What’s the difference between fat necrosis and skin induration post Kybella?

Question

I had kybella done 6 weeks ago and I developed a firm spot under the chin, which the doctor says is induration. However, I’ve been reading a lot about fact necrosis. What is the difference between the two and how do I know which one I really have if the symptoms are pretty much the same? What treatment options are best to administer at this point?

Jason Emer, MD · Answer

Thank you for your question, This is difficult to answer without pictures and needs an in-person evaluation. Kybella is good for dissolving the submental fat under the chin area while contouring the jawline and making the chin more defined, but a combination approach is needed to get the most improvement with non-invasive options. I recommend a combination approach with thermage, ultherapy, exilis. VASER liposuction in combination with ThermiRF is the best alternative for contouring the chin and can be performed with a neck lift, if you're a candidate. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Mats Hagstrom, MD (license on probation) · Answer

The terms are pretty simple. They're both readily available with an Internet search. Induration is the terminal generally used for tissues that are inflamed and from that feels firm with potential fibrosis.  The important distinction is the tissues are not dead.  Necrosis comes from the Latin term necrose meaning dead. This treatment does indeed create necrosis of cells. The cell membrane is a ruptured from the toxicity of the injected agent.  The cells contents are released and the bodies immune system absorbs the cell debris through enough laboratory process.  This level of necrosis is more on an individual a cellular level.  If this treatment did not cause any fat cell necrosis then you would not have results.  When we talk about tissue necrosis it is usually a complete block of tissue rather than individual cells on a microscopic level.  Your physician and used a precise and correct term.  This is a normal response from the treatment you had.  That's how this works.  To date we have no way of reversing at in the process continues until it's healed.  I'm not a big fan of Kybella. It seems crude and imprecise.  Each individual will have a varied response.  There are numerous people who have been over treated despite having normal injections.  These results will be permanent and there is limited options for restoration once this is happened.  Liposuction it causes far less inflammation. It's more predictable and results are achieved much sooner.  With liposuction it's not quite as simple as what you see is what you get during the procedure but much much closer.  This allows the provider to determine how aggressive the treatment should be performed.  Continue following up with your provider. Wait until the area is not tender does not show evidence of swelling and assess final results around three months The results at six weeks will probably be close to your final results.  Best, Mats Hagstrom MD

What’s the difference between fat necrosis and skin induration post Kybella?

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What’s the difference between fat necrosis and skin induration post Kybella?

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