Between Botox and Juvederm, the pharma pioneers at Allergan have virtually defined the world of nonsurgical aesthetic treatments. Now the company is looking to score a three-peat with Kybella, the only FDA-approved injection for “submental fullness”—better known as the dreaded double chin. But just how does Kybella work? And can it really zap stubborn fat cells? We spoke with Terrence Keaney, M.D.—a Washington, D.C.-based board certified dermatologist, and one of the first physicians trained in using Kybella—to give us the skinny on the new drug promising to erase your double chin for good.
Men's Fitness: What about Kybella first sparked your clinical interest?
Terrence Keaney: You can’t hide a double chin, or what we call “submental fullness.” Patients see it in their photos. In the era of social media, people see it when they’re smiling in photos. “Gosh, look at my chin.” It’s an especially important area for men, probably because at least here in D.C.—men wear ties and collared shirts, which provide a “frame” for submental fullness.
So even when Kybella was in clinical development, I recognized that this would be a very important—and popular—aesthetic treatment for men.
Men's Fitness: Can’t you just exercise away a double chin?
TK: Even fit patients may be genetically inclined to have that submental fullness. We have patients who are in great shape, but who struggle to lose that stubborn area, even with diet and exercise.
Men's Fitness: So what exactly is Kybella?
TK: It’s called deoxycholic acid. Your body produces it naturally to aid in the breakdown and absorption of fat. In this case, we’re injecting it.
Men's Fitness: And how does it destroy the fat cells?
TK: Fat cells are like storage containers. When we gain and lose weight, they get larger or smaller. Kybella causes adipocytolysis, which disrupts the fat cells, leading to fat reabsorption from the the submental space, which is then redistributed in the body.
Men's Fitness: That’s it?
TK: It’s just a straightforward series of small injections. You mark out that little pocket under your chin, and inject the product in an even distribution.
Men's Fitness: So people must ask you…
TK: “Why not inject it all over the place?” Yeah, I’ve heard that. But I always tell patients it’s not a weight-loss treatment. We call it body contouring.
Men's Fitness: Could you use it for, say, belly fat? Or love handles?
TK: Theoretically, yes. But right now it’s just meant for the submental space. It’s an area of high cosmetic concern, and submental fat is just a little pocket, so you get substantial reduction with less product.
Men's Fitness: How many sessions, on average, do patients need?
TK: It depends on how “full” they are, so to speak. In my hands, two to four treatments are characteristic. Usually, each treatment is separated by one to two months.
Men's Fitness: So, what happens—what can you expect—after the treatment?
TK: For around 10-15 minutes you’ll feel a slight tingling, a slight sensitivity to the area. Maybe you’ll see some swelling that may last 3-5 days, depending on how much fat your body has to process. Then your immune system removes those fat cells.
That’s the beauty of this treatment: After a cycle has been completed, the fat cells are no longer there. It’s a long-lasting result.
Men's Fitness: What kind of guys are asking about it?
TK: There are two basic categories: There’s the 30-to-40-year-old guy who’s let himself go a little bit, and his double chin is really bothering him. The treatment shifts his health perspective. He’s like, “I’m gonna make sure this treatment lasts. I’m gonna make sure the rest of my body reflects that change.”
Then there’s the active guy—he goes to the gym, he watches his diet and exercise, he’s in pretty good shape—but the submental area is his trouble spot and it drives him crazy. Then he turns to Kybella.
Men's Fitness: What’s their top concern?
TK: Guys are afraid they’ll look feminine. But with Kybella, we get rid of the double chin and make the jawline look more defined, prominent, and chiseled. The jawline is probably the most masculine area of the male face, and Kybella is creating a more masculine facial structure.
Here’s How Kybella Works, in Five Steps:
1) A doctor dispenses Kybella—a man-made form of deoxycholic acid, a chemical naturally occurring in the body-through a series of injections under a patient’s skin.
2) Kybella begins to break up the membranes of the fat cells under the chin, “essentially ‘injuring’ the fat cells,” Keaney says.
3) The body registers the change—“It now thinks these fat cells are somewhat deficient,” Keaney says—and that triggers the immune system to race to the area to investigate.
4) Over a period of a couple weeks, Keaney say, the immune system removes the now broken-up fat cells from under the chin. That's why Kybella treatments are spaced one or two months apart.
5) The immune system takes the leftover fat that it has now gathered from under the chin and shuttles it elsewhere in the body. “It’s not like it appears on top of your head,” Keaney says, “it just gets redistributed to all the other fat cells.”