Do you have more than a hair on your chinny-chin-chin? Modern medicine has a new injectable solution for fat that’s settled in the most irksome of places: the chin. It’s called Kybella, and it will knock both the chinny and the chin off of your chinny-chin-chin. The active ingredient in Kybella, which was approved by the U.S. Food and Drug Administration in April, is deoxycholic acid, a naturally-occurring molecule in the body that destroys fat cells. If you are shouting sign me up, slow down a bit. Like with all procedures, you shouldn’t go under the Kybella needle blindly. To get answers to pressing questions about this double chin annihilator, we turned to Stamford, Conn., dermatologist Omar Ibrahimi and San Francisco dermatologist Richard Glogau. Here’s what they shared with us about Kybella:
Q: Who should consider Kybella?
A: People who can blame their parents and grandparents for their double, triple or quadruple chins are good candidates. Glogau says, “It is almost like they are mid-swallow. They don’t like it because they may be in good physical shape, and it is the sort of thing that doesn’t disappear with diet and exercise. That makes them crazy.” Unlike most aesthetics treatments, Kybella’s appeal crosses gender lines. Ibrahimi explains, “I get a lot of guys that come in that say, ‘Hey, I work out, but, as I get older this is bothering me, and it makes me less competitive on Wall Street. I want to have that sharp look.”
Q: What’s the process like?
A: The first step is an assessment from a skilled physician. If the assessment reveals Kybella is appropriate for the patient, the Kybella session starts with his or her face being marked up to form a grid indicating where the injections will go. Ibrahimi estimates most people require ten to 30 injections per treatment session, although Kybella has been approved for 50. Local anesthesia may be applied prior to the injections. The injections themselves take mere minutes, and Ibrahimi approximates sessions are about 20 minutes overall. Multiple treatments may be needed to rid the chin of the offensive fat, and Ibrahimi tells patients to expect two to four treatment sessions. Treatments are typically 30 days apart, but Ibrahimi says patients do wait two months before subsequent treatments.
Q: Is it painful?
A: Modern medicine is miraculous in many ways, but it hasn’t figured a way to get Kybella underneath the skin without needles. Therefore, it isn’t pain-free. “You can feel it when it goes in, and it is usually swollen, sore and red for a few days after the injections,” says Glogau, who instructs patients to take a Tylenol or Advil for discomfort and “not to engage in very strenuous exercise for a day or two. Most of the patients say it is a little tender and there is swelling, but they went back to work and nobody said anything, and it went away in a week.”
Q: Are there any horrible side effects?
A: If Kybella isn’t injected exactly right, it can produce temporary paralysis of the muscles that control the mouth. Ibrahimi details that 4 percent of patients in the Kybella clinical trials experienced this condition, which causes an off-kilter smile. About 2 percent had difficulty swallowing. He concludes the risks from Kybella injections are low. “It is something that your body naturally makes. There is no reason why it should be dangerous or cause harm. Nothing serious was noted in the clinical trails,” says Ibrahimi. “People have tolerated this well, and there hasn’t been any issues.”
Q: How fast does Kybella work?
A: During the clinical trials, Glogau relates the majority of patients noticed 80 percent of the correction within two treatments. “People can see a significant change in one treatment, but those are the people with small [chins]. People with large necks are going to require two or three before they will start to see something significant. The average patient after the second treatment can appreciate that they are probably three quarters of the way there. They can see that the contour of the skin underneath the skin will change. They have a sharper angle to the neck from under the chin,” he says.
Q: Do the Kybella results last?
A: “There is pretty good evidence to show five years out that the fat has been obliterated and even if the patients gain weight, it doesn’t grow back in this location,” says Glogau. Ibrahimi elaborates, “Once fat cells are destroyed in an adult, they don’t come back. It is not necessarily something that is going to need maintenance treatments.”
Q: How much does Kybella cost?
A: $800 to $1,800 per treatment
Q: Can Kybella injections be paired with other aesthetics procedures to boost the benefits?
A: Doctors are just beginning to experiment with Kybella and not a lot is known about its impacts in tandem with different techniques. Ibrahimi suggests it might be advantageous to couple Kybella with Ultherapy, which harnesses ultrasound energy to lift the neck. “You could use Ultherapy to tighten and tone, and Kybella to get rid of the fat,” he says. If you are considering partnering Kybella with something else, you should probably wait on double fisting the services because more will be learned about the advantages of blending procedures over the next few years. “I think the final chapter and verse on what the dosage is and how the drug can be used in combination with other agents has yet to be written,” says Glogau. “It will follow the pathway of lots of injectibles that tempt the doctors to improve on the standard recipe.”
Q: Why can’t Kybella injections zap belly fat?
A: At the moment, the FDA has only OK’d Kybella for the chin. Glogau says, “It remains to be seen if the drug will get approved as safe and effective in other places.” He doesn’t sound optimistic about the possibility it will be used for stomachs, at least not soon. Glogau says, “If it takes two or three or four sessions to get rid of it [chin fat], compare that volume to somebody’s belly, and it could take a lot of treatments. That may not be practical, and no one really knows what the long-term effects are of treating fat in that location.” Ibrahimi speculates sleevage, the underarm bulge that protrudes out above bras, is an area where Kybella might do some good. “It is a definable pocket of fat. It something that we don’t have a great solution for right now in terms of using a device,” he says. “It would be something that would be amenable to injections.”
Q: Are patients satisfied with their post-Kybella chins?
A: “They are very encouraged by what they see. They are delighted to be able to get rid of it [chin fat] with a non-surgical approach,” says Glogau. “There are a significant number of people out there that don’t want to look like their parents.”