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“Today I want to answer question from one of our video bloggers and I think it’s a really good question and that’s about the use of Kybella in general outside of the neck area which would be an off-label use of this product and the package insured to the FDA recommendation says specially that Kybella is “Not recommended” outside the chin area mostly because there’s no studies about it and not much knowledge. That doesn’t mean doctors can’t do it that’s what’ off-label use is but it also, and people should be aware of this, there isn’t a lot of data yet published about of the outside of the neck area.

Now, it doesn’t mean the fat is fat so wherever you inject fat it’s going to work but what we know about Kybella is it can be an irritant to nerves and possibly to other tissues and it really works only, you know, on fats. So, we want to make sure that wherever we’re using it doesn’t matter if it’s on the bottom of your own arm or on the little bra fatty area here or in areas of the abdomen or other regions where there might be irregularities after liposuction for example where we’re using it quiet extensively. It doesn’t matter where the fat is it almost always work so really fat is fat and the body’s reaction to the deoxycholate molecule is going to be the same.

Now, specifically we had a question that I think was a very good one. Miss Players sent me a question asking “Can she use it in the area where the foot or ankle joins the lower leg which often is referred to as kankles?” and this is an area that has been difficult to treat historically, liposuction has been tried with some success but it is an area that’s very difficult because of the skin to relate in this area and there’s the course to leg are dependent so there’s often very much swelling and bruising associate with it and so it does sound like an attractive area. The only thing that is cautionary in this and there’s a number of them is that there are number of sensory and motor nerves that travels through this area and so before we get into the injection, someone would certainly have to be thoroughly understanding the lower leg anatomy and especially the ankle lower leg junction anatomy because that junction is really where all the nerve that help slide the toes and the flexion of the foot or at least near that area where the flexion of the foot and the extension of foot occur and nerves and muscles that affect them, we do not want those to be injured.

So it wouldn’t necessarily be our first choice in treating that area. Now with that said, as time passes as experts get involved in more of the use of deoxycholate or Kybella I think we’ll see an expansion of the indications and that may include areas like the ankle which I know the company that make this looking at a number of different indications for them. I would say the main off-label and we’re doing a study here at The Maas Clinic right now looking at off-label indications and those for us are primarily areas that are irregular fat after liposuction especially this happens on thinner people or people are washboard stomachs that had a little lipo and they’ve got little lumps or bumps and we’re using in combination with Cellfina to get really get rid of cellulite. There’s an inflammatory process and skin tightening and so in my opinion the way that cellulite ultimately will be treated will be with Cellfina which is just a simple way of under mining and with Deoxycholating combination and my associate, plastic surgeon associate that I work with on these and other procedures are excited about the technology and combining these technology to get super outcomes.

So relative to the question about Miss Player is a great question, I would say right now foot and ankle expert the only one I would allow to inject until we have a very clear picture of what the limitations of Kybella Deoxycholate are but there are certainly off-label indications that are being used that will be published, you’ll starting to see publications and certainly a number of presentation papers presented on a scientific meetings which are very exciting.

If you have any other questions about Kybella, Deoxycholate or any methods of removing unwanted fat or body shaping, please don’t hesitate to call or write @DrMaas.com, happy to have these dialogue and I really appreciate it. We’ll be talking to you very soon.”