Kybella injection more swollen and feels hard and tender to touch on day 3?

Question

I had my first Kybella injection in a Bangkok clinic 3 days ago. My swelling on day 3 is now worse and feels hard and is tender/sore to touch. My doctor only did about 5 injections and I have been told to have 6 sessions, each 2 weeks apart. Is this normal? I have read on the internet that people usually have 28 injections 4-6 weeks apart. I will appreciate any assistance.

David Gilpin, MD · Answer

Thank you for your question.  Kybella is the only FDA approved injectable product for submental (under the chin) fullness caused by fat.  Typically Kybella is injected in a specific pattern under the chin, and 4 cc's is injected at one session.  The sessions are usually spaced at least 6 weeks apart to allow for all swelling to resolve.  Typical, expected side effects of the injection include swelling, brusing, and numbness under the chin. It sounds as if you may have had 1 vial injected, which may not give you the results you are desiring.  I would consult with a board certified injector who has experience in injecting Kybella for a full evaluation.  I hope that this helps!-David Gilpin

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. Kybella is an innovative injectable that provides a dramatic reduction in submental fatty tissue, sculpting the chin in a quick office visit, with no downtime. You can immediately return to work or school. There are no restriction on activities or exercise. Most often, patients can see their improvement in 2 treatments, but the amount of treatments may vary based on the patient's unique needs and treatment plans. 
Best wishes,

Payman Kosari, MD, FAAD · Answer

Every neck is different and will therefore require different amount of kybella.  The swelling with kybella can be significant so not surprising to hear the amount of swelling you are experiencing.  I educated patients that it can last anywhere betwen 2-4 weeks.  With that said, some of the swelling can be caused by a hematoma.  Best to go back to your injector and let them evaluate your neck.  Best of luck!

Kouros Azar, MD · Answer

Swelling is a very normal side effect of Kybella. However, treatments should be spaced at least 4-6 weeks apart. Not two weeks. You need to give your body time to heal. And most patients only need 2-4 treatments.

Michele S. Green, MD · Answer

Kybella is fantastic for reducing the fat bulge under the neck.  However, you would never inject in two week intervals.  You need to wait 4 to 6 weeks to see the full effect and let the swelling resolve. In addition, a grid should be placed and it would definitely be more than five injection points.  Please consult an expert in Kybella for the best cosmetic results.  Best, Dr. Green

Raminder Saluja, MD · Answer

Kybella is typically injected over a grid pattern that is marked on the skin and each point has 0.2 cc, so 5 injections would be only 1 cc that you are receiving.  This is a small amount.  We have found that at least doing 3.6 cc (1.5 bottles) or more at each session, diminishes the number of treatments needed.  We also space our Kybella injections out by 8-12 weeks, in that there is healing and improvement that occurs in between treatments and often times patients will not need the 3rd or 4rth injection.  Having swelling post Kybella is normal and can last up to 2 weeks.  I typically do not like to give any type of anti-inflammatory as this may slow the time to results.

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question.  It's not uncommon to experience swelling after a Kybella treatment - for most patients, this swelling lasts approximately 7-10 days, and typically peaks around the 3 day after treatment.  In some cases, swelling can persist for up to a few weeks after treatment.  That said, I do have some concerns about your treatment - 5 injections means you were likely treated with only 1 vial of Kybella, which is an exceptionally small treatment.  I seldom use less than 2-3 vials, for even the smallest treatment areas - I find that patients who are treated with less often have less impressive results and require more treatments.  Also, although we were initially trained to repeat Kybella injections every 4 weeks, most experienced Kybella injectors are finding that they get better results with each treatment if they wait longer - I personally wait 10-12 weeks between each treatment.  Two weeks is not nearly long enough, as many patients will still be experiencing swelling at that point.  I would recommend seeing a cosmetic dermatologist or plastic surgeon for a second opinion.  Best of luck!

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question cassie12. I understand your concern. Kybella is the first and
thus-far only FDA-approved non-surgical injectable treatment for the double
chin. Swelling and areas of hardness (nodules) are normal after a treatment. Swelling typically subsides after 1-2 weeks and nodules can take longer (up to 6 weeks). The amount of product used varies based on the individual. We typically use 2 vials or 4 cc. Each injection is 0.2 cc and in this example there would be 20 injections. The manufacturer recommends having treatments every 4 weeks. However we have seen better results by waiting longer and I space them at 3 month intervals. Please
consult with a doctor for specific recommendations. Good luck!

Davin Lim, MBBS, FACD - Account Suspended · Answer

This is universally seen , as for the amount of injections sites, this should depend on the grid. 5 is unusual. Most of us would inject at 5-8 weeks intervals, or even longer. Swelling is seen in everyone and peaks at 48-72 hours post Kybella/ Belkyra, and can last for 2 weeks or longer. Brushing is seen in 99% of cases. Ensure you are getting the correct product namely Kybella or Belkyra by Allergan and not deoxycholic acid that has been compounded. All the best, Dr Davin Lim. Brisbane. Australia.

Ana Carolina Victoria, MD - Account Suspended · Answer

Swellings normal after inejctions with Kybella and it can last for weeks.  The number of sessions needed depend on the amount of fat needed to be dissolved and your response to each treatment. In the clinical trials, the average number of treatments were between 4-6.

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