Future Applications of Deoxycholic Acid in Body Contouring

January 2017 | Volume 16 | Issue 1 | Original Article | 43 | Copyright © 2017

Jonathan M. Sykes MD,a Amir Allak MD MBA,a and Brian Klink MDb

aUniversity of California Davis Medical Center, Sacramento, CA bSolano Plastic Surgery,Vacaville, CA

Abstract

Deoxycholic acid (KybellaTM, Allergan Pharmaceuticals, Irvine, CA) is a novel injectable treatment used for the cosmetic reduction of redundant submental fat. By inducing adipose cell lysis, the soft tissue alteration induces subsequent contour change and sharpening of the cervicomental angle.The safety and efficacy have been well established in several prospective clinical trials and subsequent FDA approval for this purpose. This has provided an effective and less invasive alternative to surgical liposuction with virtually no recovery time and less overall discomfort. Given its success for use in this context, a logical step would be to extrapolate to other regions of the body where cosmetic deformity is caused by excessive adipose tissue. In the current article, the authors propose potential options for further use in various targeted areas where subcutaneous fat may be amenable to reduction with deoxycholic acid injection, understanding that such uses would be off-label and require an understanding of the regional anatomy and possible complications. J Drugs Dermatol. 2017;16(1):43-46.

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INTRODUCTION

Deoxycholic acid, called KybellaTM in the United States and BelkyraTM in Canada (Allergan Pharmaceuticals, Irvine, California), is the first aesthetic injectable treatment approved for improvement in the appearance of moderate to severe convexity or fullness associated with submental fat (SMF).1 The drug was FDA approved in April 2015 and has been used as an injectable product to reduce submental fat in the US since that time. The addition of Kybella for this purpose has given patients who are averse to surgery a minimally invasive treatment option that can be performed during an office visit. During the pivotal studies leading up to FDA approval, physicians have learned a great deal about deoxycholic acid and its interaction with submental fat and soft tissue. This has included the treatment efficacy and the side effects and safety profile of the drug.2-4 Understanding the expected treatment effect after injection and the potential complications from the injection are part of the physician’s learning curve for any cosmetic injectable substance. This understanding allows the practitioner to develop new and innovative applications for any drug. Such is the case with neurotoxins and injectable fillers, each of which are used in many variant ways in addition to the applications indicated by their initial FDA approval. The goal of deoxycholic acid injection is to change the contour of the anterior neck, creating a more acute cervicomental angle. The soft tissue contour difference created by Kybella

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