Have you heard that there is a new non-surgical treatment to eliminate a double chin? It is an injection called Kybella. Kybella (deoxycholic acid) is a recently (April 2015) FDA approved drug to treat moderate to severe fat in the submental area or the so called “double chin.” Before considering, patients should be aware of the pros and cons of this new non-surgical procedure.

Deoxycholic acid is a naturally occurring molecule in the body that aids in the absorption and breakdown of dietary fat. However, when injected into the subcutaneous tissue – the fatty layer just under the skin – it will cause the lysis of adipocyte cells or simply the destruction and death of fat cells. The dead fat cells are then absorbed and removed from the body. Once these fatty cells have been removed they are permanently gone. This can all be accomplished by a series of injections in the double chin area. What makes Kybella exciting is it can accomplish what liposuction can accomplish without any surgery. The FDA has only cleared Kybella for use in the submental, or double chin, area. Any other uses of the drug is considered an off label application.

Kybella is packaged in vials. Most typical adults will require at least two vials of Kybella in a treatment session and this may need to be repeated in a couple of months or so. The actual treatment is very straightforward. The skin is cleaned and a temporary template is used to mark the injection site. A series of small injections are given and the drug begins working immediately as patients begin feeling a slight tingling or burning sensation. As Kybella is destroying fat cells inflammation occurs and this leads to swelling and some discomfort under the chin. Swelling may be significant for up to a week or two. Ice is applied after the treatment to help with the swelling and inflammation.

The best candidates are someone who has fat localized to the double chin area and has good skin elasticity. Although the treatment is very effective for eliminating fat it has little to no effect on tightening of the skin. A patient with lose skin of the neck would not be a good candidate and would require an actual tightening procedure such as a neck lift. However, in the properly selected patient, impressive results can be accomplished with no surgery. Your plastic surgeon will be able to tell you if Kybella is the treatment for you.

What are some of the potential side effects of Kybella? The most common side effects are swelling and slight pain or tenderness in injected areas. Also, temporary numbness, redness and hardness may occur. More serious side effects have also been reported to include nerve damage to facial muscles and muscles that aid in swallowing, however they were reported as temporary with a return back to normal in several months. These side effects are directly related to the injection site and placement of the drug. Knowing the potential risks should reinforce having the injection performed by a physician knowledgeable in injections and the neck anatomy.

Although Kybella is not the holy grail of treatment for the neck, it is a very nice addition to a plastic surgeon’s armamentarium to help treat the neck and especially the double chin. Now patients have another option available to choose from and this is especially exciting to those looking for a non-surgical procedure. Always remember to do your homework and seek consultation with a physician well versed in aesthetic non-surgical and surgical treatment options for the neck such as board certified plastic surgeon.


Mark A. Jabor, M.D., is an El Paso surgeon certified by the American Board of Plastic Surgery and the American Board of Otolaryngology. He practices at Cosmetic Surgery & Laser Centers of El Paso. For information visit www.elpasocosmeticsurgeon.com.

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