Recently I attended the American Society of Aesthetic Plastic Surgeons meeting in Montreal, Canada. I enjoyed the meeting and I enjoyed Montreal. As an aside this is a great city to visit and is not very far away. And, our Canadian neighbors are great!
One of the things I always do at meetings is to take some time in the exhibits. Basically this a convention floor filled with all the companies and vendors who make products and services for plastic surgery. And as you might imagine, I am always looking for something on the horizon that looks promising. This is not always an easy task and a lot of products are hawked as being the greatest thing since sliced bread, only to be quite stale, outdated, or ineffective upon further study.
But one of the products we will be keeping an eye on is Kybella. This is a drug, deoxycholic acid, which has recently been approved by the FDA for the treatment of fat in the neck. This is a bit of a throwback to about 8 years ago when people were working with a procedure called “Lipodissolve.” While attempting to achieve the same results as Kybella , fat reduction via injections, the drugs used for Lipodissovle were not critically tested or approved – certainly not by FDA. And there we no set protocols for its use. As such, this has pretty much fallen by the wayside.
However, same areas of fat can be well-treated with injections, and the makers of Kybella (Kythera) decided to properly develop a drug for this as well as the protocols for its successful use. This takes time and money to complete these studies which are critical for patient safety and outcomes. They have passed the first hurdle which is FDA approval. But wisely, Kythera is taking its time in rolling out Kybella to physicians. I spoke with them at the meeting and they are very intent on setting up the proper protocols for its use. Then they will train physicians in these protocols after which it will come into clinical use. This is the right way to approach a new procedure or drug and I respect Kythera in this approach. (Nothing as formal and as scientific was done with Lipodissolve.)
How Kybella Works
The treatment of fat in the neck with Kybella will consist of a series of injections into the neck area. Apparently there can be up to 50 very small injections can be done for a single treatment. For complete treatment of the area up to six treatments may be needed at monthly intervals. The most common side effect is swelling which can be significant.
Kybella: To Be or Not to Be
How will this fit in to my Knoxville, Tennessee practice? As yet, this is not known. I do want to be trained in the use of Kybella so that it will be available to people who are good candidates for this and who request it. Clearly this is much more I do not know about this that I do. The critical issues are results, ease of treatments, side effects, and cost. Yeah, this probably won’t be free and how much it costs as opposed to other options will be very important.
The advantages of something like this are that it may be a nonsurgical way to achieve a surgical correction of this area, as in liposuction. Thus if surgery is not wanted or for some reason cannot be performed, Kybella then becomes an option.
However, my concern is that it may end up being a six-month process, with six different episodes of swelling, possible bruising, discomfort, etc. And, people with skin looseness will not see any significant tightening of the skin of the neck (which they wouldn’t with liposuction either). But chiefly, the question for me is: Is Kybella better or more effective than liposuction of the neck. At this point, I do not know.
11/16/2015 Editor’s Note: We now have more information on Kybella and another new modality to remove neck fat. Here’s my blog with the latest.
New Neck Fat Treatments: Pros, Cons and PricesThe neck is the subject of a lot of interest lately – both concerns about the appearance of the neck and the widely-publicized debut of two new non-surgical treatments to reduce neck fat. With the convergence of both of these, our Knoxville office is getting calls and emails from people eager to learn more. How much of a concern … Read more
All the best,
David B. Reath, MD
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