So, we're going to focus on Kybella today and why is Kybella such an important procedure? Well, about 67% of patients in my clinic and probably most other places - because this was a study done by the American Society of Dermatological Surgery - 67% of patients are concerned about Submental Fullness and most of them don't know that there's anything available for Submental Fullness other than surgery, liposuction. And so, I have some good news for those patients, Kybella is on the market, it's been on the market sinceSeptember, 2015. It was FDA-approved inFebruary, 2015 and there's a lot of science behind it; over 20 clinical studies were performed before the FDA approved it and 1,600 patients were treated in those initial clinical trials. It's an extremely effective treatment and one of our most popular new treatments at our clinic in Miami Florida.

So, today I'm going to perform the procedure and you're going to see how easy it is. Most patients require anywhere from 2-6 treatments, each treatment spread one month apart and during the treatments we use about 4ml's of fluid for each treatment, that's 2 vials. This is a vial of Kybella. So, Kybella comes in a box like this, alright? And it has both a lock number on the box as well as an expiration date and inside of the box are 4 vials and that's 8 CC's of fluid. We use 2 of these vials per patient, per treatment on average and each patient needs anywhere from 2 - 6 treatments. Although, in my clinic I find that the average is closer to 2 than 6.

So, we're going to get started with the procedure now but before I get started, I wanted to thank this wonderful patient for volunteering to do this, her before-and-after photos will be available after the complete treatment is done on our website. There are a couple of things that I do need to tell patients about, it's a very benign procedure, it's a quick procedure of 15 to 20 minutes it takes at max, very tiny needles are used to inject the medication into the submental area as you will watch me do. The risk factors for this procedure are mainly benign and they are almost all related to the injection of the medication so swelling, bruising, redness are the most common things we see with this procedure.

The swelling is significant and I do tell my patients that they can expect for 3 to 10 days a decent amount of swelling, each day obviously it is going to improve. Ice after the procedure as well as some compression does help with the swelling and keeping it at bay. There are some minor additional risks with this procedure, one of them which is difficulty swallowing; I have never seen that complication in any of my patients, I think it's exceedingly rare and it's not something that I'm very concerned about. And the other one is an injury to the marginal Mandibular Nerve which runs along the jawline; also, extremely uncommon. None of these in the initial clinical trials, none of these side-effects were left unresolved; they all resolve with time. And so, it's an extremely safe procedure. Again, FDA-approved and a lot of data behind it. I’m very comfortable doing this procedure. We were one of the first clinics in South Florida to offer this procedure, so I do believe we have quite of a bit of experience with this procedure and I'm really comfortable saying that it's an extremely safe procedure.

Alright, so I'm going to just explain a few things before we start the procedure. I've gone ahead in the interest of time and marked the patient prior to the procedure, the patient also had topical numbing medication on for about 45 minutes prior to the procedure, we wiped off the topical numbing medication, we sterilized the skin with both Chloropep and 70% Isopropyl Alcohol, then I went ahead and marked the patient; we marked out the mandible and this is just kind of a landmark for us to know where the Marginal Mandibular Nerve is and I also marked out the Submental Fullness, Submental Crease and the Thyroid Cartilage down here as well and both Sternocleidomastoid. And then when I attached a tattoo on the patient's face, a temporary tattoo obviously, each of these dots are 1cm apart and they just help ease my injection points, help me identify my injection points. This is provided with the medication by the company, Allergen, who makes Kybella.

So, now we're going to get started with the procedure, I have pre-drawn the Kybella, actually, my assistant, Stephanie, my wonderful assistant, Stephanie and our patient coordinator here has drawn the Kybella for me and I've marked out, as I already mentioned, the injection point so we just get going to get started. This is a 30-gauge needle, a CC of Kybella in each of these syringes and we're going to point .2CC injections in each of these dots. The nice thing about Kybella is that it allows me to customize the treatment, something that I find hard in some of the alternative non-injectable procedures like the [Cool] Sculpting procedure, very difficult to customize that treatment, this procedure is something that I can do on almost every patient with Submental Fullness.

So, we're going to get started with the procedure right now. I usually start in the middle, just a comfort zone for me, I’ll lift the skin up and I'm going .2 in each area, it's very important to get into the Pre-platysma fat, too superficial, not very good and it's as easy as that. Again, I'm putting .2 into each injection point and important for the physicians that are watching the video, this is the Pre-platysma fat not the Post-platysma fat. So, just finishing up these dots here, the dots that I had set out to do at the beginning of the procedure. And I usually have a little bit left because we do put more than 2 CCs into each vial and I usually just target a few areas usually where the bulk of the fat is and this is kind of the customization of the treatment; why I love Kybella so much.