Can I use Kybella to reverse facial fat graft to my cheeks?

Know one knows. Kybella causes tremendous inflammation and can lead to nerve damage.  For that reason and it enormous cost, tempers one's enthusiasm to explore off label uses of Kybella.  I see 3 to 4 new consults each week for folks who have been damaged by fat grafting.  

I’m sorry you are unhappy with your fat grafts. You didn’t mention when your procedure was done. You will be swollen for up to a few weeks. It also takes awhile for the grafts to “settle.” I wouldn’t recommend Kybella to melt the fat, though. It works best on submental fat and jowls. If you are still unhappy after a couple of months, consulting a board-certified dermatologist who is an expert at contouring the face will help resolve any asymmetry using very subtle amounts of hyaluronic acid fillers.

It's possible this could work on some parts of the face, but I think it would be high risk for nerve damage. Have a formal consultation about alternatives to Kybella with an experienced injector. 

A significant amount of time should pass before you consider treatment options. With fat grafting, it is difficult to determine how much fat will resorb over time. Kybella does dissolve the fat cell membrane so it will work wherever there are fat cells. It can be injected safely in areas where there are few nerve branches. It is possible that Kybella can be used in the cheeks to dissolve excess fat.  Discuss your options with your surgeon.

This is needs an in-person evaluation. If you're unhappy with your fat transfer results, a combination of 5/FU steroids, lasers, microneedling/prp and radiofrequency can give improvement. See an expert. Best, Dr. Emer

Kybella is only indicated in the treatment of submental fat, in other words fat under the chin. Injecting Kybella anywhere else would be what is called an off label use.

Kamea,
I'm sorry to hear that your procedure has left you feeling unhappy with the results. The good news is that with fat grafting a significant portion (even up to 80%) get resorbed by the body over a year's time. It is for this reason that injectors often over fill the respective areas that require volume restoration with fat grafting. Therefore, thought it may look uneven currently, overtime the fat injected may settle into a more preferable look. Should you still not be happy with the long term result, a consultation with a trusted aesthetic surgeon is recommended to discuss possible options which include but are not limited to micro-liposuction, dilute (off-label) Kybella placement, kenalog/5-FU injections, and laser/RF therapy. Hope this helps!

Hello and Thanks for the Question
How long ago did you have the fat grafting performed? I would wait at least 1 year to let things settle with the fat grafting. Otherwise I would not recommend Kybella in the cheek areas. It's not FDA approved for this and there are plenty of vital structures to be concerned about in the vicinity (nerves, eye, etc.) 
Good Luck and I  hope this helps
Dr. David 

Kybella is not FDA approved for targetting areas that have been fat grafted on the cheeks. It may be possible to use it off-label but this is not a common use of Kybella and therefore no one should be able to guarantee whether it will work or not. If used incorrectly, there is the potential for permenant injury or damage to important facial structures. Hope this helps!Johnson C. Lee, MD Plastic Surgery@Drjohnsonlee

hello,I am very sorry about your experience with fat grafting. a photo could be very helpful to make more specific suggestions.1st important factor: Processing and preparation of fat grafting. I am not sure what technique used for your fat grafting. There are 2 reliable techniques for fat graft processing to make it 80% fat retained, otherwise you get into trouble.2nd important factor: the timing. if it is recent then definitely you should wait for few months. Kybella is a great treatment but has its limitations and complications. the ONLY indication is limited to double chin (submental area). If the fat is beyond the sub mental area (jaw line) then Kybella should not be used. It is not a safe medication to use it anywhere else because of its complications or lack of optimal results.In office consultation is crucial to determine what your options are. some non-invasive modalities may be effective or otherwise (hopefully you will not need that)  surgical intervention.  Good LuckRay Bayati, MDElite Medical AestheticsSacramento Area, California