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
