Kybella (Deoxycholic Acid) Side Effects & Adverse Reactions (List)

Kybella (Deoxycholic acid) is an injectable medication engineered by Kythera Biopharmaceuticals and approved by the FDA in April 2015 for the management of moderate-to-severe submental fat (fat beneath the chin) in adults.  Reducing the appearance of a protruding “double chin” with Kybella entails visiting a medical professional to receive a series of subcutaneous [deoxycholic acid] injections.  All injections are administered using a 30-gauge needle (or smaller) and directly target the submental region.

Data from clinical trials reveal that Kybella recipients are likely to experience clinically significant reductions in submental fat within 2 to 6 treatment sessions (each of which is spaced from other sessions by a minimum of 1 month).  The active ingredient within Kybella, known as “deoxycholic acid,” functions by penetrating and destroying the membranes of fat cells, thereby inducing cellular death.  As deoxycholic acid eradicates submental fat cells, previously unflattering “double chins” are transformed into aesthetically appealing, slimmer chins.

Although reduction in submental fat may improve self-esteem and decrease psychological distress associated with having a large double chin, Kybella is only effective in around 43% of patients.  In addition to Kybella lacking efficacy in around 57% of patients, some individuals will find the injections to be nearly intolerable.  In fact, a subset of Kybella recipients may end up experiencing such severe unwanted side effects and/or adverse reactions – that they regret their decision to pursue this type of treatment.

Kybella (Deoxycholic acid) Side Effects & Adverse Reactions (List)

Anyone considering Kybella injections should be cognizant of all possible side effects and adverse reactions prior to receiving treatment.  Everyone should realize that the specific side effects [and their respective severities] reported by one recipient of Kybella may differ from those reported by other recipients.  Variation in specific side effects and severities may be related to the degree of competence of practitioners responsible for administering the injections.

Differences in side effects among users may also vary based on amount of submental fat content and individual pain threshold.  Since Kybella is subcutaneously injected into fat cells, a majority of its side effects are localized to sites of the injection and similar across patients.  The most commonly reported Kybella side effects include: bruising, hardness, numbness, pain, redness, and swelling – under the chin or on the lower jaw.

Included below is a more comprehensive list of side effects that have been reported as a result of Kybella injections.  Understand that you are receiving Kybella because your doctor judged that the benefits of treatment would outweigh the side effects.  If at any time you experience an adverse reaction, intolerable side effects, or believe that the injections are doing more harm than good – consult emergency medical services.

Allergic reaction: Although an extremely rare occurrence, a small percentage of Kybella patients may experience an allergic reaction to its active ingredient, deoxycholic acid.  If you are allergic to deoxycholic acid, you may experience a myriad of symptoms including: difficulty breathing, noticeable swelling (face, lips, tongue, throat), skin rash, and/or watery eyes.  Allergies to a drug that was injected into your cells may also cause you to feel dizzy, nauseous, and/or physical weakness.

Anyone that suspects they may be experiencing an allergic reaction needs to seek emergency medical attention.  A medical professional will be most qualified to evaluate your reaction and can take action to get your allergy under control.  Hesitation to treat an allergic reaction could result in serious long-term, possibly permanent complications.  If you aren’t sure whether you may be experiencing an allergic reaction, ask for an evaluation from your doctor.

Anxiety: There are numerous reasons as to why receiving Kybella may make some individuals feel more anxious than usual.  Since the medication is administered via injections in which needles are involved, anyone with needle phobia (fear of needles) may panic.  Even though the needles are not large, a small percentage of the population is overwhelmed with nervousness at the sight and/or thought of needle insertion during Kybella treatment.

In fact, the anxiety associated with needle phobia may become so severe, that some recipients may faint prior to and/or upon receiving injections.  Not everyone receiving Kybella injections may experience anxiety over the actual needles, some may be more worried about experiencing pain in the submental area due to their low pain threshold.  Others may be anxious over the idea that friends, family, and/or co-workers will notice post-procedural inflammation/swelling and ask them about it.

It is also possible that abnormal sensations that occur after receiving the injections may lead some individuals to become anxious, wondering whether they’ll ever subside.  Furthermore, certain persons may develop anxiety over the idea that Kybella may be ineffective for them – after all, it only works in approximately 43% of patients.  Anyone experiencing anxiety during treatment should ask their doctor about possible anxiolytic interventions to help them cope – especially if the anxiety is a result of needle phobia.

Bleeding: Most individuals shouldn’t experience much bleeding as a side effect of Kybella.  Though the drug is injected subcutaneously (penetrating the skin), heavy bleeding remains an uncommon reaction.  Small needles are used, injections are interspaced by at least 1-cm, and only the fatty areas of the submental region are targeted with the treatment.

A couple of factors increase risk for bleeding during treatment including: abnormal anatomical features, bleeding disorders (e.g. coagulation disorders), as well as suboptimal administration by the professional.  Risk of bleeding can be reduced by ruling out medically-diagnosable bleeding disorders [prior to treatment] and working with a professional that has experience administering Kybella.  To reduce likelihood of bleeding, doctors should carefully pinpoint exact areas set to receive Kybella injection, as well as ensure they are familiar with the anatomy of their patient.

As a patient, it is your responsibility to let your doctor know whether you’re using any blood-thinners and/or supplements that may increase risk of bleeding.  Some individuals may experience minor bleeding after injections that subsides within minutes.  Any bleeding should be monitored by your doctor, sterilized, and wrapped with a bandage to minimize risk of infection.

Blisters: Another injection site reaction that may occur in some individuals is blistering of the skin.  Blisters that develop after receiving Kybella are characterized by swollen bumps or pockets of watery fluid.  Some individuals may develop an entire patch of blisters beneath their chin, whereas others may develop just a single blister.

There are numerous possibilities regarding what may have caused the blister.  Blisters can occur due to irritation induced by the needle and/or deoxycholic acid.  In some cases, blisters may result from incessant itchiness and scratching of the area [by a patient] following Kybella injections.

Though less likely of a scenario, blisters can be caused by infections as well.  To minimize blisters and/or likelihood of blisters, have your doctor rule out an infection and take steps to avoid rubbing, scratching, and/or irritating the submental area.  For most individuals, the blisters that occur after treatment should diminish within a couple weeks.

Bruising: Estimates suggest that 72% of those receiving Kybella injections will experience bruising or hematoma, often accompanied by swelling.  Hematoma is defined as the abnormal accumulation of blood outside a blood vessel (or in tissue), occurring as a result of damage to blood vessel walls.  Anyone with medical conditions and/or taking medications that may increase risk of bruising should inform their doctor – as Kybella may be contraindicated.

In some cases, too many injections to the area, improperly spaced injections, or too high of a dose may lead to bruising.  Others may end up with bruising due to poor technique or overly-forceful injections by the professional who administered Kybella.  That said, for most patients, bruising is an unavoidable aspect of Kybella treatment.  Some professionals recommend wearing a chin-strap or scarf (to control swelling/bruising) and avoiding strenuous physical activity to minimize further bruising and promote quicker healing.

Burning sensations: Many individuals report burning sensations following injections of Kybella.  For certain recipients, burning sensations may have resulted from the 20 to 50 needle injections delivered during a treatment session.  Needles are known to induce irritation, and this irritation is likely to cause burning until the area has fully healed.

In addition to needles being culpable for provoking a burning sensation, the burning may also result from deoxycholic acid entering and obliterating their fat cells.  Once the fat cells are fully destroyed and the area has had sufficient time to recover from the injections, burning should subside.  To cope with the burning, some sources recommend gentle application an ice pack to the area, as well as to avoid rubbing the area – as this may exacerbate the burning.

Contour abnormalities: Those undergoing treatment with Kybella may report irregularities in the contour of their face, chin, and/or neck during treatment.  If you notice that the shape of a particular region has shifted and appears abnormal or uneven, it is important to inform your doctor.  Sometimes the abnormal contour may have resulted from post-procedural inflammation, and once the inflammation subsides, your contour will normalize.

It also could be that your doctor injected too much Kybella on one side of your submental fat compared to the other.  With further treatments to reduce the fat, your submental region should appear more symmetrical.  Another explanation for irregularities in the shape of your face, chin, or neck could be the emergence of treatment-induced nodules.  These nodules may require several months to be fully eliminated.

Difficulty swallowing: Within 24 hours of receiving injections, around 2% of patients will report dysphagia or difficulty swallowing.  Difficulty swallowing may occur as a result of burning sensations, inflammation, and/or numbness in the neck and throat.  A majority of patients notice swallowing difficulties are at their worst during the first 4 to 12 hours post-treatment, and usually improves after the first 24 hours.

Sometimes lightly icing the submental area to expedite reduction of inflammation is can help with swallowing challenges.  Since difficulty swallowing is generally limited to solid foods, you may want to plan on consuming softer foods and/or making a smoothie your first day after treatment.  If the difficulty associated with swallowing food is overwhelming and/or doesn’t seem to be improving, talk to your doctor for his/her recommendations.

Discoloration of skin: While most recipients of Kybella do not report changes in the color of their skin, some individuals will notice skin discoloration.  Those that experience skin discoloration after treatment may want to consult a dermatologist for an analysis (e.g. to rule out allergic reactions) and management strategies.  Typically, skin discoloration appears as redness resulting from needle-induced irritation and/or a reaction to the deoxycholic acid.

As swelling decreases and the area recovers after injections, redness will diminish and coloring of skin will normalize.  Some evidence indicates that Kybella could cause hyperpigmentation in which patches of skin appear darker than the surrounding skin.  If you notice splotches of darkness across your skin, you may be experiencing treatment-induced hyperpigmentation.

Ear pounding: An unusual, yet reported side effect of Kybella is the sensation of pounding within the ears.  It is unclear as to how and/or why pounding within the ears would result from injections of deoxycholic acid beneath the chin.  One possibility is that, since the ears are connected to the throat, inflammation in the throat area has a downstream effect upon the ears, resulting in increased ear pressure or pounding.

Those that experience ear pounding will want to be sure that the pounding does not lead to any form of hearing loss and/or ear damage.  If you notice that your hearing has been detrimentally affected after receiving treatment, it is recommended to consult an otolaryngologist (or ENT).  A medical professional should help you make sense of the ear pounding and help you come up with strategies to mitigate this pounding and protect your hearing.

Fainting: It is thought that a small percentage of individuals receiving Kybella will faint prior to treatment or while receiving injections.  Fainting, medically termed “syncope” is often preceded by signs such as:  anxiety, paleness, nausea, sweating, rapid heartbeat, and/or lightheadedness.  The fainting may be triggered by a fear of needles (“needle phobia”) or the possibility that blood may drip down a person’s neck after needle insertion.

If you are afraid of needles, are concerned about possibly bleeding, or have a history of fainting episodes – be sure to let your doctor know before initiating Kybella treatment.  Since Kybella is generally administered while a patient is lying down in a comfortable position (rather than standing upright), the likelihood of fainting remains low.  Non-pharmacological strategies to reduce odds of fainting include: cognitive behavioral therapy, counterpressure maneuvers (e.g. deliberately tensing certain muscles), and drinking enough water.

Hardness of skin: In clinical trials, a reported 23% of patients receiving Kybella experienced a hardening of skin within the submental region.  This hardness is referred to as “induration” and may occur as a result of increased inflammation whereby fibrous elements in tissue are increased and elasticity of the skin is decreased.   For some patients, hardening of the neck, throat, and/or chin will occur within the first few days after treatment.

By the fourth or fifth day after receiving Kybella, some patients mention that the area feels softer and/or like a “gel.”  The emergence of the gel-like sensation will eventually solidify fat and the solidified fat will harden.  Thereafter, the fat will be broken into smaller pieces referred to as “nodules” which are often internally felt by the patient – but remain unseen.

It is thought that an immune response is triggered in which macrophages devour the dead fat that has accumulated in hardened nodules.  They transport the dead fat stores to be eliminated from the body, but this doesn’t occur overnight.  Usually the hardened nodules are no longer noticeable after 3 months post-treatment.

Headache: A fairly common Kybella side effect reported in around 8% of individuals is headache.  Some think that the headache experienced by patients may be unrelated to the actual treatment and more related to anxiety associated with receiving injections.  That said, injections into the submental area may lead to inflammation and/or increased muscle tension within the face, which could provoke a headache.

To counteract a treatment-induced headache, it may be best to engage in relaxation exercises (to decrease muscle tension), avoid strenuous physical activity (e.g. lifting weights), and apply ice to inflamed areas.  You may also want to ask your doctor whether taking an over-the-counter headache relief medication would be recommended for your headache.  Fortunately, most severe headaches subside within a few days after treatment and most mild-to-moderate headaches aren’t overly bothersome.

Heart rate changes: Some individuals may notice changes in their heart rate while receiving Kybella, or after treatment.  Since the drug isn’t understood to exert any effect upon the central nervous system, most heart rate changes are likely a result of anxiety.  The anxiety may be related to a sighting of the needle (especially among those with needle phobias), fear of bleeding (or feeling blood), and/or feeling as if you’re in a vulnerable position while receiving Kybella injections (near your neck).

Assuming you end up experiencing anxiety, your heart rate is most likely to accelerate.  There’s also a possibility that you’ll experience palpitations, characterized as your heart fluttering (or skipping a beat), beating loudly, and/or feeling funny within your chest.  Acceleration and palpitation of the heart occur when anxiety primes the sympathetic nervous system, triggering a “freeze-fight-flight” response, releasing catecholamines, and increasing blood pressure.

If you happen to experience a slower heart rate than usual, it could be related to hypotension – possibly preceding syncope (fainting).  Slow heart rate may also be a result of post-procedural orthostatic hypotension resulting from a quick transition from a supine to standing position.  In the event that your heart rate feels irregular after Kybella, talk to a medical professional to rule out possible allergic reactions and/or unrelated cardiac abnormalities.

Hypertension: Data from clinical trials indicates that an estimated 3% of Kybella recipients experience hypertension.  Based on the fact that Kybella is unlikely to modulate activity in the central nervous system (CNS), it remains puzzling as to how the drug could provoke hypertension or even a spike in blood pressure.  Knowing that the drug itself is unlikely to induce hypertension, it’s more likely that the cause of high blood pressure is treatment-related anxiety.

A subset of patients may become anxious worrying about aspects of treatment such as: injection pain, needles, post-procedural swelling, etc.  Though there’s no evidence suggesting that anxiety is a cause of long-term hypertension, it is widely documented that acute anxiety attacks can transiently spike a person’s blood pressure.  Those who exhibit high blood pressure before and/or after treatment may be dealing with unmanaged treatment-related anxiety.

Any unmanaged anxiety can activate the sympathetic nervous system, whereby peripheral blood vessels are contracted and blood pressure increases.  Make a conscious effort to reduce your anxiety through exercises such as: deep breathing, meditation, and getting proper sleep.  Should you have a history of high blood pressure and/or cardiac events, it is best to work with your doctor to monitor your blood pressure to ensure that it stays within a normative range – both before and after Kybella administration.

Infection: Knowing that Kybella has undergone extensive testing, is formally approved by the FDA, and can only be administered by a medical professional – the risk of any infection is extremely low.  Needles for injecting Kybella will have been unused (and clean), the submental area will have been sterilized before treatment, and patients will be informed of proper post-procedural care (to reduce odds of an infection).  Nonetheless, it is possible that a medical professional may fail to properly prepare for treatment and/or that a patient may end up with post-treatment wounds, making it easier for bacteria to infiltrate needle-induced wounds within the submental region.

In extremely rare cases, it is possible that someone may end up with an atypical mycobacterial infection near an injection site.  Anyone suspecting that they may have sustained an infection from treatment should consult a dermatologist for a compressive analysis.  To decrease your risk of an infection, be sure to have your doctor assess any wounds that you may have sustained during treatment for possible infection.

If you were bleeding (during or after treatment), make sure the area is properly sterilized and that the bleeding has fully stopped.  It is also important to refrain from scratching unhealed, irritated wounds – as this could reopen them and increase risk of post-procedural infections.  Fortunately, this is an extremely uncommon adverse reaction that most Kybella recipients will never experience.

Itchiness: An estimated 12% of patients receiving Kybella treatment will experience pruritus or severe itching of the skin.  There are numerous potential causes of itching as a side effect of Kybella including:  an allergic reaction, the deoxycholic acid burning fat cells, or skin irritation from subcutaneous injections.  If you develop severe itchiness accompanied by a skin rash that doesn’t seem to subside within a week or two after your injections, it may be best to seek dermatological evaluation for a possible allergy or infection.

In most cases, patients experience itchiness as a result of procedural-induced skin irritation and/or small wounds.  As the skin irritation and/or small wounds heal after the procedure, the itchiness is likely to diminish in severity and eventually abate.  It may be difficult to resist the urge to scratch and claw the itchy area, but the more you can resist scratching it, the quicker it is likely to heal (and the faster the itchiness will decline).

Lumps: Before Kybella, you may have had “lump” of fat hanging below your chin that you wanted to eliminate.  However, after receiving the injections, many recipients will notice lumps near the throat, thyroid, and/or neck.  Some of these lumps may be nothing more than inflammation near the site of injection, and once the inflammation decreases, the lumpy appearance tends to subside.

For a majority of patients, the lumpiness that is felt in the throat/neck area is not a result of inflammation, rather it’s from the body responding to deoxycholic acid.  Within the first few days following deoxycholic acid injections, patients will perceive a jellylike texture within the submental region.  By the third or fourth day after injections, the jellylike texture begins to solidify, eventually breaking into tinier pieces of dead [hardened] fat called “nodules.”

Some individuals will have visible nodules, whereas most patients will only be able to feel their nodules internally.  You may be concerned over these lumpy nodules and dislike how they feel, however, they will eventually be cleared from your body.  It usually takes several months for the nodules to fully disappear following Kybella treatment.

Nausea: A side effect that occurs in 2% of those receiving Kybella is nausea, or feeling sick and as though you’re on the verge of vomiting.  The nausea may be related to the fact that you’re receiving a series of injections near your throat, which could stimulate your gag-reflex to provoke feeling nauseated.  It is also possible that the nausea may be related to a phobia of needles, blood, or treatment-related anxiety.

If you suspect that your nausea is triggered by anxiety, it is recommended to practice relaxation exercises such as deep breathing.  Also consider that your doctor may be able to prescribe an anxiolytic to take the “edge off” while receiving Kybella injections.  Moreover, you may want to ask your doctor whether he/she would recommend taking an over-the-counter antiemetic agent to counteract the bouts of nausea that you experience during treatment.

Necrosis: While the purpose of receiving Kybella injections is to eliminate fat cells culpable for a double chin, it is possible that some individuals will experience necrosis as a side effect.  Necrosis refers to the disorganized, non-apoptotic death of cells, often resulting from severe inflammation, infection, or serious injury.  When cells normally die, they signal for phagocytes to clean them up upon death, whereas during necrosis the phagocytes are not signaled.

Anyone experiencing necrosis may appear to have significant dead skin or tissue, in the submental area.  A medical professional will be able to recognize necrosis, as well as help patients manage any complications resulting from Kybella-induced necrosis.  In extreme cases, if left neglected and left unmanaged, necrosis could cause permanent damage to bodily tissue.

Nerve injury: Around 4% of Kybella recipients will sustain nerve injuries from the process of Kybella administration and/or as an adverse reaction to treatment.  The most common form of nerve injury is to the marginal mandibular branch of the facial nerve.  The marginal mandibular nerve functions through regulation of muscles within the lower lip, chin, and face.

Injury to the marginal mandibular nerve is most often sustained as a result of poor administration technique and/or failure to elucidate patient-specific anatomical features prior to treatment.  In the event that the marginal mandibular nerve is injured or damaged upon injection of Kybella, a person may struggle to properly control his/her facial expressions (e.g. smiling, grimacing, etc.) and/or neck movements.  Another adverse response to a marginal mandibular nerve injury is salivary incontinence or frequent, uncontrollable “drooling.”

If you sustained a nerve injury from injections of Kybella, talk to a medical professional for further guidance as to how it can be repaired.  In extreme cases, correction of mandibular nerve injuries may require advanced forms of surgery.  Working with a medical professional experienced with Kybella should help reduce your odds of a treatment-induced nerve injury.

Numbness: One of the most common Kybella side effects is the sensation of numbness after receiving injections.  Numbness occurs in around 66% of all Kybella-treated patients and is usually localized to the submental region (the area targeted during treatment).  If you happen to experience numbness as a side effect, there are numerous possible causes including reactions to needle injections and/or the deoxycholic acid.

It is also possible that some numbness may have been induced by post-procedural inflammation.  In rarer cases, a patient may end up numb following Kybella treatment as a result of an allergic reaction, injection-site infection, or nerve injury.  Assuming that the numbness was not a reaction to allergies, infections, or injuries – it will most likely diminish significantly within a few weeks after treatment and fully cease within 2 months.

In most cases, the best way to reduce numbness is to take steps to minimize post-procedural inflammation.  Minimizing inflammation may involve applying ice to the area or utilizing anti-inflammatory drugs (as approved by your doctor).  All that said, you may want to consider that your numbness may have been more related to administration of a local anesthetic such as lidocaine [prior to Kybella injections].

Pain: Another of the most common Kybella side effects that 70% of patients experience, is pain in the submental space.  Pain at submental injection sites is common due to the fact that needles pierce the skin to deliver the deoxycholic acid.  Not only is the piercing of skin painful for some individuals, but the process by which deoxycholic acid enters and kills fat cells may cause pain and/or burning sensations.

It is understood that various genes encode for pain sensitivity and nociception.  Anyone with a low pain threshold (highly sensitive to pain) based on their genetic predisposition may find Kybella administration to be painful.  That said, other factors such as administration technique (e.g. gentle or aggressive), anatomy of the patient, and concurrent usage of pain relievers – could dictate whether severe pain is experienced as a side effect.

The pain reported by most patients usually affects the jaw, chin, neck, throat, or mouth – and is often accompanied by inflammation and swelling.  Pain is most severe within the first 12 hours after the procedure and tends to significantly decrease within 24 hours post-procedure.  If you’re experiencing pain from Kybella, ask your doctor about things you can to do decrease the pain such as applying an ice pack and/or taking analgesics.

Pressure sensations: After receiving injections some recipients of Kybella will report significant pressure in their throat, face, chin, or neck region.  The increased pressure is likely related to injection of an exogenous substance (deoxycholic acid) directly into fat tissue.  Though the deoxycholic acid destroys fat cells rapidly, it doesn’t happen instantly, meaning the cells must harbor both the fat and deoxycholic acid simultaneously – causing pressure and corresponding pressure sensations.

The pressure resulting from deoxycholic acid should only last up to 20 minutes and regress thereafter.  That said, it is possible that pressure in the submental area also occurs as a result of inflammation and/or swelling.  If your pressure sensations were caused by inflammation, you should expect the pressure to decrease as inflammation subsides [which usually takes several weeks].

Redness: It is fairly common to observe skin redness or erythema after Kybella is administered.  Reports suggest that 27% of patients experience superficial reddening of the skin, most often in patches, as a result of injury or irritation (from the needles or deoxycholic acid).  The reddening of your skin after receiving Kybella is generated from the dilation of your blood capillaries.

Any redness that appears after your deoxycholic acid injections is likely to be most noticeable within 1-week post-administration.  As inflammation decreases and wounds in the submental region heal, any lingering redness should fade and your skin color should normalize.  Only in cases of an allergic reaction, infection, or injury – is redness likely to linger for an extended duration.

Scarring: Some individuals may end up with scarring as an adverse reaction to Kybella injections.  Scarring is most likely to occur as an adverse reaction among patients that receive treatment from a professional who is unskilled or unexperienced with Kybella injections.  Injecting the drug too quickly, too deeply, using too large of a needle, and/or being unintentionally rough (from lacking dexterity) could damage the submental area and lead to the formation of a scar.

When the dermis is damaged from a needle and collagen fibers repair the damage, a scar may emerge.  It should also be considered that scarring may also be a side effect among patients who’ve recently undergone surgery, have acne in the area, and/or sustained an injury to the submental area – especially if it hadn’t fully healed prior to receiving Kybella.  To reduce your risk of scars, be sure to keep in close touch with your doctor and follow his/her advice to ensure that skin irritation and/or damage properly recovers after Kybella injections.

Skin rash: An unlucky 12% of Kybella recipients may develop a skin rash or hives, medically referred to as urticaria.  The skin rash may develop from needle-induced irritation or the drug itself, and appear as welts on the surface of the skin.  The welts may appear in clusters or patches, may be red in color (but also could be skin-colored), and could be extremely itchy.

If you appear to have developed a rash after receiving Kybella, it is probably a smart idea to avoid scratching it, as this may prevent the area from properly healing.  Any minor skin rashes resulting from treatment are thought to diminish within a week or two after treatment.  That said, if the rash doesn’t seem to diminish, is worsening, and/or spreads throughout your entire body – it is recommended to contact a dermatologist to rule out allergic reactions and infections.

Skin loss: A small percentage of patients receiving Kybella may experience the adverse reaction of skin loss.  It is speculated that skin loss is more likely to occur among individuals that are injected with too much of the deoxycholic acid formula.  Excessive deoxycholic acid within the submental region will kill the fat cells that it enters, but may also damage healthy cells near the surface of the skin.

Damage to healthy cells could lead to the disconcerting reaction of skin loss, possibly accompanied by discoloration of the area.  It is possible that losing a modest amount of skin may be nothing more than a benign reaction, however, losing a significant amount of skin may be the sign of something serious.  If you notice skin loss after receiving your Kybella injections, be sure to ask your doctor for an explanation.

Soreness: It is very common for recipients to report significant soreness in the submental region as a side effect of Kybella.  Soreness typically emerges within several hours of receiving the deoxycholic acid injections and diminishes within 24 to 48 hours of the procedure.  A modest or negligible soreness may linger near the submental space for several weeks after the injections are delivered, but most patients have no difficulty handling it.

There are many possible causes of soreness from Kybella including: the deoxycholic acid burning fat cells, rough jabbing of the needle into your skin by the doctor (this shouldn’t happen), a large number of total injections per session, inflammation, and/or hardening of tissue (post-procedural).  If you feel extremely sore and the soreness doesn’t seem to improve within several days of your procedure, consult your doctor to rule out nerve injury.

Realize that some individuals have a lower pain threshold than others based on gene expression.  If you happen to have a lower pain threshold, you may perceive a significant amount of soreness compared to someone else.  To cope with the soreness, avoid strenuous activity after your procedure, avoid putting pressure on the area, keep your head/neck in a comfortable sleeping position, lightly ice the area to reduce inflammation, and ask your doctor about over-the-counter analgesics.

Stinging: It is understood that the submental area can be sensitive for certain patients, and when a needle penetrates the area up to 50 times, some stinging may be felt.  The stinging could be caused by using the wrong size needle, inserting the needle too deeply beneath the skin, and/or inserting needle into a suboptimal area to deliver the drug.  Even if the procedure is conducted properly by the medical professional, some patients may be prone to endure a stinging sensation.

Some of the stinging could be attributed to the process by which deoxycholic acid destroys fat cells.  It may sting to have a large number of fat cells dying from the forced injection of a bile acid.  A number of users note that slight stinging sensations may persist for up to several days after the procedure.

If you are worried about potential stinging during the operation and/or are overly sensitive to needles, you may want to ask your doctor whether he/she would be willing to inject lidocaine, a local anesthetic and skin-numbing agent.  Lidocaine injections should help numb the area to minimize the intraprocedural stinging.  Any stinging that continues after the procedure may be best managed by applying an ice pack to the area.

Swelling: An estimated 87% of patients receiving Kybella will experience swelling or edema – making this the single most common side effect.  It is reported that swelling is especially noticeable and/or severe for the first week following the injections of deoxycholic acid.  Knowing that swelling is likely to occur, many patients end up taking several days (or the full week) off of work to avert questioning from co-workers as to why their throat/neck appears abnormally swollen.

Most suspect that the greater amount of fat a person has in the submental space, the more significant the swelling is likely to be.  In other words, a double chin may temporarily appear to be even larger after the procedure than it did prior to the procedure.  Swelling is thought to peak within around 24 hours after the procedure and should be significantly reduced within 48 hours.

Although uncommon, some patients may also experience swelling in their upper chest area.  Experts suggest that swelling in the upper chest is not related to deoxycholic acid entering the chest (e.g. seeping out of the submental space).  While swelling should significantly diminish within 48 hours from the injections, an inflammatory response is generated during the procedure that can last up to 4 weeks.

Inflammation is usually most noticeable within 1 to 2 weeks after the procedure.  Within 3-to-4 weeks post-procedure, the inflammation should’ve significantly reduced – possibly to the extent that it is unnoticeable to casual acquaintances.  To hasten the speed by which inflammation is reduced, some professionals may recommend icing the area and/or using over-the-counter anti-inflammatory agents.

Temperature sensations: Around 4% of patients report experiencing sensations of temperature change in the submental space after receiving Kybella injections.  It is most common for individuals to experience sensations of warmth, but some may experience brief bouts of warmth followed by coolness.  The warmth sensations may be triggered by the large number of needle injections in close proximity to each other (just over 1 cm apart).

Another explanation is that warmth may be experienced as deoxycholic acid enters the skin and annihilates fat cells.  Those that report experiencing “coolness” in addition to warmth may have received lidocaine or another topical anesthetic to numb the area, also causing them to perceive coolness of the skin.  Perhaps as the effect of lidocaine wears off (after the procedure), the coolness subsides and warmth from swelling, irritation, and/or inflammation persists.

Tenderness: After receiving an onslaught of between 20 and 50 injections to your submental space, you may notice that the area becomes extremely tender to touch.  Even the slightest bending of your neck and/or turning of your head may be painful.  Post-procedural tenderness tends to be most extreme within the first few days after treatment, but should gradually diminish over the span of 2 to 4 weeks.

Within 2 months post-treatment, most recipients report that their submental space no longer is tender or sore.  Usually the tenderness goes hand-in-hand with the degree of submental inflammation that you experience.  To manage the tenderness, it is recommended to follow post-procedural recommendations given by your doctor such as: avoid strenuous physical exercise (e.g. heavy lifting), keep your neck in a comfortable position (e.g. on a pillow), and apply ice to the area for recovery.

Throat soreness: Though the Kybella injections target the fat beneath your chin, a side effect occurring in 3% of recipients is oropharyngeal (throat) pain.  In other words, you may end up with a lingering sore throat after your procedure.  The sore throat is not unlikely related to deoxycholic acid somehow entering your oral mucosa, rather it’s probably from receiving a series of subcutaneous injections all within the submental space.

Needle injections around your throat may provoke external irritation and/or inflammation.  Any swelling or inflammation that remains after your treatment may cause you to perceive throat soreness, sensitivity, and/or pain while swallowing.  To cope with the sore throat, ask your doctor if it would be safe to use an over-the-counter analgesic medication or apply ice to the area.  If the throat soreness is most severe while eating, you may want to consume only soft foods and/or liquids for your first few days after treatment.

Tightness of skin: Research suggests that tightening of skin is experienced as a Kybella side effect in around 5% of recipients.  The tightening of your skin is likely related to the fact that deoxycholic acid will have burned away all of the fat responsible for your “double chin.”  When this fat is fully eliminated and inflammation subsides, submental skin will have tightened.

What was previously saggy skin may feel as though it’s hardened and/or look taut.  In most cases, it takes around 1-month post-procedure for patients to notice skin tightness.  Though skin tightness may not occur after just one round of Kybella treatment, after several treatment sessions, tightness of the skin is a common occurrence.  If the skin tightness feels uncomfortable and/or is accompanied by pain – ask your doctor for some guidance.

Tingling sensations: A side effect experienced by 14% of Kybella users is paresthesia, characterized as tingling sensations and/or pricking (e.g. “pins and needles”).  Tingling is understood to be a result of pressure and/or damage to peripheral nerve endings.  The tingles that occur as a side effect of Kybella may be from receiving injections of an exogenous bile acid beneath the skin and/or the corresponding death of fat cells.

It is also reasonable to consider that tingling could be related to receiving a substantial number of needle injections to the submental space and/or administration of a pre-procedural numbing agent (e.g. lidocaine).  Furthermore, since it is known that inflammation is a common response to Kybella, some of the tingles may be a direct result of this inflammatory response.  Although tingling sensations may be distracting and/or unwanted, they are usually easy to manage and subside with enough time.

Ulceration: It is fairly uncommon, but some individuals may develop ulcers in the submental space after Kybella injections.  Ulcers are considered sores on the surface of the skin accompanied by the breakdown of tissue and/or skin cells.  They often appear as open craters with a rounded shape and eroded skin – and are usually easy for patients and medical professionals to recognize.

If left unmanaged, ulcers could lead to loss of the epidermis, dermis, and cause permanent skin damage.  Since most professionals properly follow the administration guidelines issued with Kybella, risk of ulceration is extremely low.  Risk of ulceration may be increased among patients with unhealed wounds in the submental space (such as from a recent surgery or injury) or possibly if a practitioner makes a mistake with delivery of injections (as to cause an injury).

Sometimes ulcers may take up to several months to fully heal, and in the process of healing, they may feel painful and/or appear to leak fluid.  Provided you sustain a noticeable wound and/or suspect that you may have contracted a bacterial infection from Kybella injections, seek emergency help from a medical expert.  Anyone that experiences ulceration from Kybella will need to refrain from further injections until the ulcer has fully healed.

Uneven smile: A problematic adverse reaction to Kybella that some patients experience is nerve injury, specifically to the marginal mandibular nerve branch.  The marginal mandibular nerve branch controls facial expressions.  If an injury to the marginal mandibular nerve is sustained from Kybella injections, some patients may report that their smile (and other facial expressions such as frowning) appears uneven.

A portion of your lips may elevate to form a smile, but another part may be unresponsive.  You may make a conscious effort to smile, but no matter how hard you try, you cannot achieve a full smile.  Some patients have reported feeling as though the bottom portion of their lip and/or mouth feels completely paralyzed.

In most cases, if your smile is uneven and you’ve sustained a nerve injury, it could take between 6 and 12 weeks for full recovery.  Those with an uneven smile are recommended to abstain from further administration of Kybella and to work closely with a doctor to ensure proper healing.  Extreme damage to the marginal mandibular nerve from an injection may require surgery to correct.

Weakness: You may notice facial weakness as a side effect of Kybella injections.  The weakness may be isolated to a particular area of the face or widespread throughout your entire face.  In most cases, weakness from Kybella injections is transient and facial strength will return within a few weeks of the procedure.

Some weakness may be related to post-procedural swelling and inflammation, but could also be a result of a mandibular nerve injury.  If the weakness is related to swelling/inflammation, some may find it helpful to apply an ice pack to the area.  In the scenario that weakness resulted from a nerve injury, it may take longer than expected (e.g. several months) to regain facial strength and/or function.

• Source: http://www.fda.gov/Drugs/InformationOnDrugs/ucm448086.htm
• Source: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0077994/

Note: Evidence suggests that 96% of Kybella recipients will experience injection site reactions.  If you are concerned about any Kybella side effects that you’re currently experiencing or have any questions about them, do not hesitate to contact a medical professional.  Also keep in mind that the above list of side effects above may be incomplete.

Variables that influence Kybella side effects

There are multiple variables that influence the side effects reported by recipients of Kybella.  Influential variables that dictate the side effects you’re likely to experience, include: procedural details (e.g. number of injections, needle size, spacing of injections, etc.), skill of the practitioner administering Kybella, time between treatment sessions, total number of treatment sessions, and individual factors (e.g. amount of pre-procedural submental fat, pain perception, comorbid medical conditions, etc.).  When contemplating the specific side effects you’re likely to experience, as well as their respective severities – it may be helpful to reflect upon these variables.

1. Procedural details

The details of your individualized procedure may be primarily responsible for any side effects you experience.  Details regarding your procedure such as: anesthetic usage, depth of injections, dosage of deoxycholic acid, needle size, number of injections, spacing of injections, and targeting (of the submental space) – could influence side effects.  For example, someone who receives an anesthetic and receives an optimal number of perfectly-interspaced injections may find the procedure more tolerable, whereas someone who receives too many closely spaced injections without an anesthetic may be more prone to side effects.

• Anesthetic usage: Some medical professionals reportedly numb their patients with lidocaine before the Kybella procedure to minimize pain around the injection sites. If a local anesthetic was administered prior to your Kybella injections, the pain resulting from Kybella will be minimized and more tolerable.  In addition to the pain reduction, you may have an easier time coping with the post-procedural aftermath.  Realize that Kybella is likely easier to tolerate among those who received a local anesthetic.  That said, the local anesthetic may cause side effects of its own (e.g. numbing) that may overlap with those of the Kybella.
• Depth of injections: Kybella is intended to be administered subcutaneously, meaning it should be injected within the fatty layer of tissue just beneath the skin. Most professionals will know the approximate optimal depth by which injections should be administered [based on their patients].  However, it is possible that Kybella could be injected too deeply beneath the surface of the skin, possibly hitting muscles and/or nerves around the submental area.  If the depth of injections is too deep – expect a greater number of side effects and treatment-induced complications.
• Dosing: Manufacturer guidelines state that the recommended dose of Kybella is 0.2 mL injections spaced 1-cm apart until all sites in the planned treatment area have been injected. The maximum dose to be delivered per treatment is 10 mL (50 injections of 0.2 mL).  In clinical trials, the average dose was 4-6 mL of deoxycholic acid per treatment session.  Generally, the larger the dosage of Kybella administered, the more side effects you should expect to experience.  A person receiving the full 10 mL per session will be more prone to side effects than someone receiving a smaller amount.  This is because high doses require a greater number of injections, as well as larger quantity of deoxycholic acid penetrating fat cells.
• Needle size: Kybella is intended to be injected subcutaneously into the submental fat with a 30G (or smaller) 0.5-inch needle. Most professionals are aware of the recommended needle sizing guidelines for Kybella administration and will adhere to these guidelines.  That said, since smaller needle sizes are allowed, it is possible that size of a needle used to deliver Kybella may be subject to individual variation.  In general, the larger the needle that is used (smaller the gauge), the greater the likelihood of injection site reactions such as: bleeding, injury, and pain.  If you want to know the size of the needle used to deliver Kybella injections, ask your doctor.
• Number of injections: On average, most treatment sessions will involve delivering between 20 and 40 injections of Kybella into submental fat.  Despite the average of 20 to 40 injections per session, some patients may only receive 15 injections per session [if they have less submental fat], whereas others may receive up to 50 injections per session [if they have more submental fat].  If you’re only receiving a small number of injections due to having less submental fat, you’ll probably experience fewer side effects (such as skin burning, inflammation, and irritation) than someone receiving the maximum 50 injections per treatment.  Furthermore, a greater number of injections increases likelihood of an administration-related error on behalf of the doctor (e.g. abnormally deep needle insertion, improper spacing, etc.).
• Spacing of injections: Injections of Kybella are intended to be spaced apart by at least 1-centimeter. The purpose of properly spacing deoxycholic acid injections is to minimize likelihood of an injection site reaction (associated with too many injections in the same area), as well as to avoid an excessive number of injections.  It is understood that 0.2 mL deoxycholic acid are delivered per injection, which is enough to account for 1-centimeter of the fat.  If multiple 0.2 mL deoxycholic acid injections are delivered to an area smaller than 1-centimeter, the skin become more irritated from the cumulative number of needle insertions within a confined space.  Furthermore, if injections are not properly spaced by 1-centimeter, a greater number of injections will be needed to cover the full area of the submental fat.  Though it’ll be difficult for you as a patient to assess the spacing of your Kybella injections, realize that spacing may influence the side effects that you experience.
• Targeting: If you receive Kybella injections that properly target your submental fat, the efficacy of treatment should be greater and side effects should be lesser – than if injections partially or insufficiently target submental fat. Medical professionals administering Kybella usually have extensive understanding of the submental space and are able to differentiate accumulated submental fat from non-fatty areas.  Still, not all patients exhibit the same shape and/or size of submental fat, nor do they exhibit the same anatomical contour.  The degree to which the submental fat is properly targeted by your doctor (with Kybella injections) may have an impact on the side effects that you experience.

2. Practitioner skill + experience

When it comes to delivering Kybella treatment, not all professionals are equally skilled.  Practitioner skill may be a result of: understanding administration guidelines, knowing the anatomy of each patient, fine motor skills (e.g. hand-eye coordination), and cumulative number of Kybella procedures conducted.  Receiving Kybella injections from an unskilled and/or inexperienced practitioner will increase your risk of side effects, whereas receiving injections from a skilled and experienced practitioner should decrease odds of side effects.

• Adherence to administration guidelines: The guidelines developed for Kybella administration are issued with the intent of maximizing safety of the recipient. Some known guidelines include: use a needle 30G (or smaller) for injections, space injections at least 1-cm apart, only target the submental fat, use a dose of 0.2 mL per injection, do not exceed 50 injections per session, do not exceed 6 total sessions, and allot at least 1-month’s time between sessions.  If a medical professional were to stray from these issued guidelines, it could compromise the safety of a patient.  The stricter a professional adheres to the medically-issued guidelines, the lower the risk of side effects for his/her patient.
• Anatomical understanding: Prior to administering Kybella, it is important to that a doctor distinguish submental fat from non-fat in the submental space. Failure to understand the submental anatomy of each patient set to receive Kybella injections increases likelihood of severe side effects and adverse reactions.  Besides fat, there are other structures within the submental area such as nerves, the thyroid, and muscles.  Anatomical alterations may have occurred as a result of a prior surgical operation, aesthetic procedure, or injury.  If the deoxycholic acid were to be administered to the wrong area, serious complications could result.  The better the understanding your doctor has of your submental space, the fewer treatment-related complications you should expect to endure.
• Area of injection: Research suggests that when deoxycholic acid is administered to areas of the body besides submental fat, it could cause detrimental side effects. Some doctors have expressed concern over the idea that, if Kybella were approved for at-home use by patients, it may be administered improperly to areas besides their “double-chin” (e.g. belly fat).  Since Kybella administration is reserved for medical professionals, we need not worry that it’ll be injected into regions other than the submental space.  Still, it may be difficult to ensure that every injection only targets the submental fat in certain patients.  There’s a risk that Kybella could hit salivary glands, lymph nodes, neuromuscular structures, nerves, and/or thyroid – if improperly injected.  If a professional accidentally injects deoxycholic acid into areas other than the submental space, you may end up with more side effects of greater severity.
• Experience with Kybella: The amount of experience a practitioner has accrued in terms of administering Kybella could affect his/her skill. A professional that has only administered Kybella to a few patients may be less skilled than one who has treated hundreds of patients.  Many professionals refine their administration technique over time and learn how to minimize risk of serious side effects for their patients.  While a professional’s experience may not always predict his/her competency, fewer mistakes should be expected among someone with a lot of experience.
• Manual dexterity: The manual dexterity of a doctor can dictate whether he/she delivers Kybella injections of proper spacing, depth, and smoothness. Manual dexterity is defined as a person’s ability to make precise, coordinated hand/finger movements.  If a medical professional with poor manual dexterity is delivering Kybella, he/she may deliver Kybella roughly – possibly injuring the patient.  Lacking sufficient manual dexterity could lead to deep needle insertion which would cause a nerve or neuromuscular injury.  The greater the manual dexterity exhibited by the doctor delivering your Kybella, the lesser your risk of severe side effects.

3. Time between sessions (Recovery)

The amount of time between Kybella treatment sessions could make a difference in terms of the side effects that you experience.  A medical professional shouldn’t allow patients to receive injections less than 1-month apart from each other – manufacturer guidelines dictate that 1-month is the absolute minimum amount of time between Kybella treatments.  Someone who waits just 1-month between treatments may experience more side effects than if he/she had waited 2 or 3 months between treatments.

By 1-month post-procedure, not all patients will have fully recovered from their first series of injections.  Some may still exhibit inflammation and/or irritation in the submental space due to receiving a significant number of injections (e.g. 50 injections) in their first treatment.  If a person were to receive another round of injections despite his/her irritation in the submental area, this may exacerbate existing side effects and could lead to a serious adverse reaction.

On the other hand, waiting 2 or 3 months between sessions should allow most patients to fully recover from their first series of injections.  All inflammation and irritation in the submental space should’ve declined within a 3-month post-procedural window and residual effects from the first series of injections shouldn’t be exacerbated upon receiving a second round of treatment.  In short, the greater the amount of time between treatment sessions the more likely you are to have fully recovered before your next treatment, thereby minimizing side effects.

4. Total number of sessions

Depending on the size of your submental fat, as well as how your body responds to Kybella, you may require between 1 and 6 treatments to see a reduction in submental fat size.  On average, most individuals receive between 2 and 4 treatment sessions, but a subset of individuals may receive the maximum 6 sessions in order to lose sufficient submental fat.  In any regard, it is reasonable to suspect that the greater the total number of treatment sessions you undergo, the more likely you are to deal with side effects.

A person who undergoes the full 6 treatment sessions will likely be subject to a greater number of injections than someone receiving fewer treatments.  It is possible that a person receiving the maximum 6 sessions could’ve received up to 50 injections per session, for a cumulative total of 300 injections over a 6-month duration.  As was already mentioned, receiving more injections often yields a greater number of side effects and adverse reactions – than receiving fewer injections.

Though the amount of time for recovery between sessions may be more important than the total number of sessions received, but there could be a synergistic influence of these two variables upon side effects.  Receiving 6 treatments with full recovery between each treatment may be less problematic than receiving 3 treatments with insufficient recovery time.  That said, assuming recovery times are equal, the more treatments a person undergoes – the greater his/her risk of side effects and/or adverse reactions (such as from an inadvertent administration error).

It should be noted that some patients mention tolerability of side effects improving as more treatments are received.  In other words, some individuals find that side effects are most severe after the first couple treatment sessions, but as they receive a third or fourth treatment – side effect severity diminishes.  Diminished side effect severity may be related to the fact that fewer injections are required in later treatment sessions (compared to the first couple), but it also could be a result of changes in the submental area.  Based on anecdotal reports, it is necessary to acknowledge that side effect severity is not always contingent upon total number of treatment sessions.

5. Individual factors

It is possible that variables such as: procedural details (e.g. number of injections), skill of the professional (administering the injections), time between sessions (recovery), and total number of sessions – could be identical among 2 Kybella recipients.  Assuming all of the aforestated variables were the exact same in recipients, the side effects and respective severities should be predictably analogous.  However, it may turn out that despite commonalities of these variables, side effects are different and/or significantly more debilitating for one individual than another.

In this case, differences in side effects can likely be best accounted for by assessing individual factors.  Individual factors such as: amount/shape of submental fat, co-administered substances, medical conditions, pain tolerance, and recovery efforts – can make a difference in terms of side effects that a person reports.  Consider that simple individual differences such as the size of submental fat or utilization of an anti-inflammatory medication – may dictate differences in perceived side effects.

• Amount/shape of submental fat: Usually the more submental fat a person has, the greater the number of treatment sessions and/or injections per session will be required for fat reduction.  As was already mentioned, the greater the number of treatments and injections issued per session (i.e. larger quantities of deoxycholic acid), the more severe side effects are likely to be.  Additionally, the greater the submental fat a person exhibits, the more noticeable its hardening and/or lumpiness following the injections – each of which are considered side effects.  Recipients of Kybella should also be cognizant that certain shapes of submental fat may be more difficult to target by professionals, thereby increasing odds of adverse injection site reactions.  It is also possible that the ratio of injections to amount of submental fat may dictate side effect severity.  Someone receiving a high number of injections with a small amount of submental fat may be more prone to adverse reactions (because they have less fat to buffer against the significant number of injections).
• Co-administered substances: Patients taking drugs or supplements while receiving Kybella may report different side effects than those who aren’t using any substances.  For example, a person taking a blood thinner or antiplatelet drug prior to injections end up bleeding or bruising excessively as a result of treatment.  Others who are taking an over-the-counter analgesic or opioid medication may find that they experience minimal or no pain during the procedure.  In short, certain substances may attenuate the severity of unwanted side effects (e.g. pain), whereas others may exacerbate or increase the likelihood of various side effects.  Also consider that some side effects you may have attributed to Kybella injections may have resulted from a co-administered substance – especially if you recently began taking something new.
• Medical conditions: Administration of Kybella is contraindicated among individuals with various medical conditions involving: bleeding problems, swallowing difficulties, thyroid abnormalities, lymph node conditions, and infections near the submental space. Other contraindications include: individuals under age 18, breastfeeding or pregnant women, anyone with soy allergies, serious medical illness/infections, impaired circulation, and those who are immunocompromised.  Your doctor should avoid treatment if you exhibit a medical condition that is known to be contraindicated.  That said, it is possible for medical conditions that aren’t contraindicated to exacerbate Kybella side effects.  Reflect upon your medical diagnoses and realize that they may help explain some of your side effects.
• Pain tolerance: Scientific data suggest that not all individuals have the same ability to tolerate pain. Anyone with a high pain tolerance will be able to handle the pain associated with receiving Kybella injections, and should have a favorable perception of soreness after the treatment.  On the other hand, someone with a low pain tolerance may struggle to cope with pain from Kybella injections and report overwhelming post-procedural soreness.  In brief, if you have a high pain threshold, any side effects related to pain and irritation may be perceived as manageable, whereas if you have a low pain threshold – side effects may seem debilitating.
• Surgery or injury: It is contraindicated to use Kybella if you’ve recently undergone surgery, a cosmetic procedure, and/or injured the submental area. Even if your surgery, cosmetic procedure, and/or injury to the submental space wasn’t recent – it is possible that submental surgery or injury may have made you more vulnerable to adverse reactions associated with any additional modifications.  Receiving Kybella injections in an area that was previously injured or surgically repaired may aggravate the region, increase likelihood of nerve damage, or provoke other serious complications.  Those that have never undergone submental surgery or injured this area should be less prone to side effects compared to persons that have.
• Recovery efforts: How much effort have you put into your recovery after Kybella injections? The extent to which you help your body recover from Kybella injections can impact side effect severity.  For example, someone who avoids over-the-counter anti-inflammatory drugs and analgesics may experience significantly more pain after treatment compared to a person who uses them.  Similarly, those who engage in strenuous exercise after surgery may aggravate the submental space and require a longer duration for recovery compared to those who rest.  Possible recovery efforts could include things like: ensuring a comfortable position during sleep, applying ice to reduce inflammation, and/or gently wrapping a cloth around the area.  The greater the effort you put into recovery from Kybella, the more manageable your side effects will be – and faster they will fade away.

Kybella (Deoxycholic acid): Do the benefits outweigh the side effects?

To qualify for receiving Kybella, a medical doctor will need to have judged that potential benefit to be attained from Kybella is likely to outweigh possible side effects.  That said, just because your doctor perceives you as being an ideal candidate for Kybella treatment, does not mean that there’s any binding agreement that you must pursue it.  Prior to receiving any injections, it is important to consider whether you’d be willing to put up with side effects for a non-guaranteed reduction in the size of your double chin.

For reference, statistics from clinical trials indicate that 96% of Kybella recipients will experience side effects in the form of injection site reactions, yet only 43% of recipients will experience significant reductions in chin size.  Accounting for these percentages, we can estimate that under 4% of Kybella recipients will respond to treatment without experiencing unwanted side effects.  This small subset (4%) of recipients able to reap the double chin-reducing benefit without experiencing side effects should be considered utopian responders.

If you happen to be a utopian responder, it makes sense to continue treatment for an improved appearance.  Another small percentage of Kybella recipients will experience no unwanted side effects, yet fail to respond to treatment.  In other words, some recipients may tolerate the injections well, but find that after the maximum 6 treatment sessions, the appearance of their submental fat hasn’t significantly improved.

In this case, even though Kybella may be well-tolerated, its inability to reduce double chin size will have been disconcerting to patients – especially given its high cost of $1,000 per treatment session.  It is also possible that a subset of Kybella recipients may experience an array of unfavorable side effects, yet continue treatment without any noticeable reduction in the size of their double chins – this would be the worst case, dystopian scenario.  In the dystopian scenario, not only will a patient have experience treatment-related complications (e.g. nerve injury), but his/her appearance will not have improved and thousands of dollars will have been wasted in the process.

Despite the extremes of excellent responders without side effects (utopian) and non-responders with severe side effects (dystopian), the bulk of Kybella recipients will experience a blend of side effects with submental fat reduction.  Assuming a doctor properly targets submental fat with his/her injections, the deoxycholic acid within Kybella should eliminate fat cells from the region – leading to some measurable fat reduction.  It is also known that since needles are used, some side effects are likely to occur – even if they’re only of minor severity (e.g. inflammation).

It will be up to a patient to judge whether the submental fat loss outweighs the side effects or vice-versa.  If submental fat loss is negligible, yet side effects were of moderate severity – treatment may have been a bad option.  On the other hand, if fat loss was moderate to significant, putting up with fairly severe side effects may have been a worthy sacrifice.

Throughout your treatment with Kybella, you may want to consider maintaining a journal to document treatment-related side effects.  In addition to documenting side effects in a journal, you could also add photos of your submental fat to daily entries to determine how long it takes for your appearance to improve.  Journaling and/or keeping a picture diary should make it easier for you to keep track of any side effects that you planned to share with your doctor.

Unfortunately for most, it’s impossible to predict whether post-procedural aesthetic improvement will have outweighed any side effects and expenses associated with Kybella injections.  It’s possible that you may experience wicked side effects and spend upwards of $6,000 on treatments without much fat reduction to show for it.  It’s also possible that you may find side effects easy to manage and experience substantial submental fat reduction.

A majority of individuals treated with Kybella report being satisfied with their post-procedural appearance.  Furthermore, other than some minor injection site reactions, the side effects associated with Kybella are generally manageable and tend to diminish with each consecutive treatment session.  If you find it difficult to tolerate side effects of Kybella and/or aren’t responding well, you may want to get a second opinion as to whether continued treatment is a smart idea.

Possible ways to reduce Kybella side effects

If you’re receiving Kybella injections to reduce the size of your double chin, there may be some ways in which you can decrease the number and severity of side effects that you experience.  Possible strategies for reducing side effects of Kybella include: working with a competent medical professional, ruling out contraindications, extending time between treatments, and making an effort to recover.  Prior to implementing any of these side effect prevention and/or mitigation strategies, confirm their safety and hypothesized usefulness with a medical professional.

1. Find a skilled MD: Though all licensed medical doctors have the credentials necessary to practice medicine, not all doctors are equally skilled and knowledgeable when it comes to Kybella treatment. If you want to minimize your odds of experiencing side effects and/or adverse reactions, it is recommended to find a doctor that is both skilled and experienced with administration of Kybella – your best bet may be a plastic surgeon. Ideally, you’ll want a doctor with optimal fine motor skills (manual dexterity) to deliver your injections, as well as someone with an in-depth understanding of your submental anatomy.  Additionally, a medical professional that stringently adheres to manufacturer guidelines issued for Kybella administration (e.g. needle size, dosing, etc.) is preferred.  Moreover, your doctor should take steps to prepare you for treatment, help you with post-treatment recovery, and regularly evaluate your treatment progress.
2. Rule out contraindications: Not everyone qualifies to receive Kybella injections, especially individuals with a recent surgery and/or injury to the submental space. Patients with medical conditions that affect: bleeding, circulation, immune function, lymph nodes, swallowing, and/or thyroid – are also recommended to avoid Kybella treatment. Furthermore, Kybella is contraindicated among: breastfeeding/pregnant women, individuals under 18 years of age, those with soy allergies, and anyone with serious illnesses/infections.  For personal safety and to minimize odds of an adverse reaction from Kybella, always inform your doctor of your medical history, medication/supplement usage, and current medical status – prior to treatment.
3. Extend time between sessions: Patients receiving Kybella are required to space each treatment session by a minimum of a 1-month period. It is thought that waiting less than 1-month between Kybella treatments could increase odds of complications and/or adverse reactions. While many patients are able to tolerate treatments spaced exactly 1-month apart from one another, other patients may be better off with a larger time-spacing between their treatments.  In certain cases, a 1-month duration may be an insufficient duration for the submental area to fully heal (after the first set of injections).  If you aren’t fully recovered from your first series of injections, it may be best to extend the time between treatments to 2 or 3 months.  Extending the time between sessions should ensure that you’re fully recovered from prior injections before receiving another series.
4. Recovery efforts: Among the most effective ways to reduce Kybella side effect severity is to proactively manage your recovery. Some commonsense recovery efforts will likely include: icing the submental region to decrease inflammation and resting/sleeping in a comfortable position (with pillows) to minimize odds of post-procedural irritation. Other things that you may want to try during your recovery include: avoiding strenuous physical labor/activity, reducing stress (for improved pain tolerance), and resisting the urge to scratch itchiness in the area.  You may also want to ask your doctor about using over-the-counter medications to help you cope with pain and attenuate inflammation.
5. Continue treatment: While side effects from deoxycholic acid injections can be severe after the first couple treatments, they often significantly decrease by the third or fourth series of injections. A reduction in the severity of side effects after a couple rounds of treatment may be a result of a person’s body adjusting to the deoxycholic acid OR based on the fact that fewer injections are needed in later rounds of treatment – prompting less substantial reactions and correspondingly fewer side effects. Knowing that side effects may subside and/or become easier to manage after several treatments, your best bet may be to continue with another round of Kybella injections.
6. Discontinuation: It may be challenging to determine whether you should discontinue Kybella treatment or continue receiving the injections (in hopes that side effects will eventually subside). If after your first series of treatments, you experienced an allergic reaction and/or dealt with intolerable adverse effects – it may be smart to permanently refrain from further Kybella injections. If you aren’t sure as to whether you should avoid future Kybella treatment, consult a medical professional.  Sometimes discontinuing Kybella is the smartest option to avoid serious and/or potentially deleterious long-term complications.

Have you experienced Kybella (Deoxycholic acid) side effects?

Assuming you’ve received Kybella injections to reduce your submental fat (i.e. double chin), leave a comment documenting any noticeable side effects you experienced.  In your experience, which side effects were most debilitating and/or difficult for you to manage?  On a scale of 1 to 10 (with 1 being “tolerable” and 10 being “intolerable”), what number would you assign each of your side effects?

To help others get an accurate understanding of your situation, provide additional details such as:  your submental fat size (pre-treatment), experience/skill of your practitioner, number of injections you received per treatment session, total number of treatment sessions you underwent, as well as the amount of time between each of your treatments (e.g. 1.5 months).  Did you find that side effects became more manageable after several treatment sessions?  Or did side effect severity remain fairly consistent throughout your entire series of treatments?

Feel free to mention how long it took for side effects to diminish after each round of your Kybella injections, as well as any strategies you consider useful for coping with side effects (e.g. applying ice, taking NSAIDs, etc.).  In your opinion, why do you think you experienced side effects from your treatment?  Examples of hypothetical answers include: a normal reaction to the deoxycholic acid and injections, allergies to the drug, poor skill on behalf of the practitioner, insufficient recovery between treatments, etc.

Assuming all goes as planned with Kybella, the size of your submental fat will shrink, your appearance will improve, and any lingering side effects of treatment will eventually subside.  That said, since no treatment for submental fat is universally effective and tolerable, there’s a chance that you may experience less-than-stellar results.  If you are struggling to tolerate the side effects of Kybella or believe that it isn’t working, share your thoughts with a doctor.

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