Could Kybella be used to create contour around peri-oral area?

Question

So many good looking men have indentions in their cheeks, specifically in the area right beside where the lips come together on each side. Is this the peri-oral area? I was wondering if Kybella could be used to slim down the fat in this area? I have heard that facial liposuction of this region is dangerous, but it seems to me that you could approximate some of the contour by removing fat using Kybella? Do any of the doctors here do this procedure?

Stephen Giordano, DO · Answer

Honestly I would not inject Kybella in that lower cheek area, as it's definitely an off label area to be treated, and that probably isn't a "fat issue" anyway. More than likely if you had fillers added to your upper/lateral cheek area, that would lift the area of your concern and make it appear more hollow. The trick is to get enough filler to elevate that  area, probably 2-3 syringes. Without seeing a picture, another option would be to add filler along jaw line if needed,  to enhance that area also, then there is an option of Botox to lateral jaw area (masseter muscle) to thin a square jaw from masseter hypertrophy, if that's an issue.Best of luck, Dr. G

Sabrina Fabi, MD · Answer

Kybella uses deoxycholic acid to melt fat underneath the chin. I have also used it for the jowls very successfully. Occasionally, I might treat a small area of fat elsewhere; this is an off-label use but can have nice results.
However, I wouldn’t use Kybella in the cheeks and particularly would not try to remove a small, defined area of fat. I commonly use Ultherapy to contour the lower face by tightening the SMAS (muscle) that helps reposition the superficial fat pads and makes the lower face more contoured without the destroying fat that keeps us looking younger. Consulting a board-certified dermatologist is the best way to answer your question; you need to be examined in person to find the most satisfactory solution.

Aldo Guerra, MD · Answer

This would be high risk because Kybella cannot tell the difference between fat, muscle and nerves. I would be concerned about muscle weakness, paralysis and drooling if this was injected here. Consider dermal filler and neuromodulators instead.

Kenneth D. Steinsapir, MD · Answer

That does not mean that it can't be done.  What it is more likely to mean is that we are still trying to figure out how to control kybella.  You could end up with the result you want or something else.  Let the buyer beware.

Lillian Overman, MD · Answer

Hello, 
You have posed an interesting question about using Kybella to create dimples on the face.
The following issues should be considered:
1. This would be an "off label" use. In this case, the word "label" refers to the information that the FDA allows and requires after a medicine is approved. "Off label" designates usage in ways other than those approved. Practically speaking, this means Kybella has not been tested and proven safe and effective for creating dimples.
2. Kybella spreads out from the injection site so the results might look more like a bowl than a puncture.
3. Dimples are caused by tugging while the smile muscles contract. Having a permanent dent in your face, even when you are not smiling, may not look attractive.
4. Kybella can damage the protective layer that surrounds nerves and can cause loss of sensation or paralysis. The approved area under the chin carries a much lower risk than the face of injuring a nerve and causing paralysis of a muscle.
Regarding dimples, I have a patient who had his cheeks pierced and small studs placed in the location typical of dimples. This was done before I met him. If he had asked me beforehand, I would have advised against it. However, the effect was surprisingly charming for this person's face and the site where the studs were placed. This might not work well or look good on your face.
I hope that this information is helpful to you.
Best regards,
Lillian Overman, MD

Barry Ginsburg, MD · Answer

I would never recommend kybella for precise fat reduction as there is no way to predict how much fat will dissolve .. it would also take 3 months to decide if the result was enough..  without seeing you in person i could not tell you whether lipo would be a good option.. an experienced  liposuction surgeon can remove very small amounts of fat safely.

Shaun Patel, MD · Answer

Thanks for sharing your question. Kybella is approved by the FDA for the treatment of submental fullness (fat below the chin). Any other use for Kybella is off label. I commonly use Kybella off label for the jowls which in my experience is safe and effective. As for fat in other areas on the face, it is really based on injector experience and preference. I do not use Kybella on any other parts of the face except for the jowl fat.

Stanley Kovak, MD · Answer

Thank you for your question! Kybella is an FDA-approved injectable for the treatment of submental (double chin) fat; it is not approved for use on other areas of the face. Because of this, you may end up with undesirable results. Without seeing a photo of you, I would probably recommend fillers in your cheeks to make the lower part of your face appear smaller or more contoured. Be sure to consult with your physician to get the best treatment plan for you. Best of luck!

Justin Harper, MD - Account Suspended · Answer

Hi calitigerboy, Theoretically, it would be great for something like Kybella to contour areas where there is some excess fat. However, Kybella patients have reported issues with swelling and pain which go away but can last for 2 weeks (or even three)! The pain will be excessive since it will always be in motion when one is talking or eating. It may also be difficult to come up with symmetrically even results - even if this procedure were to proceed. It is also not an FDA-cleared indication for Kybella.Have you asked your provider about Botox injections? Masseter hypertrophy may also make the face look fuller and Botox can help reshape the area.All the best,Justin Harper, M.D.

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