Kybella timing for trip? (Photo)

Question

I started my first of expected 4 treatments on June 22, 2017. I have a big trip Sept 21-25 (13 weeks from first treatment). I am now 8 days from my first treatment and my swelling was noticeable the first 2-3 days and back to about normal now. For best results on sept 21, is it better to have next treatment at 4 weeks and 3rd treatment at 8 weeks leaving me 5 weeks till my trip? Or 2nd treatment at 5-6 weeks leaving me a full 8 weeks of recovery before my trip. I would have 3rd on return.

Sabrina Fabi, MD · Answer

It sounds like your swelling is minimal after Kybella. I recommend the second treatment be between 6 and 8 weeks after the first session. Therefore, you could have your 2nd treatment before your trip, and still have plenty of time to recover. It's perfectly fine to wait more than 2 months between treatments if that's what works for you. Be sure you work with a board-certified dermatologist for your Kybella to get the best results.

Michael I. Echavez, MD · Answer

I would recommend waiting at least 6 weeks in between Kybella treatments and to be on the safe side, I would have your treatment at least 2 weeks before you leave on your trip.  I would schedule your treatments with those parameters.

Carmen A. Traywick, MD, FAAD · Answer

I always tell my patients to do procedures 2 weeks before a scheduled event. For Kybella, you can do treatments as early as 4 weeks apart, but I advise doing them 6-8 weeks apart. 
Hope this helps

Alex Eshaghian, MD, PhD · Answer

Thank you for your question and for sharing your
photograph dm9876. I understand your concern. Kybella is the first
and thus-far only FDA-approved non-surgical injectable treatment for the double
chin. The double chin can be formed by various factors including age, weight
gain, and genetics.The active ingredient in Kybella (deoxycholic
acid) is used by the body to digest the dietary fat. When injected into
the double chin it will dissolve the fat and it is eliminated by the body
naturally over time. The pivotal studies demonstrated that most
people require two to four treatments, sometimes up to six treatments. The
pivotal studies used two vials per treatment, which is what I use for my
patients. Some doctors use more or less than this amount, which is fine. The
more product is used the more swelling can be expected after the treatment.
Although some people see results after a single treatment, for my patients I
recommend starting with at least two treatments because many people do not see
a significant improvement after only one treatment. Each vial contains 2 mL of
product and 0.2 mL aliquots are used for each injection per the manufacturer’s
guidelines; therefore, one vial would be enough for 10 injections using this
method.Although in the pivotal studies treatments were
performed at four week intervals, I find that performing treatments at twelve week
intervals provides for better results. This may be due to an increased amount
of time for healing of the skin, allowing nodules to dissolve and swelling to
completely subside. Therefore, I recommend that patients start with one
treatment, followed by a second treatment three months later, and return three
months after that to assess initial results. At that point, more treatments may
be performed if further enhancement is desired. Patience is important.With any injection, there is a risk for pain,
bleeding, bruising, redness, tenderness, swelling, and infection, We take
special precautions to minimize these risks. We numb the skin prior to the
treatment and apply cold air to maximize our patients' comfort. We treat
bruises with a laser as early as the next day. Bruises usually resolve by two
weeks and after a laser treatment they usually resolve in one to three days,
although it still can take up to two weeks for full resolution. Most people
feel a burning sensation for about 15 minutes after the treatment. This is
addressed by placing cold compresses on the area which we provide in our
office.The most common concern for our patients after a
treatment is swelling, which occurs 100% of the time and I feel that this is an
indication that the treatment is working. I tell my patients to expect swelling
for one to two weeks. Some people describe it as looking like a pelican or
bullfrog. Therefore, patients prepare for this by scheduling their treatments
at times where they are not planning any special events where they want to look
their best. Some people will wear a turtleneck or scarf during this time to
hide the swelling. For my patients, I recommend applying cold compresses such
as ice packs to the area to reduce the swelling. We provide cold compresses
which can be frozen and re-used which attach to a wrap that goes around the
neck and crown of the head. Also sleeping on an extra pillow if not
uncomfortable will help to reduce the swelling.For those scheduling treatments around events, the swelling is the biggest concern. Therefore if a patient knows how much swelling he had from a previous treatment, he can expect a similar amount of swelling if the same amount of product is used. This recovery time can be used as a guideline to schedule treatments around events. For example if swelling took two to three days after a treatment for my patient, I would recommend that he schedule a subsequent treatment at least this many days before an important event, preferably one week prior to the event just in case there is more swelling. That being said, as mentioned above I find that my patients get better results when the intervals between treatments are extended up to three months rather than four weeks.Those interested in Kybella treatments for the
double chin are usually also interested in improving jawline definition. While
Kybella, Cool Sculpting Mini, and liposuction all improve jawline definition,
there are other treatments that can be performed to further improve the jawline
definition. Fillers such as Voluma can be placed on the jawline or in the chin.
This will sharpen the jawline. Such fillers can also be placed in the upper
cheeks to restore lost volume to the mid-face. This provides the structural
support for the face that is slowly lost over time. As a result, this will pull
up on the lower face to improve the jawline definition. Simultaneously it will
restore the youthful apple of the cheek and address nasolabial folds (the
wrinkles that go from the sides of the nose to the corners of the mouth),
marionette lines (the wrinkles that go from the corners of the mouth to the jawline),
and jowls. Skin tightening treatments such as fractional CO2 laser resurfacing
can stimulate the skin to form its own natural, new, fresh, and healthy
collagen. This will tighten the skin and pull the lower face upward. Finally,
Botox can be placed in the platysma muscle in the neck which pulls down on the
lower face. When this muscle is relaxed it will lead to a subtle lift of the
jawline further improving the definition. Combinations of such treatments yield
improved results.Please consult with a doctor for specific
recommendations. Good luck!

Kouros Azar, MD · Answer

I would recommend that you wait 6 weeks between your first and second treatment and then save your third treatment until after you return.

Shareef Jandali, MD · Answer

Hi dm9876,
It's great that you are thinking about this ahead of time, since there is a window of recovery to consider when undergoing Kybella treatments. In our Trumbull, CT office, we allow a full 8 weeks of recovery/healing between Kybella treatments, and most commonly receive feedback that the majority of swelling and bruising takes about 2 weeks to improve post treatment. Most patients have reported less swelling with each subsequent treamtent but since this can not be guaranteed I would err on the side of caution and give yourself a minimum of 2 weeks prior to your upcoming trip. There is no physiologic benefit to undergoing treatments in closer succession, aside from completing your treatment. If you were a patient in our office, we would recommend waiting to undergo your 3rd treatment until you return from your trip! Bon voyage!

Pamela Stuart, MD · Answer

I would recommend waiting for 6 weeks before your second treatment. However you should speak with your physician to help you with your decision and the timing of your next treatment. Best wishes.

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