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Revisiting Kybella

Article-Revisiting Kybella

Approved in April 2015, Kybella (deoxycholic acid, Allergan) generated a lot of buzz as an injectable treatment to rid adults of their double chins. So what are physicians saying about Kybella three years later?

Kybella works well for patients who need minimal fat removed and jaw line contouring, according to Walter W. Tom, M.D., a cosmetic surgeon practicing in California and Hawaii, who says he had the procedure and liked the results.

But it’s not popular among patients who have more fat and true double chins, Dr. Tom says.

“I think when Kybella first came out it was being marketed a lot for patients with double chins, with a fair amount of fat. And it can work for that, but it may take three or four treatments. Because of the cost, many of those patients opt to have laser liposuction of the neck in my practice,” he says.

Patients find the thought of prolonged swelling of a week or more after each Kybella treatment unacceptable, Dr. Tom says. As a result, the cosmetic surgeon says he rarely performs Kybella treatments nowadays.

RELATED: Don't miss these CME opportunities to learn advanced injection techniques

Fat dissolving injections (Kybella) were the least performed of all minimally invasive procedures measured in the 2017 Membership Study by the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS).While member surgeons reported performing an average 11 Kybella treatments in 2016, they reported an average six such treatments in 2017, according to the AAFPRS study.

AAFPRS President and facial plastic surgeon William H. Truswell, M.D., says his practice offers Kybella.

“It is an alternative for patients who just do not want to have… liposuction,” Dr. Truswell says.

He agrees with Dr. Tom that the need to repeat treatments is an issue for patients. In clinical studies looking at the use of Kybella for moderate or severe submental fat, researchers used six treatments, according to the FDA.

“It is sometimes more costly than liposuction if more than two injections are needed. It is uncomfortable, perhaps a bit more than liposuction. And the swelling persists longer than liposuction, Dr. Truswell says. “It is not suitable, in my opinion, in a very heavy face.”

Liposuction, on the other hand, is a one-time treatment, which might cost less, can easily be done with local anesthesia and results in little downtime, according to Dr. Truswell.

Demand for Kybella might increase as more people become aware of the option for the cosmetic treatment of neck fat, but there are competing approaches, including cryotherapy and subcutaneous ablation.

Three-quarters of the 226 ratings for Kybella on RealSelf, as of March 27, 2018, give the treatment a “Worth It” rating.

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