2 years ago a PA suggested Kybella for tiny marionette lines. I didn’t know it’s not FDA approved for face. How can I fix?

Thank you for your question.  I'm sorry that you were not satisfied with the service you received.  Kybella is FDA approved for the chin however not to treat marionette lines. I would suggest getting fillers for the indents in the face and to smooth out the area.  The fillers would not react with the Kybella.  Please schedule an appointment with an experienced doctor to receive the best treatment and results.  All the best!

this was indeed off label. Doing off label treatments it's pretty common. Botox was only FDA approved for frown lines but treating crows feet in the four head became pretty standard by almost all practitioners.  The drug Lamictal is an anti-seizure medication but it is probably prescribed more often as a mood stabilizer then for seizures.  So off label use it's not wrong or illegal it's simply something the FDA has not given the rubberstamp for.  The FDA does not control how medicine is practiced. It is the governing body for allowing medical products and drugs to be available or not available in the United States among other things.  You most certainly developed fat necrosis. That is the purpose of this treatment.  Fat necrosis is how you get rid of the fat permanently.  I realize it's been two years but it is very important that the person who did this injection is aware of the results so that they don't do it again.  I am not a fan of this treatment. There are way too many negative side effects of the amount of swelling and inflammation is beyond what is reasonable. Liposuction is so much better and I can't imagine that injecting for marionette lines is a good idea.  Fillers are probably going to be the easiest way to restore volume in this area. The scar tissue that formed from your treatment may inhibit the skin to come out normally even if volume is restored. It's worth giving it a try It's worth giving it a try.  Fat transfer may seem like a desirable option but it is far less precise.  It's unfortunate this happened to you.  Best, Mats Hagstrom MD 

You options are to do nothing or to try to fill in the hollow areas with fillers. I would do this slowly over a couple of visits.  The chances of making this small and tight and thin again are remote, The problem is not that you have lumps but you have a big hollow. There is a difference between too little and too much. You had too much in an area that has not been studied with kybella and the product did what it is supposed to do which is kill fat.