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Kybella in the Eyelid to reduce eyelid fat: Good idea or Terrible idea? A Warning for patients.

As an oculofacial plastic surgeon in Denver, Colorado I not only perform eyelid and facial surgery but also perform injectables. These injectables include Kybella. Kybella is a new injectable used to dissolve fat under patients necks. It has worked wonders for many of our patients. It works by literally dissolving fat cells. Though it is approved for under the neck there are many other areas where it is being tested such as behind the knee. That being said Kybella is not without risks.

Most people associate fat as something negative but the reality is that fat is critically important for us. In our bodies fat is important for neural tissue. What is neural tissue exactly? It the tissue that makes up the brain and nerves of our bodies. In the FDA trials it was noted that the Kybella caused temporary stunning of the nerves that eventually regenerated. The outer covering of nerves are surrounded with a layer of fat. This layer of fat helps the nerve conduct their signal from the brain to the muscle. For Kybella placed too high on the neck, it can cause stunning of the nerves that control the facial muscles. Patients may have problems frowning while the nerves are regenerating.

Around the eyelids, it is common for patients to have fat that pushes forward. In the lower eyelids these fat pads are often contoured by eyelid specialists like myself in Denver. Also fillers can be used to help improve the appearance of the lower eyelids.

What about using Kybella? Would it help dissolve eyelid fat? I recently had a patient tell me that a doctor (who does not perform eyelid surgery and is not an eyelid specialist) offer to inject Kybella into the eyelid “to see if it dissolves the eyelid fat”. As an eyelid specialist, I would say that using Kybella in the eyelid is a terrible idea. Why is that? The eyelid fat is in the eye socket and pushes forward with time. Injecting a material that dissolves fat into the orbit would be great for the fat that cosmetically causes a problem but there are critical nerves for vision and eye movement that can be damaged.

The eye socket contains such important nerves which control eye movement, tearing, sensation of the eye among other things. Most importantly, the eye socket has the optic nerve which supplies the messaging from the brain to the eye. In optic neuritis, a disease seen in multiple sclerosis the fat around the nerve is damaged or lost and vision is damaged. Usually the vision improves as the fat regenerates to a certain extent but the vision usually does not fully go back to normal. If Kybella was injected into the orbit, damage to the optic nerve could occur resulting in optic neuritis like symptoms.

I would recommend never letting a doctor inject Kybella in your eye socket or eyelid under any circumstances. By not understanding the science of how a medication works, it would be a critical error to inject Kybella into the eyelid or eye socket where so many critical nerves are located. Enjoy Kybella under your neck but not in your eyelids…ever.

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