Cosmetic
Dermatology

Shrinkage of under chin area after one session of Kybella.
Results may vary for different people.

KYBELLA (DEOXYCHOLATE)

In 2015, the FDA approved Kybella (deoxycholate) as an injectable compound to shrink under the chin fullness and laxity. It is now more popular to treat the jowls and the bags under the eyes, than the under the chin area. Deoxycholate is a compound that our liver produces to be poured in the small intestine to break down, and digest fat. Prior to 2015, for many years, deoxycholate was injected by healthcare providers as mesotherapy to shrink fatty tissue in various parts of the body with no reported irreversible side effects. Deoxycholate has a very long safety profile.

Deoxycholate emulsifies (solubilizes) fat molecules. The cell wall of all of our cells contain fat. As you are aware, much of the content of fat cells is fat. When the cell membrane, and the content of the fat cells are disrupted, the fat cells die. The ensuing gathering of the immune cells to digest away the remnant of the damaged cells results in fibrosis, which means shrinkage clinically by substituting the fat cells with collagen fibers. The overlying skin does not form unsightly laxity or excess at all.

Kybella is FDA approved to be injected under the chin, where it is primarily populated with fat cells, and far from vital organs. Inadvertent injection, or diffusion of deoxycholate into non-fat cells, has not been reported to result in irreversible loss or damage.

WHAT IS INVOLVED IN KYBELLA TREATMENT?

The boundaries of where it would be safe to inject Kybella is drawn under the chin. Small amounts of the clear fluid that contains deoxycholate is injected about 1/4 of an inch deep from the surface of the skin, where it is populated with fat cells.

IS THE TREATMENT PAINFUL?

Shortly after the solution is introduced into the skin the patient feels a tolerable local heat sensation. Most patients can tolerate the procedure without prior lidocaine injection. If a patient requests, Dr. Silvers would inject the area with lidocaine beforehand. Placement of a cold pack eases the discomfort quite a bit. The heat sensation lasts for a few minutes. Thereafter, minimal to mild soreness is the most some patients report.

WHAT IS TO BE EXPECTED AFTER THE TREATMENT?

It is now believed among doctors that the recommended dose must be injected to be able to expect noticeable shrinkage of the fullness under he chin. Injection of the recommended dose results in marked swelling of the area for three days, and decreasing from then on. After a week, most, if not all, the patients are presentable, although the area still remains somewhat puffy over the first seven days after he injection. Patients are asked to massage the area daily on that first week after the treatment. Patients report a crackling feeling when they massage the area. No redness, discharge or wound is expected. The shrinkage will be noted in six to eight weeks, after six weeks of disappointment. In the great majority of cases, the shrinkage is not appreciable after the first session, unless when the before-and-after photographs are compared.

HOW LONG OF A GAP IS THERE SUPPOSED TO BE IN BETWEEN KYBELLA TREATMENTS?

When it has been a few weeks after a treatment session that the patient no longer notes any further change or shrinkage, which is usually about six to twelve weeks after a treatment, it would be time to repeat it. Only if the patient wishes to note further shrinkage of the site, another round of treatment can be done

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