JAAD ONLINE: SURGICAL PEARLS
A template for estimating doses
of deoxycholic acid for
submental fat fullness
Amy Brackeen, MD
Lubbock, Texas
See related article on page 788
Key words: cosmetic surgery; deoxycholic acid; lipolysis; mesotherapy; submental fat; template.
SURGICAL CHALLENGE
Deoxycholic acid (Kybella, Kythera Biopharmaceuticals, Inc, Westlake Village, CA) injections are indicated
for improvement in the appearance of moderate to severe convexity or fullness associated with submental fat in
adults.1 Deoxycholic acid is injected as 0.2-mL doses 1 cm apart in the treatment area. Providers may charge
patients by the amount of product used or per treatment. A more accurate estimate before the procedure allows
for a better estimate of cost and allows the appropriate amount of medication to be available and drawn up at the
time of treatment. During treatment, a tattoo grid is placed over the area to be injected and then removed after
treatment with alcohol. Applying and removing a tattoo grid during a consultation is time-consuming and
irritating to the skin. Also, the provided tattoo grid has an opaque backing obscuring use until it is applied to the
skin.
Fig 1. The provided tattoo grid with its copy and multiple copies of the template on
transparency paper.
From Lubbock Dermatology and Skin Cancer Center. J Am Acad Dermatol 2016;75:e151-2.
Funding sources: None. 0190-9622/$36.00
Conflicts of interest: None declared. Ó 2016 by the American Academy of Dermatology, Inc.
Reprints not available from the author. http://dx.doi.org/10.1016/j.jaad.2016.04.058
Correspondence to: Amy Brackeen, MD, Lubbock Dermatology
and Skin Cancer Center, 3601 22nd St, Lubbock, TX 79410.
e151
e152 Brackeen J AM ACAD DERMATOL
OCTOBER 2016
SOLUTION
The provided tattoo grid can be used to make a clear grid that can be used during consultation to give an
accurate estimate of medication needed within seconds. A copy is made of the tattoo grid after the plastic cover
is removed. The copy of the tattoo grid is then outlined. Multiple templates can be placed on 1 sheet of paper.
This is then copied onto a clear transparency sheet (Fig 1). This provides clear individual templates that can be
used directly over the patient’s skin to see the exact number of injection sites for treatment (Fig 2).
Fig 2. Use of the clear template.
REFERENCE
1. Kybella [package insert]. Westlake Village, CA: Kythera Biopharmaceuticals, Inc; 2015.
