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It was approved unanimously by the FDA in March, based on two placebo-controlled studies involving more than 1,000 adults. In the clinical trials of over 1,600 patients, 79% of them experienced very good results. In these studies, up to 50 injections of 0.2 mL of the 1% DCA solution were given to patients in one session. Up to six treatments were performed over a period of 1 month to reduce the appearance of double chins.

Severe side effects of injections of 1% DCA include swelling, bruising, pain, numbness, and itchiness in the treatment area. Side effects include tingling, swelling, rash, itching, and skin thinning. Other potential effects include alopecia (baldness) or skin cancer. In the trials, all the signs of nerve damage, such as asymmetric smiling or facial weakness, resolved spontaneously (range 1-298 days, median 44 days). Dysphagia occurred in the clinical trials as a result of adverse reactions to the injections (for example, pain, swelling, and induration in the submental area). These reactions were not severe and resolved spontaneously (range 1-81 days). Dysphagia occurred in a small number of patients, but resolved spontaneously (range: 1 to 81 days; median: 3 days).

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If a patient has a history of medical problems in the neck or has difficulty swallowing, or if the patient takes blood thinners, precaution should be taken. It is very important to exercise caution in patients who are pregnant or who plan to breastfeed, as Kybella has not been studied in these groups. Injection of the drug is contraindicated in patients who have already developed an infection at the injection site. Kybella should be administered only by a medically trained person.

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In addition to assessing whether a patient is a good candidate for injection of Kybella and setting realistic expectations for future treatment, a good consultation should include taking pictures of the patient before and after the treatment. Patients who have moderate to severe asymmetry or asymmetrical structures in their submental area are ideal candidates for the procedure. Patients who have very little fat in the undermental area or who have excessive skin in the neck area may not be good candidates for this procedure, and should consider having a neck lift surgically performed. Patients who have prominent platysmal bands before having the procedure may still notice these bands after the procedure and may consider using Botulinum toxin injections or applying bandages to treat these problems. While it may target fat cells, there are some potential side effects of the injection that result from inflammatory or fibrotic processes.

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It is highly recommended that when taking photographs of a patient, that the doctor mark out particular anatomic landmarks to help him or her to avoid causing injury to the nerves that control his movement and speech, and to the lymph nodes that are located in his abdomen.

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Fat removal DeSoto
Fat removal DeSoto

It takes about 15-20 minutes to perform the procedure, and there is no waiting time involved. Antihistamines and anti-inflammatory medications, such as loratadine and ibuprofen, are sometimes given to patients prior to the procedure to help reduce the risk of being uncomfortable or causing edema after injecting a chemical to treat their symptoms. If possible, a patient should be given a local anesthetic before the procedure to help prevent any discomfort or edema after the injection.

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When a temporary tattoo is put on the skin and the patient is instructed to start injections, 0.2 mL of the injection drug is injected by using a needle that is about 12 inches long. It is supplied in a box with four small vials that contain 10 mg/mL each. No cooling of the product is necessary. One vial of Kybella is allowed to be injected into one patient at a time. Patients can have only one injection session, allowing up to 10 mL of drug to be injected in each session. Ice can be applied to the treated area following treatment. Postprocedure swelling and throbbing are common and may last for several days or even 1 month. It is estimated that patients may need from two to six treatments spaced a minimum of one month apart.

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