PCDC
A course of injections, no set schedule There is no approved schedule. Published plans used up to five treatments, about four weeks apart.
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Dermapedia / CompareProcedures
PCDC vs Kybella
PCDC is a fat-dissolving injection mixed by a compounding pharmacy. There is no approved strength and no fixed dose, and the recipe changes from one pharmacy to the next. Kybella is an approved fat-dissolving drug. It has one label, one dosing table and published side-effect rates. Nobody has compared the two head to head.
At a glance
| The difference | PCDC | Kybella |
|---|---|---|
| What is in the syringe | Phosphatidylcholine and deoxycholate | Deoxycholic acid, made in a lab |
| Cost | Paid out of pocket, over several sessions | Paid out of pocket, over up to six sessions |
Kybella
Side by side
The differences that matter
What you actually do
PCDC
A course of injections, no set schedule
There is no approved schedule. Published plans used up to five treatments, about four weeks apart.
Kybella
Up to six sessions, a month apart
Small injections about 1 cm apart across the pad of fat. Most people needed 3 sessions before they responded. 59% went through all six anyway.
What is in the syringe
PCDC
Phosphatidylcholine and deoxycholate
There is no approved strength to check a batch against. A percentage a clinic quotes you is the prescriber's own recipe, not an approved dose.
Kybella
Deoxycholic acid, made in a lab
The deoxycholic acid is made in a lab rather than taken from bile. Each vial carries a hologram to guard against fakes.
How it works
PCDC
Detergent damage to cell membranes
The mixture breaks open cell membranes. Lab work called the effect non-selective. It damaged fat and muscle alike.
Kybella
Detergent damage, deoxycholic acid alone
The drug also breaks open cell membranes. Fat is hit hardest because fat holds little protein, which otherwise soaks up the detergent.
What you can expect to see
PCDC
Small change under the chin
Only one study looked under the chin. It found a small change, with either recipe.
Kybella
A moderate cut in the pad under the chin
In two placebo-controlled trials in 1,022 people, 68% improved by one grade on both the doctor's scale and their own, versus 21% on placebo. 16% improved by two grades, versus 1.5%. Scans showed the fat under the chin shrank by at least 10% in 43% of treated people, versus 5%.
More photographs
Kybella
The downside
PCDC
Swelling, redness, pain and burning
No one has counted these for a set recipe. So how often they happen is unknown. FDA says it has had reports of lasting scars, serious infections, skin damage and deep, painful knots after unapproved fat shots.
Kybella
Swelling 87%, bruising 72%, pain 70%
Counted in 513 treated people, along with numbness in 66%. Beyond 30 days, 42% still had numbness and 20% still had swelling. Nerve injury showing as an uneven smile happened in 4%. Every case cleared up on its own.
Cost
PCDC
Paid out of pocket, over several sessions
There is no standard product behind the price, so there is nothing to compare between clinics.
Kybella
Paid out of pocket, over up to six sessions
Budget for the whole course, not one visit.
The at-home or drugstore version
PCDC
No home version, and no standard product
A compounded mixture is made to order for one prescriber. Nothing sold over the counter contains it.
Kybella
No home version
Creams and "fat-dissolving" gels sold online sit on the surface of the skin. The pad of fat under the chin is centimetres below that. Both of these treatments put a detergent into the fat itself.
Who tends to be happy with it
PCDC
- Best for — Someone with a clear reason to choose an unapproved mixture, who has asked what strength and volume they are getting.
- The mindset — The strength, the schedule and the side effects come from the prescriber, not a regulator.
Kybella
- Best for — Someone with a clear pad of fat under the chin and firm skin over it. They want a fixed dose and published side-effect rates.
- The mindset — Several rounds, real swelling for a week or two, and a moderate result rather than a dramatic one.
Nobody has run the comparison you want
Kybella
The closest study is from 2009, and it did not involve Kybella. It split 42 people between deoxycholate on its own and a phosphatidylcholine-deoxycholate mix, under the chin. Mean improvement on a 0-to-3 scale was 0.8 for deoxycholate and 0.6 for the mix. The authors found no clear difference from adding phosphatidylcholine, and said the injections "produced minimal aesthetic improvement."
What "compounded" changes for you
Kybella
Kybella's own figures need one caveat. The rates come from trials the drug's developer paid for. That does not make them wrong. It does mean there is no independent set of numbers to check them against.
The fine print
PCDC
There is no FDA-approved PCDC product. FDA's consumer page on fat-dissolving injections, current as of 20 December 2023, names lipodissolve among unapproved products, with phosphatidylcholine and deoxycholate as common ingredients.
Kybella
Kybella is FDA approved, for one place on the body. It is deoxycholic acid at 10 mg/mL, 20 mg in a 2 mL single-patient vial, with benzyl alcohol, salt and buffer at pH 8.3. It was approved on 29 April 2015 under NDA 206333 as a new molecular entity, and AbbVie now distributes it; the current label revision is dated October 2024. The indication is "improvement in the appearance of moderate to severe convexity or fullness associated with submental fat in adults." The label says use outside the submental region "has not been established and is not recommended," and "Do not dilute or mix KYBELLA with other compounds." It sets the dose at 2 mg per square centimetre, 0.2 mL per injection, injections 1 cm apart, no more than 50 injections or 10 mL in one session, and up to six sessions at least a month apart. The single contraindication is injecting into infected skin.
Common questions
Questions Patients Ask
Is PCDC the same thing as Kybella?
No. Kybella is a single approved drug. It is man-made deoxycholic acid at 10 mg/mL, with a fixed labelled dose and a published side-effect table. PCDC is a compounded mixture of phosphatidylcholine and deoxycholate. It has no FDA approval, no standard strength and no such table. They share a mechanism, which is detergent damage to cell membranes. They share almost nothing else.
Does the phosphatidylcholine actually do anything?
The lab evidence says the deoxycholate is doing most of the work. A 2004 study found that sodium deoxycholate on its own matched the whole phosphatidylcholine product for cell damage. A 2009 randomised trial found no clear difference in results or side effects when phosphatidylcholine was included. A split-body study in 37 women reached the same conclusion. Kybella was built on that finding, which is why it contains no phosphatidylcholine.
Which one works better?
Nobody knows, because no trial has compared them. What can be compared is the quality of what each one has behind it. Kybella has two identical placebo-controlled trials in 1,022 people, with validated rating scales and MRI, showing a moderate effect. Compounded PCDC has small studies of assorted recipes. The largest submental one enrolled 42 people and called the improvement minimal.
Is PCDC legal?
It is not an FDA-approved product. The American Society of Plastic Surgeons' 2019 position is that mixing phosphatidylcholine and deoxycholate for injection makes a new drug that is not approved for any purpose. So using it is not "off-label" use. It is use of an unapproved drug. Compounding for this purpose falls under sections 503A and 503B of the federal drug law, and the society notes that prescribers may face enforcement action if those conditions are not met. That is a different question from whether a clinic near you offers it.
Is one of them cheaper?
There is no published price comparison between them. The nearest sourced figure is the American Society of Plastic Surgeons' national average surgeon fee for the whole non-surgical fat reduction category. That was $1,157 in 2023, the last year the society published it. The number lumps Kybella in with several unrelated devices, does not break Kybella out at all, and covers the physician's fee only.
Will either one leave me with loose skin?
In the Kybella trials, skin laxity under the chin was unchanged or better in 93.4% of treated people at 12 weeks, against 91.1% on placebo. But people with a lot of laxity at the start were kept out of those trials. So that figure describes people who started with fairly firm skin. For compounded PCDC there is no equivalent measurement.
How long does the swelling last?
For Kybella, the documented medians are around 10 to 11 days for swelling and 43 days for numbness. They come from a pooled re-analysis of the two pivotal trials, funded by the drug's developer. The label adds that beyond 30 days, 20% still had swelling and 42% still had numbness. For compounded PCDC there is no comparable duration data. The day-by-day timelines clinics publish for either product are not drawn from a study.
Safety to keep in mind
Injecting a compounded phosphatidylcholine and deoxycholate mixture means giving an unapproved new drug. The American Society of Plastic Surgeons said so in 2019: combining the two makes a new drug that is not FDA-approved for any purpose, so its use "would NOT be considered 'off-label' use." Compounding for this purpose sits under sections 503A and 503B of the federal drug law. Kybella under the chin is approved use; anywhere else is off-label use of an approved drug, which is a different legal category.
On 7 April 2010 the FDA issued seven warning letters over the marketing of lipodissolve — six to US medical spas and one to a Brazilian company. The agency named several claims as unsupported, including that the products were safe and worked for fat removal and that they beat liposuction. The harms it said it had documented were permanent scarring, skin deformation, and deep painful knots at injection sites.