Just recently I was lucky enough to watch Kerry from North Coast Medispa who was treating patients for their second Belkyra treatment, two lovely ladies, Jodie & Nicole.
Jodie had her first treatment 9 weeks prior to her second treatment. She was told not to expect too much after her first treatment, but she definitely noticed feeling about half the bulk gone, with a bit of tightening.
So what is Belkyra and how does Belkyra work?
Belkyra contains synthesised deoxycholic acid. This occurs naturally in the body and aids in the breakdown and absorption of dietary fat. So Belkyra is just a synthetic version of that; and how it actually works is by destroying the fat cell membrane. When injected below the chin, Belkyra breaks down the fat cells, causing the fat to then be absorbed by the body. So unlike other fat reduction methods where they just shrink the fat cells, Belkyra actually completely destroys the fat cells so it can’t ever grow back again. Basically our fat cells are pretty much laid down by the age of 16 or 17 – they either just expand or contract as we gain or lose weight. Once they’ve actually been destroyed we don’t regenerate fat cells either, so that’s the key difference with Belkyra vs other fat reduction methods – it destroys that fat cell membrane.
Another way to think of it is a bit like balloons popping – so when the Belkyra goes in, it destroys those fat cells straight away so the discomfort that a patient feels is due to that fat cell destruction, which happens immediately. Following on from that, the fat cell destruction elicits a localised inflammatory response so what happens almost immediately afterwards is all the macrophage cells come in and clean up all the fat cell debris. That’s why you get that localised swelling.
Swelling can last up to 3 to 4, even 5 weeks. The inflammatory response process typically ends at the end of week 2, at the beginning of week 3 you get the infiltration of the fibroblast cells (the cells that generate collagen – collagen production). It’s like a naturally occurring immune response and part of that inflammatory response process of the cells that generate collagen is why we start to see the cell retraction. Finally, even though the fat is gone, patients are not left with the loose pocket of skin.
Is it similar to liposuction? When they do liposuction they take out the fat cells…
Basically, they’re taking away the fat cells – it’s destroying the fat cells. Liposuction does not elicit a localised inflammatory response; so the localised inflammatory response that we get with Belkyra because of that fat cell destruction is then what causes the swelling initially; but is then also what causes that retraction. And, once they’re gone, they’re gone – they’re not coming back again.
Clinical trials have got data on Belkyra for up to 5 years. They can’t say it’s permanent but they can say retreatment is not expected. And Kerry tells us you don’t generate new fat cells either. Once they’re gone, they’re gone. However, that’s not to say you can’t put weight back on! Kerry says, “You can definitely put weight back on after a treatment, however it’s the pre-existing fat cells that we haven’t destroyed just getting bigger. But we don’t actually accumulate new fat cells as we age. It’s not like other cells that regenerate. Essentially, our fat cells are laid down by the time we’re 16 or 17.”
Most people need a minimum of two treatments – 2 vials, 2 treatments. Kerry explains. “That’s what we say to people, it’s not just a one off. It’s a series, very similar say to the laser therapies, like laser hair removal. You’re not going to get a final result from just one treatment. Average of 3 – 4 treatments with 2-3 vials at each treatment. We can do a maximum of 5 vials, so 50 dots in one hit, and we can do a maximum of 6 treatments if we need to but on average the studies show at least a 1 – 2 grade improvement after the 2 – 3 treatments. It’s totally up to the individual as well. If they’re happy with the aesthetic outcome after two treatments and they don’t want to go ahead with a third or a fourth they don’t have to. But, you know, if they feel like they just need a little bit more contouring they can go ahead and get that third or fourth treatment.”
Kerry also says depending on how much submental fullness a patient has initially, some people may benefit from some other contouring treatment first and then having Belkyra otherwise the amount of product you will need and the cost associated with that will not be beneficial. “A lot of places are using it in conjunction with a liposuction or other contouring as well for those bigger patients. But there’s a lot of people who wouldn’t qualify to be a candidate for liposuction but they just want a little bit of contouring… if you can pinch it you can inject it. If you can grab it you can stab it!”
Allergans’s newest addition to our aesthetic toolbox is Belkyra – the non-surgical injectable treatment for submental fullness, known as the ‘double chin’.