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Kybella Will Get Rid of Double Chin Permanently Without Surgery

One of the most common nuisances patients express is the double chin, or fat under your chin.  With the exploding popularity of selfies, more and more people are becoming more self-conscious about this distracting feature.  People compensate by adjusting their poses, or even try not to take photos or selfies anymore—which really doesn’t solve the problem.  Having submental liposis (the medical term for this finding) doesn’t necessarily mean one is fat or overweight either.  Many non overweight people have collection of fat under their chin—it’s just genetics.  In the past, the only way to address this was with surgery, either with liposuction or direct removal (lipectomy).  While the surgery is simple and same, still many patients are hesitant to have surgery.  However, recently, the Food & Drug Administration (FDA) approved the first and only non-surgical technique to permanently destroy the fat cells under your chin.  This treatment is called Kybella.

Kybella (or deoxycholic acid) is a naturally occurring chemical that destroys fat cells.  It was developed by Kythera, a company that conducted excellent trials  proving the efficacy and safety of Kybella.  In the trials, they demonstrated that 60-70% of patients achieved statistically significant reduction of the submental fat, as measured by MRI scans, as well as objective photo analyses by BOTH patient and doctor.  The criteria were strict by design, but the researchers found that when they defined success as EITHER patient or doctor deciding there was reduction, the success rate approached 90%!  Shortly after the launch of Kybella, Kythera was purchased by Allergan, a leader in cosmetic injectables and maker of Botox.

Kybella requires a series of injections into the submental area.  The injections are dictated by a proprietary mapping grid system developed by Kythera.  The map is basically a dissolvable tattoo pattern that helps the doctor calculate how many vials or ml of Kybella to inject.  The dots also guide the doctor where to inject.  The treatment does require a series of injections, which are spaced 6 weeks apart.  In the trials, the researchers found patients required anywhere from two to six sessions, with most requiring four sessions before achieving success.  I have found this to be true in my practice.  One should also realize that the endpoint is dictated by collaboration between the patient and doctor.  Once the patient and doctor determine the submental fat is reduced enough, the treatment is done.  The best candidates are patients with moderate to moderately severe submental fat.

The treatments are safe, with minimal side effects or complications.  The most common adverse reactions are temporary pain, swelling, and firmness.  Bruising may also occur.  One should also expect some degree of redness afterwards.  In the trials, there were a handful of temporary weakness of the marginal mandibular nerve—but this can be almost eliminated if the doctor stays away from the “danger zone.”  Some patients experienced dysphagia (or trouble swallowing).  This is due to the swelling of the submental area that caused sensation of dysphagia, and not really due to direct injury to the esophagus.  In the trials, ALL the adverse reactions resolved.  The downtime is very acceptable.  Many will develop noticeable swelling the day or two afterwards, which will progressively resolve.  There is no restriction to activity.  One interesting finding during the trials was the interest of men to undergo this treatment.  This may be related to men’s higher disinterest in surgery.  A nice thing about the recovery is one can work out the next day, or even go play a round of golf.

Eliminating the double chin is becoming more popular as people take selfies with their smart phones.  In the past, the only available option was surgery. Today, Kybella offers those patients who don’t like surgery a non-surgical procedure that can permanently destroy fat cells with minimal downtime.