Kybella Treatment by Dr. Eric Rosenberger, Facial Focus Cosmetic Surgery — Transcript

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1. 0:00hello dr. Eric rosenberger a facial
2. 0:01focused cosmetic surgery today we're
3. 0:03going to be demonstrating kybella
4. 0:05injection we have a patient who has had
5. 0:08an initial treatment with 2.5 ml of
6. 0:12kybella to the submental region you can
7. 0:16now see the initial pre and then the
8. 0:21two-month post-op with a significant
9. 0:25reduction in submental fat
10. 0:29this patient would like a little
11. 0:31additional tightening of the skin the
12. 0:35submental region so next what we're
13. 0:37going to do is we're going to mark out
14. 0:39surgical landmarks being the mandible
15. 0:42the thyroid cartilage and then
16. 0:45delineating the region that we're going
17. 0:47to address today and then we'll be
18. 0:50applying a template so mark out the
19. 0:52angle of the mandible the body of the
20. 0:55mandible we marked the pregel sulcus
21. 1:00we had the patient bite down bite down
22. 1:03for me you can't see it very well but
23. 1:05right here you can feel the edge of the
24. 1:07masseter the facial artery and vein run
25. 1:09with the marginal radicular branch of
26. 1:13the facial nerve that's going to be
27. 1:14coming down lupine underneath the
28. 1:16mandible coming across the mandible
29. 1:18somewhere in this region and that's why
30. 1:20I marked out the the jowl and white this
31. 1:25is an off-label area your risk of a
32. 1:29marginal mandibular nerve palsy
33. 1:31increases injection here he gel sulcus
34. 1:33continues you don't want to create a
35. 1:35depression you usually have this pregel
36. 1:38slogans continue the mandible so if
37. 1:39you're trying to make a nice mandibular
38. 1:40contour you'd want to avoid making this
39. 1:43a depression and instead focus on
40. 1:46pulling in the jaw line here we've mark
41. 1:50the midline
42. 1:51interfere border of the mandible you
43. 1:53Mark the hyoid bone we've marked the
44. 1:55thyroid cartilage notch there's no
45. 1:58advantage to to injecting in this region
46. 2:02down here the supplied a grid pattern
47. 2:05that comes with a kybella has been
48. 2:07applied it's a series of these
49. 2:10multicolored dots that are spaced ones
50. 2:12one centimeter square and there are 30
51. 2:16of them total that I'm going to use I
52. 2:18have made a kind of jigsaw pattern with
53. 2:20my wax pencil to kind of feather where
54. 2:23these injections are going to go
55. 2:24anything that's within the Sawtooth I'm
56. 2:27actually not going to use and then I
57. 2:29pencil in a few areas where the dot
58. 2:31didn't
59. 2:32stick and that's actually going to be
60. 2:34right here in the in the jowl region
61. 2:36here and here she's got a little bit of
62. 2:39a depression right here I'm not gonna
63. 2:41use this dot and I'm not going to use
64. 2:42this stuff border of the impure Board of
65. 2:45the mandible but we're gonna use the
66. 2:47rest of these in here the order of
67. 2:50events based going to be two-tenths of
68. 2:53CC is going to go at each dot we move
69. 2:57quickly and then we apply ice as soon as
70. 3:00we complete the injections what we're
71. 3:02going to do to ensure that we're in the
72. 3:04right plan is we're going to grab the
73. 3:07tissue go ahead and grim us make sure
74. 3:11that there's no muscle in there and
75. 3:13we're going to go ahead and get started
76. 3:14we've got our syringe ready to go and
77. 3:18we're gonna getting it started here so
78. 3:22two tenths
79. 3:30two tents
80. 3:38you
81. 4:06conclusion of the procedure the patient
82. 4:08has been cleaned and obviously all the
83. 4:11marks are gone you can see that there is
84. 4:14a line of erythema and the submental
85. 4:18region you really can't appreciate the
86. 4:20swelling but I promise you that tomorrow
87. 4:22it will be significant but but overall
88. 4:28relatively bloodless it can you describe
89. 4:32your discomfort now sure oh gosh maybe
90. 4:36two at this point it just is a little
91. 4:38bit of a warm egg and I suspect pretty
92. 4:41much take care of it great okay well
93. 4:45that's it so this is a lateral view of
94. 4:47our patient after four days following
95. 4:51injection with kybella you can see as we
96. 4:55zoom in here that there is still
97. 4:57significant fullness in the submental
98. 5:01region this is the anticipated result
99. 5:08that we will be getting so all this is
100. 5:10just kind of full and is continuing to
101. 5:15resorb
102. 5:16essentially could you give us a little
103. 5:19overview of the past four days as far as
104. 5:21healing and swelling pain etc sure so
105. 5:25after the procedure I had a significant
106. 5:28amount of redness and I would say at
107. 5:30that point about pain went from 2 to
108. 5:33about a 6 over about the next hour and I
109. 5:35treated that with ice which helped a lot
110. 5:37the next day it was red just slightly
111. 5:41and I'm kind of tense feeling it was a
112. 5:44good day to wear a pretty scarf but not
113. 5:47painful anymore certainly no problems
114. 5:49swallowing or talking I went to work
115. 5:51that day and the next two days it became
116. 5:54more soft and kind of gel like so it's a
117. 5:57fullness that I noticed but someone who
118. 5:58doesn't know me or even my co-workers
119. 6:00don't really notice that being out of
120. 6:02the ordinary