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Fat Busting, Non-Invasive Drug Takes on Double Chins

KybellaIndividuals lose weight in different areas of the body and at different rates, often leaving some with what they feel are specific "problem areas," where the fat just won’t disappear. Double chins in particular have a tendency to make people feel like they look older or heavier than they are, even when the patients may be of an ideal weight. In fact, 68 percent of more than 8,300 respondents to the 2014 American Society for Dermatologic Surgery’s Consumer Survey said they are troubled by excess fat under their chin and upper neck. 

But, in April, the U.S. Food and Drug Administration (FDA) approved the first injectable drug to treat chin fat. Kybella is designed to dissolve under-the-chin fat in a non-surgical, and therefore less invasive process than other procedures such as neck lifts. 

Approval of the drug was based on two identical clinical trials in healthy adults (ages 19 to 65) with moderate or severe "submental" - or chin - fat. Subjects received up to six treatments with Kybella or a placebo, at roughly one month intervals. Results of the studies showed that over 68 percent of subjects responded to Kybella. Not only did the subjects see an improvement in the amount of fat in the area under the chin, but they also reported improvement in the emotional impact of fat in the area when asked how happy, bothered, self-conscious, embarrassed, old and overweight they felt following treatment.

"Before Kybella, the most effective solution to a double chin was undergoing liposuction or a neck lift, which are procedures that are far more invasive and risky than an injectable drug," said Ivona Percec, MD, PhD, an assistant professor of Surgery in the division of Plastic Surgery, associate director of Cosmetic Surgery, and director of the Skin Care Program at Penn Medicine. “With the drug, patients can receive the treatment the same day they come in for a consultation and go back to work the very next day.”

According to the FDA, Kybella is identical to the deoxycholic acid that is produced in the body, which helps absorb fats. “Kybella is a cytolytic drug, which when injected into tissue physically destroys the cell membrane. When properly injected into submental fat, the drug destroys fat cells,” the FDA press release announcing the approval stated, adding that it can also destroy other types of cells, such as skin cells, if it is inadvertently injected into the skin. Because of the potential to inadvertently target non-fat cells, licensed physicians are required to undergo appropriate training prior to purchasing the drug and administering it to patients.

For the handful of cosmetic surgeons across the country like Percec and her colleagues at Penn Plastic Surgery and Penn Dermatology at Penn Medicine, several of whom underwent training earlier this summer, the drug is already becoming popular. While not a substitute for regular diet and exercise to manage weight, Percec says the drug is unlike any other product on the market today, and could provide longer-lasting results than other solutions for dissolving chin fat. Percec began administering the treatment in July and says that patients are very hopeful about its prospects. 

One Penn patient who received her first Kybella treatment in August says she hasn't seen results just yet, but despite some moderate swelling and numbness at the injection site, she is already looking forward to her next session.

“All the women in my family have this double-chin and it’s something that has bothered me my whole life,” she said. "I tried topical gels and other skin treatments, but nothing worked."

According to Kythera Biopharmaceuticals Inc., the original makers of Kybella -- which was recently acquired by Allergan -- swelling and numbness are among the most commonly experienced side effects, along with injection site bruising, which was experienced by 72 percent of participants in clinical trials.

While some patients in the clinical trials began seeing results in as little as two treatment sessions, Percec says patients should expect anywhere from two to six sessions of treatment, spaced four to six weeks apart. If that sounds like a lot of time and pain, Percec notes that at only about 20 minutes per session, the process is generally painless and takes less time than it would take to watch the next installment of the latest Netflix binge. 

With a potential price tag of $1,000-$3,000 per session - depending on the amount of submental fullness - the cost (which is not covered by insurance) may end up being higher than the more invasive alternatives, but Percec says the results are likely much longer-lasting.


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