How do I fix a deep indentation from Kybella or exilis? (Photo)

Question

I had kybella done for marionette lines. 3 shots from top going down towards jowels. One side worked. The other was much more swollen from the start. After 6 weeks they did exilis to bring it down. It didn’t help but two weeks later there was a deep dent next to a kybella shot. 2 days ago they shot the puffy parts with steroids to check if it’s fat but nothing’s changed yet. I don’t want a temporary solution like filler or fat graphting. How do I fix this?

Sue Ellen Cox, MD · Answer

Kybella is deoxycholic acid, a naturally occurring substance which permanently dissolves fat cells. Used properly, it's an effective treatment for localized fat.  Swelling after treatment is normal and will dissipate on its own, though it may last some time.  While an oral steroid may be used to treat generalized swelling, an injected steroid may cause atrophy of the injected area.  Filler is the first line of treatment to correct the depression.  I would strongly encourage you to seek out a board certified dermatologist for your subsequent treatment.

Shanthala Shivananjappa, MD · Answer

Hello, you have stated that you do not want any temporary solution such as fat grafting or filler to treat the indentation after kybella, I would suggest you to try Bellafill, PRP  and PDO threads.
Best
Dr. Shanthala

Maria Milone, MBBS · Answer

Hello 
I also would love to see the good side
Both Kybella and exilis remove fat permanently so cautious approach is advised for areas on the face . Steroid injections can also cause depressions in the skin and tissues which can be temporary or permanent so I would be hesitant to advise this in an area where you already have a depression granted the injections where directed towards the puffy area. The assessment and plan would depend a lot on comparison to the other side. If you do not wish to have filler , you may need to consider more fat dissolving injections aiming at the residual pockets of fat to reduce the difference in contour. I hope this helps and look forward to see the  other side

Val Lambros, MD, FACS (retired) · Answer

well, if you have a dent and you don't want fillers or fat to fill it, you are kind of stuck. I'd really like to see pictures of the side that worked

How do I fix a deep indentation from Kybella or exilis? (Photo)

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