The search to non-surgically reduce fat for aesthetic purposes has been ongoing for years and many methods exist today to do so. Numerous energy-based devices are available (e.g., Vanquish) for body contouring which induce fat cell atrophy through an apoptosis process. But such devices have limited use in the face due to the smaller fat collection locations and the difficulty with such device application.
Fat dissolving injections have recently become available based on the introduction of deoxycholic acid solutions. (Kybella) This chemical causes the dissolution of fat cell walls which release their lipid contents into the surrounding tissues. The free fatty acids are then absorbed from the injected area reducing the treated contour. Kybella injections have been clinically tested and FDA-approved for the treatment in the head and neck area of the submental area. Known as the double chin neck deformity, the smaller submental area is a good location for the use of fat dissolving injections in properly selected patients.
Other facial areas can potentially also benefit from Kybella injections for small fat reductions. One such area is that of the jowls. The jowls are an area along the jawline which develop from the descent of facial tissues with aging. Skin and any underlying fat drifts down over the jawline creating the classic jowling and increased lower facial width. While fat reduction alone is not the complete solution to jowls in most patients, it is one component whose reduction can help reduce their appearance.
Kybella injections to the jowls works identically to that of the submental area. It requires a series of injection treatments spaced four to six weeks apart. Two to three injection sessions may be needed for optimal reduction. The jowl area is smaller than the submental area so a lower number of injections are needed. There will still be considerable swelling after the injections for the first week due to the inflammatory process of how the solution breaks down the fat cells.
Because fat injection therapy can be done just about anywhere, Kybella will continue to evolve in both its face and body applications.
Dr. Barry Eppley