Kybella: demand is crazy for drug that melts chin fat

Demand is crazy for drug that melts away double chin fat

By Lindsay Putnam

June 23, 2015 | 2:34pm

Demand is crazy for drug that melts away double chin fat

Double chins may be on the decline thanks to a new injectable drug. Photo: Shutterstock

Double chins, beware.

The unsightly facial feature that has plagued people of all shapes and sizes has finally met its match, thanks to a newly approved remedy.

Kybella, a fat-melting injectable drug created by Kythera Biopharmaceuticals Inc., was approved by the FDA in April and became available June 15 to dermatologists and plastic surgeons who completed training at the drug company’s Westlake Village, Calif., offices.

Kybella is made from deoxycholic acid, which is a chemical produced in the body to help absorb fats. When injected into the fat below the chin, known as submental fat, it destroys the fat cells. Patients can receive up to 50 injections in one single treatment, with up to six treatments administered no less than one month apart.

“I’ve never seen a demand like this, except for Botox,” Derek Jones, a dermatologist on the faculty at UCLA and lead investigator in the clinical FDA trials of Kybella, told the Hollywood Reporter. “We have a waiting list of people who have been calling for months.”

The brains behind Botox have taken notice. Allergan, the pharmaceutical company that owns the wrinkle-smoothing drug, is set to acquire Kythera Biopharmaceuticals this week for $2.1 billion.

It’s a worthwhile investment. Though pricing on Kybella hasn’t yet been released, professionals estimate that it will cost between $500 and $600 per treatment. Manhattan plastic surgeon Alan Matarasso believes patients should expect to make two or three total visits, spaced a month apart.

Comparatively, liposuction for double chins routinely costs between $1,500 and $2,000.

According to Kybella’s website, 79 percent of patients treated with Kybella reported satisfaction with the appearance of their face and chin, as well as a marked improvement in self-perception.

Possible side effects including swelling, bruising, pain, numbness, redness, difficulty swallowing and nerve injury in the jaw that cases facial muscle weakness. If injected incorrectly, it could destroy the wrong kinds of cells — including skin cells.

“Kybella should not be used outside of the submental area,” warns the FDA — not that everyone is heeding the warning.

“Now that it’s FDA-approved, approved doctors are allowed to use it ‘off label,’ which means we can attempt it with discretion on other places,” dermatologist Peter Kopelson reveals to the Hollywood Reporter. “I suspect it will be for targeted use, like love handles, under-eye fat pockets and fat above the knees — something even young women complain about.”

Kybella, For chin fat reduction

Tucson Cosmetics Introduces KYBELLA™ What is KYBELLA™? KYBELLA™ is used to improve the appearance and profile of moderate to severe fat below the chin (submental fat), also called "Double Chin.” Kybella is a injectable medication that dissolves fat cells. So no surgery! Chin fat reduction with injections! Join us Thursday, August 27th 2015 5-7pm for our Kybella Open House at Tucson Cosmetics Meet the expert from Kybella and see live Kybella demos done by Dr. Rubbani! Prices valid now until August 27th 25% OFF each treatment! $900 per treatment regularly $1200 *Each treatment is 1 vial. Most patients will require multiple treatments. Limit 4 treatments at sale price per patient. Free consultation for Kybella! Buy now, use later! Call to order! Tucson Cosmetics 520.638.5553 400 W MAGEE RD TUCSON, AZ 85704

Carbs and acne new study

WCD: Cut simple carbs to clear acne

By: AMY KARON, Dermatology News Digital Network |

VANCOUVER, B.C. – Mounting evidence suggests that consuming a low glycemic index diet can substantially improve acne, according to Dr. Hyuck Hoon Kwon. 

The approach has held up in several small-scale randomized clinical trials, earning it a grade of 1B last year from the American Academy of Dermatology, noted Dr. Kwon of Seoul National University in South Korea.

“Dermatologists can recommend dietary modification to patients, and can advise them to avoid foods that they believe worsen their acne,” Dr. Kwon said at the World Congress of Dermatology. He said he has seen clinically meaningful reductions in acne lesions as soon as 4 weeks after patients cut their intake of refined carbohydrates and other high glycemic index (GI) foods, although results can take up to 12 weeks, and more studies of time to effect are needed.

Scientists and clinicians have long debated the role of diet in the pathogenesis of acne, and until recently, there were no randomized, controlled trials or meta-analyses of the topic. But observational studies have repeatedly documented “astonishingly” low rates of acne in cultures with “traditional” diets that are lower in refined carbohydrates and fat than typical Western fare, said Dr. Kwon. 

pedphoto36pm/Thinkstock.com

In one study of 1,285 individuals in Korea, those who did not have acne reported consuming significantly higher amounts of fish and yellow, leafy green, and cruciferous vegetables, while those with acne ate significantly more instant noodles, processed cheeses, and “junk” foods, he noted (Eur. J. Dermatol. 2010;20:768-72).

In another trial, Dr. Kwon and colleagues randomized 32 individuals with mild to moderate acne to either a low-GI diet that emphasized beans, barley, vegetables, fish, and whole-grain breads, or to a high-GI control diet (Acta Derm. Venereol. 2012;92:241-6). The low-GI group ate more protein to replace calories lost from cutting carbohydrates. At 10 weeks, the groups had similar mean calorie intakes and body mass indices, but the low-GI group had reduced its dietary glycemic load from baseline and had significantly fewer inflammatory and noninflammatory acne lesions compared with baseline and with the high-GI group, Dr. Kwon said. The low-GI group also had significant decreases in total average area of sebaceous glands, and decreased expression of sterol response element-binding protein-1 (SREBP-1), which stimulates lipogenesis in sebocytes.

Most recently, scientists have explored the molecular mechanisms linking diet to acne, Dr. Kwon noted. High GI diets trigger chronic hyperinsulinemia, which impairs the ability of FoxO1 transcription factor to mediate androgen receptor signaling, oxidative stress, lipogenesis, and sebaceous gland homeostasis. Importantly, FoxO1 inhibition also is associated with activation of mTORC1, which promotes lipid and protein synthesis, sebaceous gland hyperplasia, and sebaceous lipogenesis, he said.

Dr. Kwon reported having no relevant conflicts of interest. 

For Better Facial Rejuvenation: Combo Therapy

Combination treatment: better facelift results, less downtime

June 12, 2015

By Lisette Hilton

Nonsurgical procedures are the fastest growing area in aesthetics and can delay the need for invasive procedures, but they cannot treat all concerns, such as excess skin in the neck and upper eyelids and excess fat deposits, according to Palo Alto facial plastic surgeon Jill L. Hessler, M.D.

Dr. Hessler, an adjunct clinical assistant professor, otolaryngology, head and neck surgery at Stanford University School of Medicine, presented on the subject of combined treatments yesterday at the 11th annual Vegas Cosmetic Surgery and Aesthetic Dermatology multispecialty aesthetic symposium in Las Vegas.

Among the topics she tackled: surgical and non-surgical combination treatment for facelifting.

When assessing the aging face, first surgeons need to assess volume loss from skeletal changes, bone resorption and bony remodeling, as well as facial fat loss, which leads to a gaunt and hollow appearance, Dr. Hessler says.

“Secondly, there is laxity of the skin, as some of the elasticity and collagen weakens [thereby] creating the jowls, neck redundancy and dropping eyelid skin,” Dr. Hessler says. “Thirdly, there are intrinsic changes of the skin, which cause discolorations, fine and deep lines and lack of a uniform color and smooth texture. We need to address each of these areas separately.”

Nonsurgical treatments, such as laser resurfacing can address the third area, according to Dr. Hessler.

“In that past, it was suspected that combining laser resurfacing with facelift surgery would be too traumatic to the tissues and lead to a higher risk of complications,” she says. “Multiple experiences and studies have demonstrated that this is not the case, and laser resurfacing can safely be performed at the same time as facelift surgery — particularly, with new fractionated lasers….”

Patients often are concerned with fine lines and deep lines around the face. The laser, alone, can treat superficial fine lines, but, can’t adequately address the deeper lines and folds without some form of additional skin tightening, according to Dr. Hessler.

Volume loss in the face is yet another missing piece in this picture for many patients. While facelifts reposition tissue and remove the deeper lines and folds and lasers remove fine lines and discoloration, adding volume for more youthful contours creates a synergistic enhancement with these other procedures.

“Combining these procedures allows the surgeon to obtain enhanced results, while being slightly less aggressive with each treatment, which allows faster recovery and a lower chance of side effects,” she says. “Combining surgical procedures with the less invasive procedures allows surgeons and patients to obtain the best from both worlds: optimizing treatment results with more limited recovery and downtime.”

Dr. Hessler reports no relevant disclusures. 

Lid Lift with latisse! This is a very good thing!

Bimatoprost for ‘chemical’ blepharoplasty?

June 12, 2015

By Lisette Hilton

Topical bimatoprost (Latisse, Allergan) is approved for the treatment of hypotrichosis, but using it off-label might help patients achieve a chemical blepharoplasty, according to a presentation given yesterday at the 11th annual Vegas Cosmetic Surgery and Aesthetic Dermatology multispecialty aesthetic symposium in Las Vegas.

Deborah S. Sarnoff, M.D., clinical professor of dermatology at New York University School of Medicine, presented her experience and new study, published May 2015 in the Journal of Drugs and Dermatology, on the use of bimatoprost beyond eyelashes.

In the study, Dr. Sarnoff and plastic surgeon Robert H. Gotkin, M.D., report significant changes in the appearance of the periorbital area after applying topical bimatoprost ophthalmic solution, 0.03% to the upper eyelid margins. The authors write that while published reports in the literature suggest side effects and potential complications from the drug, including prostaglandin-associated periorbitopathy, or PAP, theirs is the first report in the dermatology and plastic surgery literature looking at the rejuvenating effect of topical bimatoprost on the periorbital area. 

“While periorbitopathy implies pathology or a state of disease, we report changes that can be perceived as an improvement in the overall appearance of the periorbital area. We, therefore, propose a name change from PAP to PAPS — prostaglandin — associated periorbital syndrome. This better describes the beneficial, as well as the possible negative effects of topical bimatoprost,” according to the study authors.

Dr. Sarnoff says she treated herself with bimatoprost for eyelash enhancement and used her case report for the study. She applied the topical to the base of the upper eyelid cilia daily for three months; then, reduced application to two to three times a week. By 3 months, her eyelashes were noticeably fuller. Dr. Sarnoff also notes deepening of the upper eyelid sulcus, improvement in the hooding of the upper eyelids, involution of the dermatochalasis in the upper and lower lids, decrease in lower eyelid fat bulging and lower lid skin tightening, according to the study.

"Although there is a risk for periorbital changes that could lead to disfigurement in some patients, in properly selected candidates, when used bilaterally and the dose titrated appropriately, bimatoprost can have a rejuvenating effect beyond eyelash enhancement. It can improve hooding and dermatochalasis of the upper eyelid, diminish lower eyelid fat pads and tighten periorbital skin,” Dr. Sarnoff says. “The striking improvement in the periorbital appearance of some individuals using bimatoprost (Latisse), warrants further research into its potential use to achieve a 'chemical blepharoplasty.'"

Dr. Sarnoff reports no relevant disclosures.

Kythera

KYBELLA™ (deoxycholic acid) injection is indicated for improvement in the appearance of moderate to severe convexity or fullness associated with submental fat in adults

The safe and effective use of KYBELLA for the treatment of subcutaneous fat outside the submental region has not been established and is not recommended.

Important Safety Information

KYBELLA should only be administered by a trained healthcare professional.

Available at Glow Medispa

And

Tucson Cosmetics

Call for an appointment with Dr Rubbani!

520.638.5553

http://mykybella.com/

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