Is Kybella™ the best double chin treatment?

Amiya Prasad M.D. Dr. Prasad's Blog

Kybella™ may be the hottest buzzword in cosmetic medicine since Botox®. The drug that holds promise in treating double chins non-surgically just gained FDA approval this month.

Kybella trial results

Pre-FDA approval trial results of Kybella™ double chin (submental fat) injectable drug treatment by Kythera Biopharmaceuticals. Images courtesy of Kythera Biopharmaceuticals.

Kybella™ is applied in a series of injections to reduce the fat that causes double chins called submental fat. Kybella™’s active ingredient is deoxycholic acid. Currently, the standard treatment for submental fat involves liposuction/liposculpture, which is perceived as a more invasive procedure. It is however it’s well established that liposuction for submental fat is a precise, predictable and fast procedure.

Diet and Exercise Should be First for Submental Fat Kybella™

Addressing submental fat, or double chins, may not require any medical intervention at all as the undesirable fat can be improved through diet and exercise. As a health advocate and a cosmetic surgeon, I encourage my patients who are dealing with unwanted fat and are not within 10 pounds of their ideal body weight to first manage their diet before undergoing any fat sculpting procedure. Submental fat can be a genetic trait which responds minimally to diet and exercise. I’ve performed liposculpture for fitness models, runners and personal trainers.

A Little Fat is Your Friend

Maintaining a youthful look always means maintaining a small layer of fat underneath the skin of the face. A little fat right under the skin creates youthful, healthy volume. Fat also contains adult stem cells that are important for cell renewal and collagen generation. If fat under the chin is aggressively removed through liposuction, Kybella™, or even extreme weight loss, the lost volume can result in wrinkling and rippling of the skin which will appear more aged. Patients and doctors should be aware of maintaining a small layer fat for best results. Whether or not a small layer of fat can be maintained as precisely with Kybella™ injections compared to liposculpture remains to be seen.

Choosing a Facial Specialist for Kybella™ Treatment

Since liposuction continues to be one of the top cosmetic procedures, there’s no question that Kybella™ will gain immense popularity across the US and the world, and many doctors will be cashing in. While it does say that Kybella™ will only be used by licensed dermatologists and cosmetic surgeons, the drug will be in the hands of any doctor who wants to use it. With an American Society of Dermatologic Surgery survey stating that 68% of patients think double chins are a primary concern, many doctors, qualified or otherwise, will want to tap this market. I caution those thinking about Kybella™ treatment to seek it through a specialist who has extensive experience with the face, cosmetic surgery, and liposuction. As a surgeon who routinely performs procedures under the chin such as platysmaplasty, I know this anatomy very well. I am confident that my knowledge and direct experience below the skin as compared to non surgeons such as many dermatologists who only do injections is advantageous for patients who want to try this injection. Thus far, the promised effect of Kybella™ on double chins has already been successfully performed with liposuction. Doctors with extensive experience in facial surgical procedures can better manage issues with double chin treatment with Kybella™ as the familiarity with this space is already well established. There will be many doctors jumping on the Kybella bandwagon who will not have the experience to manage problems. There was drug with similar objectives called LipoDissolve® which had to be discontinued for many reasons including problems with irregularities and lumps created by doctors who don’t perform liposuction or other cosmetic surgeries.

Convenience: Multiple Kybella™ Sessions or One Lipo Session

One of the potential drawbacks of Kybella™ is that it is may be very inconvenient for the patient. Multiple sessions may be needed for desired results, and this could reach up to 50 injections. While liposuction may sound more invasive, a double chin can be addressed in a single session under local anesthesia.

Not Approved Outside the Chin Area

Potential patients should be well aware that Kybella™ is not approved for use outside of the chin and neck area. With many people desperate to address fat in problem areas, the temptation for patients and doctors to satisfy their wishes may lead to Kybella™ used improperly. Patients and doctors should be conservative in their use of Kybella™ only in the chin area until results can become more consistent and predictable. Off label use of drugs and devices by physicians is common so there may be potential benefit in areas outside of the chin. Clinical experience on a large scale will ultimately determine the practical use of Kybella™.