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  • Tracy Spring


Goodbye double chin (and assorted other unwanted bulges)

Sometimes we have areas of stubborn fat that just won't budge no matter how much we diet and exercise. It used to be that liposuction was the only answer to these unwelcome bumps and bulges. But in 2015 the FDA approved Kybella, a non-surgical, injectable treatment for fat under the chin (also known as submental fat).

Allergen (the makers of Botox and Juvederm) developed the fat-dissolving injection. Once approved, Kybella began refining the jawlines of women and men alike. This extraordinary breakthrough has created quite the buzz in the relatively short time it has been available—and it begs the question: if an injection can dissolve the fat that gives someone a double chin, why can't it dissolve fat elsewhere on the body too?

How it works

Kybella is made from deoxycholic acid. It’s a salt found in human bile that aids in the digestion of fat. Just like in the digestive tract, Kybella breaks down fat cells by destroying the cell membrane.  The fat cells then clear into the lymphatic and circulatory systems over the next several weeks. The Kybella is metabolized, broken down, and excreted by the body as waste along with the fat.

Fat cells

The number of vials of Kybella required is usually between one and three, depending on the amount of submental fat a person has. Anywhere from two to four treatments (or visits) is necessary for optimal results. For most people, a single treatment consists of a minimum of about 20 injections. Your injector will give you a local anesthetic, or ice to help minimize any discomfort.

Treatments should be spaced at least one month apart. All told, it can take three to four months for your final, desired profile to materialize. As the body gradually metabolizes fat cells following treatment, new collagen also forms, helping tighten things up a bit.

Kybella permanently eliminates fat cells, so provided your weight remains stable your results should be permanent.

Image courtesy of Allergan

Side Effects

Some swelling is normal after having Kybella injected. Some patients experience an aching sensation under the chin which can be managed with Tylenol. Other common side effects include numbness, bruising, and firmness around the injection sites. All of these potential issues should resolve within a couple of weeks.  You can resume regular activity immediately after the injections. You should wait a day or two to exercise, but it’s okay to wash the area, and men may resume regular shaving habits.

Kybella vs. Liposuction

Due to the number of vials and the number of treatments usually needed, the cost of Kybella can sometimes end up exceeding the cost of liposuction. Many people are willing to pay slightly more to avoid going under the knife, however. Kybella is a quick and easy appointment that takes about twenty minutes. When it comes to results, it does require a bit of patience though. That “quick and easy appointment” may be required up to four times. After Kybella injections you can go back to work that very day though, while the same can’t be said for a surgical procedure. 

While Kybella is great at destroying fat cells, it can’t do anything about excess or loose skin. If you are someone for whom fat and excess skin is an issue, traditional liposuction allows the surgeon to do something about the excess skin while you’re under anesthesia. It’s also important to be sure that the fullness under the chin is actually fat and not something else (like lax skin). Dr. Pierone will assess your chin and jawline and suggest the right procedure for you.

Off-Label Use

Currently, Kybella is only approved for use underneath the chin, but practitioners are finding it works for sculpting other areas where fat accumulates. In addition to contouring the jawline, Kybella is used for the anterior abdomen, “love handles,” outer thighs, back fat, bra bulges, armpit fat, upper knee fat and the fatty folds under the butt.

“Off-label” use of a product refers to the use of a product in a manner beyond what it's approved for. For example, Botox is used off-label for many things, such as the treatment of excessive sweating. For off-label use of Kybella, the ideal patient should be close to their ideal body weight and be concerned with a small area of excess fat that they can’t eliminate through diet and exercise.

Photo credit: One Aesthetics, Winter Park, FL

The mechanism of action is simple. Kybella destroys fat cells. If it's successful at treating fat under the chin, shouldn’t it be able to get rid of fat everywhere? The answer isn’t quite so straightforward.

While deoxycholic acid destroys fat, it can also damage nerves and muscles if not injected judiciously and away from specific vital structures. This risk is why it's important to see someone who is board certified, experienced and reputable. It's also why some practitioners aren't yet comfortable using Kybella off-label. It isn't without risk, especially in the wrong hands.

Everyone Loves Kybella

Kybella has attracted a new group of consumers to the world of medical aesthetics, with almost half of patients so far citing their Kybella experience as their first time visiting an aesthetic physician’s office. Many men express that they wouldn’t have otherwise had an interest in cosmetic enhancements had it not been for the opportunity to sharpen their jawline.

Image courtesy of Allergan

hysicians appreciate the precision factor and the ability to refine with Kybella. Much in the same way a plastic surgeon can use fat grafting to add a little here or there, Kybella has made it possible to take away a little here or there, without surgery. For example, after a surgery like liposuction or breast reduction, a small area of excess fat can be refined using Kybella. This ability to fine tune things post-procedure can mean the difference between a good and great result.

Kybella has been an exciting development for patients and physicians alike. People could previously only dream of an injection that dissolves fat. What could possibly be next in the world of medical aesthetics?

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