The philosophy of our injectors Dr. Shah and Dr. Chughtai is to use kybella for select patients when liposuction or other methods of fat removal are not ideal for patients. Our practice has a variety of proven approaches to remove and reduce fat noninvasively including kybella, coolsculpting, bodyfx, bodytite, facetite and we help patients select the best approach for them pending goals and downtime.
How does Kybella work?
Kybella works by using a natural bile acid called deoxycholic acid to break down fat. The danger of kybella is that it can breakdown muscle, nerves and other tissues if not injected properly. Insert diagram of kybella molecule shrinking fat. This acid will remove fat when injected there and it takes several months for fat to be absorbed.
Areas to Treat
The neck area is the only FDA approved indication for kybella. Kybella works only on the superificial fat which is superficial to the platysma muscle. Deep fat can not be injected by kybella or affected. Dr. Shah is a facial plastic surgeon and can determine based on your goals and anatomy various options. We see many patients in our office who have used 8 or more vials without a result. The main reason for this is that patients without the proper anatomy will not respond, especially deep fat and prominent submandibular glands. In addition, patients with large amounts of fat and loose neck skin can often benefit from alternative procedures which can be more effective and cost effective. Our practice is one of the busiest kybella practices in Chicago for necks (we are Diamond level for Allergan), however we choose our patients wisely.
Jowls can lead to heaviness along the lower part of the face. Injection of jowls is considered an off-label use of kybella.
The jowls are one of the trickiest areas to inject. Nerves from the lower part of the neck converge on the mouth. For this reason, only an expert anatomy physician facial plastic surgeon should inject here.
Dr. Shah has written 3 landmark articles on facial anatomy and is a board certified facial plastic surgeon. He injects jowls on select patients, espeically where there is prominent puffiness along the marionette line. The mistake most injectors do here is to keep adding filler and creating a blowfish look. Recreating a younger face often involves removing volume from the lower portion (with exception of jawline) and adding to the upper and midface.
Prominent N/L folds
Fullness above the nasial labial folds or smile lines can make it difficult or impossible to remove the lines in some patients. While fillers are the mainstay of reducing nasal labial folds, reduction in the amount of volume can be helpful in some patients. Options for reduction include liposuction, buccal fat removal, and kybella. Liposuction is often not the best choice since facial liposuction can lead to divots and dents. Buccal fat removal is better at chiseling a face then removing true excess fat above the fold but can contribute in some patients. Kybella, in the right patient and in the right hands, can lead to a subtle reduction in fullness allowing for filler or other procedures to be more effective. Kybella in the face must be performed by an expert in facial anatomy, preferably a facial plastic surgeon or surgeon who specializes in facial aesthetics.
Bra fat can contribute to difficulty wearing certain shirts, dresses, and workout gear. Isolated fat of the bra area has many options including liposuction, kybella, bodytite, amongst others. Kybella is a nice option in that it has little to no downtime and this area tends to be more responsive to kybella than other areas. Dr. Chughtai specializes in use of kybella in non-facial areas. She enjoys use of nonsurgical options to help women feel their most confident.
Love handles and abdomen
Perhaps the most common area for desired fat reduction is the lower abdominal area and love handles. With hormonal changes, diet, exercise and a multitude of factors lower abdomen fat can be the most difficult to remove. There are fortunately a variety of options including liposuction, coolsculpting, bodyfx, kybella, and bodytite amongst others. Many patients are seeking nonsurgical methods of removal.
Kybella can be helpful for patients with spot areas that desire removal. Kybella can also be helpful in etching abdominal muscles after a treatment with coolsculpting or bodyfx, Injection lipolysis has been shown in combination with cryolipolysis (link to recent coolsculpting article) to reduce fat more effectively than either alone. The benefit for patients seeking kybella is that with Dr. Chughtai and Shah there are plenty of options.
Dr. Chughtai is an expert in body contouring noninvasively. She works with patients on ways of creating improvements in their shape with minimally invasive techniques, often combining treatments.
Women often complain of having fat in their arm area. Hormones and other factors can lead to excessive fat in the arm area, despite diet and exercise. Surgical options are not ideal since they can involve a scar and unnatural contours. Nonsurgical options such as coolsculpting, kybella, and bodytite can help contour the arm area with objective changes.
Dr. Chughtai uses kybella in the arm area. In her experience, she has noticed that in many women, kybella causes a contracture of the surrounding skin, creating a lift like effect. She chooses best option based on women’s anatomy, age, and goals.
Legs are the most difficult area to treat, either surgically or nonsurgically. Cellulite, spot fatty areas and other factors can contribute to fat in the leg and thigh area. Spot areas can often be treated with kybella. These areas are often too small for more invasive procedures but can lead to improvements in contour and shape.
The recovery time for kybella varies from person to person. Early on patients might notice some swelling and discomfort. This is a result of the nature of kybella which is acidic (it is a bile acid). The fat cells are permanently destroyed but it takes a period of weeks and months for the fat to be absorbed and the area treated to remodel. Most patients see results as early as 4 weeks and can see a final result in about 6 months. We don’t recommend kybella a few days prior to a big event but 2-4 weeks should be sufficient to attend a 3 months to start to enjoy your results.
Cost of Kybella
The cost of kybella varie depending on the treatment size of session, treatment location and if it is used in combination with another procedure. Most injections cost in our office around $650 per syringe.
Risks and Complications
Kybella is an extraordinarily safe injection based on data from Allergan. However, it must be used in the appropriate hands as the injection can destroy muscle, nerves and surrounding tissue. Nerve weakness can occur with use of kybella in the face and neck area. Localized divots and dents can also occur with over zealous use of kybella. Minimize your chance of risk by seeking attention from a kybella expert physician team. Be wary of kybella imposters which can lead to a host of problems and tissue loss!
Dear Dr. Shah, A quick note to say hello from Italy ! Thanks to you I look & feel beautiful! I thought you’d enjoy this postcard, as several doctors did an analysis of the celling of the sixteenth chapel and found that Michelangelo included detailed anatomical paintings (embedded in the ceiling) With best Wishes.
Interesting facts about Kybella
- Kybella is an injection in the neck.
- Kybella is Deoxycholic Acid used to destroy fat cells
- Kybella can only be used in the pre-platysmal fat and requires multiple injections.
- Some patients may experience some bruising and swelling.
- There are some risks in using Kybella but for patients who do not want to have a surgical option on the fat in the neck, Kybella can be adventitious.
- You can remove fat without incision.
- Some patients will require multiple treatments.
- Kybella is only FDA Approved for the submental area under the neck, however doctors can use Kybella off-label in other areas, including the abdomen, underarms, saddlebags, legs and other areas to spot treat areas where patients have persistent fat.
- Since Kybella can destroy fat, you want to make sure not put it near any associated nerves or blood vessels.
- The person injecting Kybella needs to have knowledge of the anatomy of the neck.
- One of the weaknesses of Kybella is it does not treat post-platysmal fat which is fat deep into the platysmal muscle.
- For patients who have post-platysmal fat are not a good candidate for Kybella.
- Patients with waxiness skin to the skin, platysmal bands are also not good candidates for this treatment because it could make those conditions worse.
Frequently asked questions about Kybella
Kybella is best used in patients seeking removal of preplatysmal fat of the neck. It is a nonsurgical alternative to liposuction. Patients with laxity of skin or platysmal bands are not good candidates since these conditions can be exacerbated with use of Kybella. Kybella is part of noninvasive neck contouring
Kybella is relatively safe procedure with little to no downtime that is effective in the removal of preplatysmal fat in the neck. It offers patients a fairly reliable nonsurgical alternative to fat removal of the neck and other areas.
Not necessarily. Neck liposuction can be done safely in the office by an experienced physician under local anesthesia with minimal downtime. Neck liposuction has the potential for hematoma (collection of blood), nerve and vessel damage but these risks are low in an experienced physician’s hands. Kybella has similar risks except for collection of blood. In a nonsurgeon’s practice Kybella will be the only alternative. Patients should look at a surgeon’s rate of complications with both Kybella and neck liposuction as well as recovery times to get a complete picture of safety profile of both.
Likely not. Kybella often requires multiple sessions to remove fat. Neck liposuction typically removes the fat in 1 session. Depending on the degree and amount of fat present in the neck, Kybella may be more or less expensive than neck liposuction.
Kybella is not as effective as neck liposuction since neck liposuction can lead to contouring of the neck in BOTH pre and postplatsymal areas and can directly remove fat here.
Other neck contouring procedures such as Necktite or Facetitie remove fat and have the added benefit of a contracture component which can help reshape the neck in patients with older skin. Patients with Necktite or Facetite have more potential downtime and the procedure is more invasive. For more information about Necktite and Facetite, please click here.
Procedures that heat the neck such as Ultherapy and Thermage are not as effective in removing fat as Kybella but can contract the skin in some patients. Coolsculpting mini can remove some fat in patients but is not as effective in this area as Kybella. Coolsculpting does not contract the skin (since there is no heat).
Lipodissolve was a product that had a combination of phosphatidylcholine and deoxycholate while Kybella is just Deoxycholic acid. Lipodissolve had issues with permanent scarring, skin deformation and deep painful knots where the product was injected and was not FDA approved for removal of fat. Although Kybella is also a version of injection lipolysis, its chemical structure appears to be much more stable and predictable with a much improved safety profile. Kybella is FDA approved for injection lipolysis in the neck.
Dr. Shah is a double board certified facial plastic surgeon who has written over 50 scientific articles including three landmark articles about facial anatomy revolutionizing the way plastic surgery is performed. Dr. Shah specializes in Kybella and takes an analytical approach to patient recovery after the procedure. Based in Chicago, IL; Dr. Shah is not only recognized as one of the top plastics surgeon not only in the city of Chicago, but in the world.