Nonsurgical Injections to Remove Chin and Neck Fat
There is a new procedure that has just gained FDA approval for the nonsurgical removal of chin and neck fat. This is called ATX-101, also known as Kybella, and is made of a material called deoxycholic acid. This acid specifically dissolves fat and is effective at reducing the unwanted fat volume in the submental region.
The treatment requires anywhere between 10 and 50 injections to the neck and region under the chin, and four to six repeat treatments will be needed at one-month intervals to achieve significant fat reduction. The injections will rupture the fat cells, at which point the body’s immune system will remove the ruptured fat. This does cause an inflammatory response that will result in inflammation and swelling of the injected area. The inflammation and swelling can be mild to severe and may last from anywhere between one and two weeks. Over the course of four to six months, the unwanted fat in the area will be significantly reduced.
It is important that the injections be performed by a specialist to ensure that the chemical is injected into the appropriate area. If it is injected too shallow, it can cause an ulcer to the skin, and if it is injected too deep, it can cause damage to the underlying structures.
As a facioplasty specialist, it is my obligation to determine who is an appropriate candidate for given procedures. ATX-101 will significantly reduce fat in the submental region, and this would be appropriate for somebody who has good skin elasticity and excess subcutaneous fat. In general, this is a younger population of people. It is very important to note that if fat is removed from somebody with poor skin elasticity, the skin can and will become saggier and create more of an aged appearance. If fat is removed from somebody who does not have a significant excess of fat, then we will see skeletonization of the underlying platysma muscle, causing an advanced aged appearance in the neck. In general, ATX-101 will be appropriate for candidates who are also good candidates for submental liposuction.
As an international facioplastic surgeon, it is my experience that submental liposuction is overperformed in many parts of the world. I have seen many problems from people who have had submental liposuction who were not good candidates for it. It is of significant importance that ATX-101 is performed in people who are good candidates. If it becomes an overperformed procedure on those who are not, we will see many people with significantly aged necks that can be very difficult to correct. For the right candidates, ATX-101 is an excellent treatment for those who do not want to have a surgical procedure. I look forward to treating those who are good candidates for this nonsurgical procedure.
For people who do have poor skin elasticity (usually those over 40 years old), we can perform a minimally invasive neck lift to tighten the skin as the fat burden is removed. There are many different ways to achieve skin tightening, including a standard neck lift, minimally invasive neck lift, mini facelift, and in-office skin tightening. Each patient must be evaluated individually to determine whether they are a good candidate for any of the above-mentioned procedures.
Jason Diamond, MD