| Category Name | Content |
| Name | Kybella (Deoxycholic Acid) |
| Uses | Minimally invasive injectable treatment used for the reduction of moderate to severe submental fat (double chin) and off-label for small localized fat pockets in other areas. |
| Route Of Administration | Subcutaneous injection into the targeted fat deposit. |
| Frequency Of Use | Typically administered every 4-6 weeks for a total of 2-4 sessions; additional treatments may be required based on patient response. |
| Concentration(s) | Each Kybella vial contains 10 mg/mL of deoxycholic acid in a 2 mL vial. |
| Maximum Dosage (Day, Wk) | Maximum of 50 injections (up to 10 mL total) per treatment session. Do not exceed FDA-recommended dosing per treatment area. |
| Contraindications | Pregnancy or breastfeeding, active skin infections or inflammation at the treatment site, history of difficulty swallowing (dysphagia), previous facial or neck surgery with altered anatomy, bleeding disorders, or hypersensitivity to deoxycholic acid. |
| Possible Side Effects | Swelling, redness, bruising, tenderness, numbness, hardness at injection site, temporary nerve injury (marginal mandibular nerve), difficulty swallowing, or asymmetry. |
| Compatibility With Other Treatments/Drugs | Avoid combining with recent neurotoxin (Botox, Dysport) or filler injections in the same area within 2 weeks. Safe to combine with skin-tightening treatments after healing. |
| Allergies | Assess for hypersensitivity to deoxycholic acid or any inactive ingredients in Kybella formulation. |
| Administration Time | 15-30 minutes per session, including marking and injection process. |
| Dosing/Settings | Customized based on patient anatomy and goals: - **Injection Grid Spacing**: 1 cm apart - **Injection Volume**: 0.2 mL per injection site - **Total Dosage**: 2-10 mL per session, up to 50 injections. |
| Test Spot Requirement | Not required, but recommended for patients with a history of skin sensitivity or prior adverse reactions to injectables. |
| Pre-Treatment Guidelines | - Avoid blood-thinning medications (aspirin, NSAIDs, fish oil) for 7 days before treatment to minimize bruising. - Discontinue alcohol consumption 24-48 hours prior. - Ensure treatment area is clean and free of infection, irritation, or active breakouts. - Ice packs may be provided before treatment to reduce discomfort. |
| Provider Clearance Guidelines | - Ensure the patient has no contraindications before proceeding. - If the patient has a history of difficulty swallowing or prior facial surgery, consult with a physician before proceeding. - Document all clearance decisions in the patient’s medical record. |
| Pre-Treatment Screening Workflow | - Does the patient have a history of dysphagia (difficulty swallowing)? (If YES, physician consultation required) - Has the patient had recent surgery or filler in the area? (If YES, delay treatment for 2-4 weeks) - Does the patient have active skin infections or inflammation? (If YES, delay treatment until resolved) - Is the patient pregnant or breastfeeding? (If YES, contraindicated) |
| What To Do If Adverse Reaction Occurs | - **Severe swelling or pain**: Apply ice packs, elevate the head, and monitor for worsening symptoms. - **Nerve injury (asymmetrical smile, drooping mouth)**: Reassure patient that symptoms typically resolve within 4-6 weeks; document and monitor. - **Prolonged bruising (>2 weeks)**: Consider arnica or bromelain supplements. - **Difficulty swallowing or breathing**: Stop treatment, assess airway, and refer for emergency care if severe. - **Infection (redness, warmth, pain, pus formation)**: Consider antibiotic therapy (e.g., oral cephalexin or topical mupirocin). |
| Clinic Implementation Guidelines | - Mark treatment grid before injections for precision. - Ensure patient consent and pre-treatment screening is completed. - Monitor patient for 10-15 minutes post-injection for any immediate reactions. - Educate patients on expected swelling and aftercare instructions. |
| Photographic Documentation Protocol | - Capture pre-treatment photos from front and side angles. - Take follow-up photos at 4-6 weeks to assess fat reduction. - Store images securely in the patient’s medical record. |
| Post-Treatment Care | - Apply ice packs intermittently for the first 24 hours to minimize swelling. - Avoid strenuous exercise and excessive salt intake for 48 hours. - Expect swelling, bruising, and tenderness for up to 2 weeks. - Avoid touching or massaging the treated area. - Follow-up visits should be scheduled at 4-6 week intervals as needed. |
| Additional Documentation Requirements | - Signed informed consent detailing potential risks and expected results. - Treatment session log including number of injections, total volume used, and patient response. - Pre- and post-treatment photos for medical record keeping. - Post-treatment instructions provided and documented. |