Double chin removal with Belkyra™

Double chin is an aesthetic problem which worries both women and men. It is
often formed by isolated accumulation of adipose tissue and it can appear
even in individuals with well-shaped bodies. Among the main reasons for the
appearance of a double chin can be weight gain, genetic inheritance and aging
processes. Dietary and physical regimen are recommended to obtain the
desired results for the other parts of the body, but excessive adipose tissue
under the chin remains. This makes the patients feel older and fuller than they
really are.

What is Belkyra ™?

Belkyra ™ , a cosmetic produced by Allergan, is the first product for non-
surgical treatment and contour enhancement due to submental fat caused by
the excessive adipose tissue in the area.

The main ingredient of the product is deoxycholic acid – an essential molecule
which takes part of the digestion and absorption of dietary fats. After the
product has been injected into the fat under the chin, it causes the destruction
of the cell membrane of the fat cells.

Subsequently, these cells cannot be stored and no fat is accumulated in these
areas. A tissue regenerative response in which a particular kind of cells called
„macrophages“ is stimulated. Their function is to "clean" the fatty residues.
Afterwards a second type of cells called fibroblasts stimulate the collagen
production in the area.

The treatment must be preceded by a consultation with a doctor. The specialist
assesses the cause of the weight gain (the product is effective when there is an
excessive adipose tissue in the area, not when the double chin is due to "clean"
excess skin), gives nformation on the nature of the treatment and what
patients should expect in the following days and weeks. The number of the
sessions needed to get the desired results is also assessed.

The procedure is performed after the area has been locally anesthetized with a
subcutaneous injection of Lidocaine through a fine cannula with or without the
addition of topical anesthesia in the form of cream.

A special „injection template“, given by the manifacturer, will be placed  under
the chin just before the procedure (15 minutes after the Lidocaine infiltration).
The template will map out the exact injection points. The treatment is entirely
done by injections, with the finest needle being used to reach into the
subcutaneous adipose tissue. The volume of product injected in each point is
0.2ml (2mg) (the maximum tolerated dose for one session should not exceed
10ml (100mg) of the product). During the procedure the patients often
experience burning sensation and / or pain hen the product is being injected.
Applying an ice compress for 15 minutes after the procedure reduces the
discomfort.

What to expect after the procedure

Swelling (edema) occurs as a result of the treatment. It is mostly visible in the
first 1-3 days, after which it slowly decreases and most often disappears
entirely for about 10-14 days, although it could last for about 20 days. Edema is
a result of the degraded fat and it subsides together with the removal of the
fatty residues by the macrophages. Meanwhile, the stimulation of collagen
synthesis prevents the skin from sagging and ensures its tightening in the area.
The effect of the treatment is assessed on the 28-30 day after the procedure.

The appearance of hematomas in the injection sites are also possible but they
also disappear within the next few days.
The degree of adipose deposits under the chin will determine the required
number of procedures for an optimal effect. Satisfactory results are possible
even after one procedure, although in most cases it takes about 2-4 sessions.
The interval between procedures must be at least 4 weeks. The maximum
number allowed is 6 procedures.