How deep should my doctor be injecting Kybella?

Question

I'm no stranger to injectables. I've been getting voluma on my cheekbones for years, and I love the results. My doctor doesn't do Kybella, so I have to seek out someone new, but I'm a little nervous. I know Kybella is quite different, and I want to ensure that no damage is done to me. At the risk of sounding like a micromanager, what should I ensure this doctor does when performing Kybella? My biggest concern is how deep should he be injecting? How much should he inject on each spot?

David Tauber, MD · Answer

Kybella is a non-surgical option for your neck. It is an injection that has been approved by the FDA to help improve the appearance of fullness associated with the submental (neck) fat in adults. It is also used off label in other areas and is used medically to treat lipomatosis. Unlike fillers or Botox, it works by dissolving the fat it comes in contact with. 
During a Kybella treatment, the neck is first cleaned and numbed with topical lidocaine or ice. A pattern is drawn on the neck and the product is injected into the fat under the skin and above the platysma muscle - usually at a depth of around 1/2 inch. The amount injected depends on the amount of fat to be dissolved. The body then absorbs the fat over several weeks. 
  
There is swelling, bruising, and some numbness in the area during this time. The injections are usually done once a month and it usually takes 2 to 4 treatments to reach full effect depending on the severity of the fat. 
  
See the link below for more information. 
Effective surgical alternatives for submental fat removal include liposuction and direct excision.
  
A detailed examination will help delineate the best option. Consultation with a surgeon certified by the American Board of Plastic Surgery would be the next best step.

Monika Soni, MD · Answer

Kybella is injected and FDA approved only for submental fat therefore it is injected in the under the chin area. The injection depth is half a needle and it travels only 1cm from the injection site, so the risk for any damage is minimal. The amount injected varies by the amount of submental fat. I always prefer to inject smaller doses and then have 2 or 3 treatments. It all depends how much fat you have. You may need more treatments than that. It is hard to tell without a photo. Make sure to choose experienced provide for best results. Good luck!

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question mghazi11. Kybella
is the first and thus-far only FDA-approved non-surgical injectable treatment
for the double chin. It is important to find a doctor that you trust. Look for experience, before and after photographs, and testimonials. When I perform Kybella treatments I inject using a 30 Ga 1/2 inch needle using the grid shown in the video. Approximaately half of the needle length goes into the skin. When two vials are used approximately 20 injections are made. Most injections are 0.2 cc each. But sometimes less is used. Please
consult with a doctor for specific recommendations. Good luck!

Kouros Azar, MD · Answer

The needle for Kybella only goes about 1cm into the skin so the injections are shallow. The number of injections will depend on how much fat needs to be removed. Make certain to schedule your treatment with a board certified plastic surgeon who has experience with Kybella and all should be fine.

Hardik Soni, MD · Answer

Kybella is injected and FDA approved only for submental fat therefore it is injected in the under the chin area. The injection depth is half a needle and it travels only 1cm from the injection site, so the risk for any damage is minimal. The amount injected varies by the amount of submental fat. I always prefer to inject smaller doses and then have 2 or 3 treatments. It all depends how much fat you have. You may need more treatments than that. It is hard to tell without a photo. Make sure to choose experienced provide for best results. Good luck!

Tracy Leong, MD · Answer

Thank you for your questions. It is important that before undergoing any cosmetic procedure, you feel comfortable with your doctor and that all of your questions and concerns are addressed. For Kybella treatments, I typically inject using a 1/2-inch 32-gauge needle. If a patient has a substantial amount of submental fat, sometimes the needle is inserted all the way in. If a patient has less fat, then the needle may only be inserted half way. Typically, I will spread the Kybella injections over 10-20 sites and inject about 0.2 mL in each site. However, this will vary based on a patient's anatomy and distribution of fat. I strongly recommend scheduling an in person consultation with a board-certified dermatologist or plastic surgeon familiar with Kybella treatments who can help you decide what treatment plan is best for you.I hope this answer is helpful! Best of luck.

David A. Sieber, MD, FACS · Answer

Thanks for the great question. Kybella is typically injected with a 1/2" needle. The needle is only inserted half way into the skin with each injection. The amount injected varies depending on the amount of fat present and areas being treated. Best of luck!~Dr. Sieber

F. Victor Rueckl, MD (in memoriam) · Answer

Kybella is injected at a shallower depth than fillers. I've attached a training video that I made for other Kybella injectors because I train local injectors in my area. It will show you how the treatment is done, the depth, how the treatment site is determined, and injection sites/amounts. "This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Samer Muala, MD - Account Suspended · Answer

He will not be injecting deep.  The idea is the substance in kybella digests the fat gradually.  I recommend icing the neck region for 10 minutes at a time after the procedure and intermittently during.  You will have swelling and discomfort for about 2-4 weeks.  The results are great!  Good luck.

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