Waiting List in L.A. for Double-Chin Fat Killer

Illustration by: Ciara Phelan

On Monday, injectable Kybella will be released to select Los Angeles dermatologists and plastic surgeons to melt double chins, but "we can attempt it with discretion on other places."

This story first appeared in the June 19 issue of The Hollywood Reporter magazine. To receive the magazine, click here to subscribe.

Have you ever watched a tailor take off an inch here, pinch in a dart there? The thought might have occurred to you: "Wouldn't it be amazing if someone could do this contouring to my body?" 

In a few days' time, a doctor will be able to do just that to at least one body part, with a fat-melting injectable called Kybella (brand name for deoxycholic acid). Invented and developed by Kythera Biopharmaceuticals and approved by the FDA in April, Kybella is sanctioned for use on submental, or under-chin, fat — what's commonly known as the "double chin." The product will be available June 15 to dermatologists and plastic surgeons who have completed training at the drug company's Westlake Village, Calif., offices.

"I've never seen a demand like this, except for Botox," says Derek Jones, a dermatologist on the faculty at UCLA and lead investigator in the clinical FDA trials of Kybella. "We have a waiting list of people who have been calling for months." Adds Beverly Hills plastic surgeon David Hopp: "There's been a lot of interest in the community — patients started asking for it the day the FDA cleared it!" But does it work?

"The medicine has a direct destructive effect on fat," says Hopp, who runs Robertson Blvd MedSpa (which sees 750 to 1,000 patients a month for other injectables) and will be among the first doctors approved to administer Kybella. (Doctors in the rest of the U.S. can join a training program in late summer to be eligible to use the drug.) After it has done its work, he adds, "your body recognizes [Kybella] the same way the liver recognizes bile. It's a synthetic byproduct of the fat breakdown already excreted in your body."

But one injection won't do the trick. Tests show Kybella should be injected once a month for six months, depending on the amount of fat. Some participants in the FDA study saw good results after three or four treatments. "Each Kybella treatment takes out one layer of fat," says Hopp. Prices per injection had not been set at press time, but doctors have expressed hope that it will be less expensive than liposuction. Kybella can cause bruising and redness, but there's virtually no downtime. "This could take the place of lipo," says Hopp. Adds Jones: "The data says the largest percentage of users will be female. But males willing to take steps to get rid of double chins is a growing demo. A double chin can be genetic — you can be in shape and still have one."

Even if you don't have one, Kybella could still be a part of your future maintenance regimen. "Now that it's FDA-approved," says dermatologist Peter Kopelson, "approved doctors are allowed to use it 'off label,' which means we can attempt it with discretion on other places. 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. Not for large areas like buttocks, but this is definitely very promising."

In Other News: Next-Gen Fat-Freezing 

Much has been written about CoolSculpting — a process that freezes local fat cells, dissolving up to 20 percent of them — but at least 25 percent of patients experience more modest results. "Some people have fat cells that are very resilient and don't die from treatment, or a large percentage of their fat cells don't die," says Kopelson. "Patients expect a much more extreme result. And if they stop working out and start eating a lot, they may not see any improvement at all." A newer, somewhat untested alternative for fat loss is Cryotherapy, which has previously been touted as an overexertion, anti-inflammatory and arthritis treatment for the likes of LeBron James, Mandy Moore and Demi Moore (the latter two have been spotted at the Cryohealthcare offices on La Cienega).

The procedure for warding off arthritis and for slimming down is the same: Patients walk into a Cryochamber that is set up to negative 256 degrees Fahrenheit for one to three minutes. According to Robin Kuehne, one of Cryohealthcare's owners, Cryotherapy does freeze off some fat, but more effectively has been found to burn 500 to 800 calories per session by raising your metabolism. A Hollywood personal trainer told Kuehne he stopped his weekly workouts for a time because Cryotherapy was toning him up equally well.

The Future of Fat Removal

If you think slenderizing breakthroughs have become a game of diminishing returns, you'd be wrong. "Advancements in technologies will produce more formidable techniques than anything we have now," says Beverly Hills plastic surgeon Dr. Glenn Vallecillos.

Specifically, radio-frequency procedures (such as ThermiTight, Ultherapy and Exilis) will be finessed to the point of lipo-efficacy — with none of the brutal recovery: "It will fully hyper-heat the tissue below, causing serious tightening. At the same time, it will cause dissolution of fat." In other words, put that ice cream away for now — you'll be able to eat as much of it as you want in five years.

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