Use of Triamcinolone to Reduce the Inflammation Associated with Kybella Injection

Abstract

Background: Submental fullness has been a concern for patients in dermatology for years. Liposuction and cosmetic surgery were considered the mainstay for elimination of unwanted submental fat. However, these procedures are invasive and associated with major complications like prolonged recovery times, and the risk of contour irregularities. In 2015, Kybella (deoxycholic acid) was approved as a first-in-class injectable agent for the treatment of submental fullness. Although, it is non-invasive and has less complications than plastic surgery, it is still associated with adverse effects such as pain, swelling/edema, and bruising. The most concerning adverse effect for patients is the prolonged inflammation that may occur for up to 2 weeks post-injection. Objective: This is a comparison trial of deoxycholic acid injections with or without triamcinolone acetate for the reduction of submental fat in one patient. The study will also assess the effect of triamcinolone acetate on post-injection inflammation associated with deoxycholic acid injection in the treatment of submental fullness. Method: A 35-year-old female presented for evaluation of submental fullness and opted for treatment with Kybella. Her right submental treatment area was injected with 2ml of deoxycholic acid 10mg/ml plus 0.2ml triamcinolone acetate. The left submental treatment area was treated with 2ml of deoxycholic acid 10mg/ ml alone. The patient was observed over a duration of 3 months to evaluate inflammation and treatment response between the two treatment zones. Results: This split-neck study resulted in decreased postinjection swelling. However, at 3-month follow-up, there was no clinical improvement to the submental fullness bilaterally. Limitations: Small sample size, lack of objective measures, possible diffusion between treatment zones, and prior deoxycholic acid treatment. Conclusion: Triamcinolone can decrease post-injection swelling if given as an adjunct to Kybella treatment.