My Experiment with Kybella (Deoxycholic Acid)

Written by Dr. Paul M. Graham

Continuing from last weeks article (Kybella: An Injectable Fat-Dissolving Medication), I want to demonstrate to all of our readers how Kybella works on destroying fat cells. After spending some time searching for actual pathology photos (under the microscope) of Kybella’s effect on fat cells, I came up empty-handed. This sparked my interest in conducting my own laboratory experiment to help visualize the mechanism of action of this new and novel fat-dissolving medication.

During the initial studies with Kybella, before it was FDA approved, Dr. Kolodney and Dr. Rotunda (the original discoverers of this substance) injected it into lipomas (fatty tumors), which were then surgically removed and examined under the microscope to determine how it actually worked. This experiment was my astute attempt to replicate this discovery and demonstrate how Kybella actually works by obtaining clear photos of the disrupted fat cells under the microscope after being bathed with this medication. Although this experiment was not conducted using a standardized protocol, I do believe that  I was able to demonstrate specifically how this medication works outside the human body. The main limitation of this experiment was that the fat tissue used during this experiment was
removed from the body, preventing the inflammatory response (swelling, redness, and warmth) typically seen with this medication from occurring. With that said, this does not affect the way this medication works and therefore does not affect the initial destructive effect on the fat cell membrane.

A small amount of fat tissue left over from a skin cancer surgery was used in this experiment. I placed the fat on a sterile petri dish and bathed it in approximately 1 mL of Kybella solution. The fat was then incubated in the Kybella solution for approximately 120 minutes (2 hours). Following this incubation period, the fat was then transferred to a tissue specimen bottle and sent down to the pathology lab. The pathology lab processed this fat sample and made a permanent section microscope slide. After 12 hours of suspenseful waiting, the slide was finally delivered.

After thoroughly examining the microscope slide, it appeared that the Kybella (deoxycholic acid) solution directly caused disruption of the fat cell membrane. If this experiment were to have taken place in the human body, significant inflammation would have occurred leading to complete destruction and elimination of the damaged fat cells over several weeks.

Although this was just an experiment, I do believe that we were able to prove the initial effect of this medication on the fat cells. According to several studies, this product causes immediate fat cell membrane damage upon contact, leading to eventual permanent fat reduction over several treatment sessions. This process can be appreciated by Allergan’s before and after photos.

Overall, I really do like this product and truly believe in the results that it has to offer to my patients. This procedure causes permanent destruction of fat cells (lipocytes), which is a huge plus for this product. This diminishes the need for more invasive surgical liposuction procedures. Despite the excellent results with Kybella, it is very expensive and should only be considered in patients that are willing to commit to a healthy lifestyle. Incorporating a good diet and exercise regimen should be a priority in order to preserve the results of this highly effective, non-invasive procedure.

-DrPMG

I have always had a questioning attitude with science and feel that this mindset is vital to the discovery of new treatments and procedures in our field of dermatology. I would love to hear your comments about the results and any other ideas you may have. Thank you for your continued support for Dimensional Dermatology!

Photo Credits: Allergan, Utahfacialplastics.com

References: 

1. Dayan SH, Humphrey S, Jones DH, et al. Overview of ATX-101 (Deoxycholic Acid Injection): A Nonsurgical Approach for Reduction of Submental Fat. Dermatol Surg. 2016;42:S263-S273.

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