The drug designed to treat my โsubmental fatโ (the fat pocket under the chin) is the new cosmetic injectable Kybella, which promises to dissolve fat cells through a series of injections. Thereโs very little downtime, itโs noninvasive and nonsurgical, and thereโs little risk. The drug is the first (and only) injectable designed to contour away the dreaded double chin.
Approved by the FDA in 2015, Kythera Biopharmaceuticalsโ drug (which has since been acquired by Allergan) hit the market as an alternative to liposuction or surgery, using a synthetic version of deoxycholic acidโa salt found in human bile that aids fat digestionโto destroy fat cells. In the digestive tract, deoxycholic acid breaks down fat by destroying the cell membrane. When injected into subcutaneous fat, this cytolytic drug does the same thingโin targeted locations. The dissolved fat is now cellular debris, and gets cleared into the lymphatic and circulatory systems by specialized immunologic cells. This happens gradually over the span of several weeks. As for the deoxycholic acid, it follows the same path; it gets metabolized and broken down, and then excreted as waste.
The origins of chemical fat-dissolving (a.k.a. mesotherapy) go back to France in the โ50s. By the โ60s, according to Conor Gallagher, Allerganโs executive director of medical affairs, European scientists started using a compound called phosphatidylcholine to break up fat for medical reasons. After a patient experiences trauma, perhaps from a fracture, tiny globs of fat can enter the circulation. โAnd often times they’ll end up in the lungs and can cause respiratory issues,โ explains Gallagher. โSo, they’re looking for a way to disrupt fat, to help fix that or to treat that. They were using phosphatidylcholine as a potential agent to try and dissolve that fat.โ Cut to 1980s Europe, and cosmetic researchers started looking at the compound, thinking, โif it can dissolve fat in the vessels maybe it can dissolve fat elsewhere,โ says Gallagher. Bodybuilders began injecting themselves with โPC/DAโ (a combination of phosphatidylcholine and deoxycholic acid) off-label to get rid of fat pockets for competition.
In the early 2000s, researchers at UCLA discovered that the fat breakdown caused by the PC/DA compound was actually due to the deoxycholic acidโthe active ingredient in Kybella. And now here we are. Or should I say here I am, in Beverly Hills, with a needle in my chin.