Kybella and Using Products Off-Label

Kybella is one of the latest injectable options growing in popularity for it’s ability to eradicate fat pockets. The retooled substance is used specifically underneath the chin, breaking down fat over a series of injections – no surgery required. It’s success has patients and practitioner’s wondering, can it be used successfully in other areas, off-label?

Board certified plastic surgeons Dr. Kevin Smith and Dr. Brooke Seckel discuss off-label use of products and if Kybella stands to do more than eliminate just neck fat.

Off-Label Use

The term “off-label” is used whenever products are employed beyond what they’ve been approved of. Botox, as an example, is successfully used in the armpits and hands for hyperhidrosis (excessive sweating), and even to treat migraines. While these treatments are done more and more because of their success, technically these uses are considered “off-label”; Botox hasn’t been approved for these uses.

For Kybella, it’s mechanism of action is pretty simple: the substance, when injected, destroys fat. If the product has found success in treating fat under the chin – as it is approved for – why not use it elsewhere?

“We know that Kybella kills fat – that is a given,” explains Dr. Kevin Smith, a board certified plastic surgeon in Charlotte. “We know it can do it safely when it’s put in the right place. When we inject Kybella around fat cells, the fat cells die, the body absorbs them, and the fat goes away. It is a non-surgical, minimally-invasive way to get rid of fat.”

Everything looks good, but Dr. Smith is waiting for the big “but…”. “The ‘but’ is that we have to wait until the studies are done,” answers Dr. Seckel, a board certified plastic surgeon in Boston. “I think you have to also realize that you’re going to need a series of injections, maybe 4, 6 weeks apart. It’s not a magic bullet, let’s put it that way!”

Dr. Seckel, like any great physician, scientist, engineer, etc., is waiting for results from studies. While a product may, in theory, do other things, it’s also of paramount importance for those would-be uses to be proven within a study. Unfortunately when it comes to products like Botox and Kybella, they are available to more than just experienced, board certified plastic surgeons.

What Else Might Kybella be Used For?

The excitement surrounding Kybella is somewhat similar to that surrounding fat grafting: the ability to refine and “finish off” procedures. Currently, fat grafting is used in some procedures to polish results. For example during a breast augmentation, perhaps the patient is quite thin and needs a bit of coverage on the edge of their breasts. The implants have been placed and look great, but there is just a bit of volume that needs filled to make it perfect. In this situation, a surgeon might opt to do a small amount of liposuction, process the fat, then place it in deficient areas. This specific procedure is used routinely in breast reconstruction procedures.

The reverse could be true via Kybella. If following a procedure there exists a small amount of fat in a pocket that needs to go, a Kybella injection or two could be a powerful tool. Many such fat pockets might be considered not big enough of an issue to require liposuction, but if the surgeon could use an injectable product to reduce the fat? That could be a game-changer.

“For following surgery where there may be a little leftover fat and you want to clean up a contour, the neck following a facelift, small little things,” shares Dr. Smith. “Realistically, you want to be able to use this product for one or two injections max to get rid of a little bit fat, where otherwise it’s not worth going after it surgically.”

Are Surgeons Comfortable with Off-Label Use?

Kybella, like fat grafting, is a product that adds to or subtracts minimally, creating nuance. Surgical nuance in plastic surgery is the realm of the most experienced, as it truly is the difference between good results and fantastic results. Kybella in these hands could go a long way, but Kybella isn’t just offered to board certified plastic surgeons. Like Botox, fillers and many other non-surgical devices, many different types of people can attain the product and offer services. An OBGYN, salon owner, and even a dentist may offer Kybella. Would patients feel comfortable allowing a dentist to service fat pockets after taking a weekend course? Or would they rather a surgeon who has over a decade of surgical experience?

“We need to know it’s safe and effective before we really push it,” says Dr. Seckel. “I think we learn from others who have experience and have done these off-label studies.”