≥40 as determined at screening.
• Subject has excessive skin laxity, as determined by the evaluating investigator, in the neck or chin area or other anatomical feature (e.g., predominant subplatysmal fat, loose skin in the neck or chin area, prominent platysmal bands) for which reduction in the submental fat may result in an aesthetically unacceptable outcome.
• There is evidence of any cause of enlargement in the submental area (e.g., thyroid enlargement, cervical adenopathy) other than localized submental fat.
• Subject has a history of trauma associated with the chin or neck areas, which in the judgement of the investigator may affect evaluation of safety or efficacy of treatment.
• Subject has a history of treatment with CoolSculpting or KYBELLA® in the intended treatment area or has a history of any intervention to treat submental fat (e.g., liposuction, surgery, or lipolytic agents).
• Subject has a history of treatment with radiofrequency, micro-focused ultrasound, laser procedures, chemical peels, or dermal fillers in the neck or chin area within 12 months before the first treatment session.
• Subject has a history of treatment with botulinum toxin injections in the neck or chin area within 6 months before the first treatment session.
• Subject has a known history of cryoglobulinemia, cold urticaria, paroxysmal cold hemoglobinuria or cold agglutinin disease.
• Subject has a known history of Raynaud's disease, or any known condition with a response to cold exposure that limits blood flow to the skin.
• Subject has a history of facial nerve paresis or paralysis (such as Bell's palsy)
• Subject has a history or current symptoms of dysphagia.
• Subject has a history of prior neck surgery, or prior surgery in the area of intended treatment, or implant in or adjacent to the area of intended treatment.
• Subject has a history of sensitivity to any components of the KYBELLA® or to topical or local anesthetics (e.g., lidocaine, benzocaine, novocaine).
• Subject has a history of bleeding disorder or is taking any medication that in the investigator's opinion may increase the subject's risk of bruising.
• Subject is currently taking or has taken diet pills or weight control supplements within the past month.
• Subject has any dermatological conditions, such as scars in the location of the treatment area that may interfere with the treatment or evaluation.
• Subject has an active implanted device such as a pacemaker, defibrillator, or drug delivery system.
• Women of childbearing potential not using a reliable means of contraception.
• Subject is unable or unwilling to comply with the study requirements.
• Subject has received treatment with an investigational device or agent within 30 days before the subject's first treatment session.
• Any other condition or laboratory value that would, in the professional opinion of the investigator, potentially affect the subject's response or the integrity of the data or would pose an unacceptable risk to the subject.

Adverse event data were collected from the time of enrollment through the final 12-week post-treatment follow-up visit. The final follow-up visit timing was predicated on the number of Kybella treatment sessions each subject completed. The range for the final follow-up visit was from 28 to 31 weeks.