warning sign Share +1 Pin Stumble Reddit Shares 0 Kybella (Deoxycholic acid) is an injectable medication engineered by Kythera Biopharmaceuticals and approved by the FDA in April 2015 for the management of moderate-to-severe submental fat (fat beneath the chin) in adults. Reducing the appearance of a protruding double chin with Kybella entails visiting a medical professional to receive a series of subcutaneous [deoxycholic acid] injections. All injections are administered using a 30-gauge needle (or smaller) and directly target the submental region. Data from clinical trials reveal that Kybella recipients are likely to experience clinically significant reductions in submental fat within 2 to 6 treatment sessions (each of which is spaced from other sessions by a minimum of 1 month). The active ingredient within Kybella, known as deoxycholic acid, functions by penetrating and destroying the membranes of fat cells, thereby inducing cellular death. As deoxycholic acid eradicates submental fat cells, previously unflattering double chins are transformed into aesthetically appealing, slimmer chins. Although reduction in submental fat may improve self-esteem and decrease psychological distress associated with having a large double chin, Kybella is only effective in around 43% of patients. In addition to Kybella lacking efficacy in around 57% of patients, some individuals will find the injections to be nearly intolerable. In fact, a subset of Kybella recipients may end up experiencing such severe unwanted side effects and/or adverse reactions that they regret their decision to pursue this type of treatment. Kybella (Deoxycholic acid) Side Effects & Adverse Reactions (List) Anyone considering Kybella injections should be cognizant of all possible side effects and adverse reactions prior to receiving treatment. Everyone should realize that the specific side effects [and their respective severities] reported by one recipient of Kybella may differ from those reported by other recipients. Variation in specific side effects and severities may be related to the degree of competence of practitioners responsible for administering the injections. Differences in side effects among users may also vary based on amount of submental fat content and individual pain threshold. Since Kybella is subcutaneously injected into fat cells, a majority of its side effects are localized to sites of the injection and similar across patients. The most commonly reported Kybella side effects include: bruising, hardness, numbness, pain, redness, and swelling under the chin or on the lower jaw. Included below is a more comprehensive list of side effects that have been reported as a result of Kybella injections. Understand that you are receiving Kybella because your doctor judged that the benefits of treatment would outweigh the side effects. If at any time you experience an adverse reaction, intolerable side effects, or believe that the injections are doing more harm than good consult emergency medical services. Allergic reaction : Although an extremely rare occurrence, a small percentage of Kybella patients may experience an allergic reaction to its active ingredient, deoxycholic acid. If you are allergic to deoxycholic acid, you may experience a myriad of symptoms including: difficulty breathing, noticeable swelling (face, lips, tongue, throat), skin rash, and/or watery eyes. Allergies to a drug that was injected into your cells may also cause you to feel dizzy, nauseous, and/or physical weakness. Anyone that suspects they may be experiencing an allergic reaction needs to seek emergency medical attention. A medical professional will be most qualified to evaluate your reaction and can take action to get your allergy under control. Hesitation to treat an allergic reaction could result in serious long-term, possibly permanent complications. If you aren t sure whether you may be experiencing an allergic reaction, ask for an evaluation from your doctor. Anxiety : There are numerous reasons as to why receiving Kybella may make some individuals feel more anxious than usual. Since the medication is administered via injections in which needles are involved, anyone with needle phobia (fear of needles) may panic. Even though the needles are not large, a small percentage of the population is overwhelmed with nervousness at the sight and/or thought of needle insertion during Kybella treatment. In fact, the anxiety associated with needle phobia may become so severe, that some recipients may faint prior to and/or upon receiving injections. Not everyone receiving Kybella injections may experience anxiety over the actual needles, some may be more worried about experiencing pain in the submental area due to their low pain threshold. Others may be anxious over the idea that friends, family, and/or co-workers will notice post-procedural inflammation/swelling and ask them about it. It is also possible that abnormal sensations that occur after receiving the injections may lead some individuals to become anxious, wondering whether they ll ever subside. Furthermore, certain persons may develop anxiety over the idea that Kybella may be ineffective for them after all, it only works in approximately 43% of patients. Anyone experiencing anxiety during treatment should ask their doctor about possible anxiolytic interventions to help them cope especially if the anxiety is a result of needle phobia. Bleeding : Most individuals shouldn t experience much bleeding as a side effect of Kybella. Though the drug is injected subcutaneously (penetrating the skin), heavy bleeding remains an uncommon reaction. Small needles are used, injections are interspaced by at least 1-cm, and only the fatty areas of the submental region are targeted with the treatment. A couple of factors increase risk for bleeding during treatment including: abnormal anatomical features, bleeding disorders (e.g. coagulation disorders), as well as suboptimal administration by the professional. Risk of bleeding can be reduced by ruling out medically-diagnosable bleeding disorders [prior to treatment] and working with a professional that has experience administering Kybella. To reduce likelihood of bleeding, doctors should carefully pinpoint exact areas set to receive Kybella injection, as well as ensure they are familiar with the anatomy of their patient. As a patient, it is your responsibility to let your doctor know whether you re using any blood-thinners and/or supplements that may increase risk of bleeding. Some individuals may experience minor bleeding after injections that subsides within minutes. Any bleeding should be monitored by your doctor, sterilized, and wrapped with a bandage to minimize risk of infection. Blisters : Another injection site reaction that may occur in some individuals is blistering of the skin. Blisters that develop after receiving Kybella are characterized by swollen bumps or pockets of watery fluid. Some individuals may develop an entire patch of blisters beneath their chin, whereas others may develop just a single blister. There are numerous possibilities regarding what may have caused the blister. Blisters can occur due to irritation induced by the needle and/or deoxycholic acid. In some cases, blisters may result from incessant itchiness and scratching of the area [by a patient] following Kybella injections. Though less likely of a scenario, blisters can be caused by infections as well. To minimize blisters and/or likelihood of blisters, have your doctor rule out an infection and take steps to avoid rubbing, scratching, and/or irritating the submental area. For most individuals, the blisters that occur after treatment should diminish within a couple weeks. Bruising : Estimates suggest that 72% of those receiving Kybella injections will experience bruising or hematoma, often accompanied by swelling. Hematoma is defined as the abnormal accumulation of blood outside a blood vessel (or in tissue), occurring as a result of damage to blood vessel walls. Anyone with medical conditions and/or taking medications that may increase risk of bruising should inform their doctor as Kybella may be contraindicated. In some cases, too many injections to the area, improperly spaced injections, or too high of a dose may lead to bruising. Others may end up with bruising due to poor technique or overly-forceful injections by the professional who administered Kybella. That said, for most patients, bruising is an unavoidable aspect of Kybella treatment. Some professionals recommend wearing a chin-strap or scarf (to control swelling/bruising) and avoiding strenuous physical activity to minimize further bruising and promote quicker healing. Burning sensations : Many individuals report burning sensations following injections of Kybella. For certain recipients, burning sensations may have resulted from the 20 to 50 needle injections delivered during a treatment session. Needles are known to induce irritation, and this irritation is likely to cause burning until the area has fully healed. In addition to needles being culpable for provoking a burning sensation, the burning may also result from deoxycholic acid entering and obliterating their fat cells. Once the fat cells are fully destroyed and the area has had sufficient time to recover from the injections, burning should subside. To cope with the burning, some sources recommend gentle application an ice pack to the area, as well as to avoid rubbing the area as this may exacerbate the burning. Contour abnormalities : Those undergoing treatment with Kybella may report irregularities in the contour of their face, chin, and/or neck during treatment. If you notice that the shape of a particular region has shifted and appears abnormal or uneven, it is important to inform your doctor. Sometimes the abnormal contour may have resulted from post-procedural inflammation, and once the inflammation subsides, your contour will normalize. It also could be that your doctor injected too much Kybella on one side of your submental fat compared to the other. With further treatments to reduce the fat, your submental region should appear more symmetrical. Another explanation for irregularities in the shape of your face, chin, or neck could be the emergence of treatment-induced nodules. These nodules may require several months to be fully eliminated. Difficulty swallowing : Within 24 hours of receiving injections, around 2% of patients will report dysphagia or difficulty swallowing. Difficulty swallowing may occur as a result of burning sensations, inflammation, and/or numbness in the neck and throat. A majority of patients notice swallowing difficulties are at their worst during the first 4 to 12 hours post-treatment, and usually improves after the first 24 hours. Sometimes lightly icing the submental area to expedite reduction of inflammation is can help with swallowing challenges. Since difficulty swallowing is generally limited to solid foods, you may want to plan on consuming softer foods and/or making a smoothie your first day after treatment. If the difficulty associated with swallowing food is overwhelming and/or doesn t seem to be improving, talk to your doctor for his/her recommendations. Discoloration of skin : While most recipients of Kybella do not report changes in the color of their skin, some individuals will notice skin discoloration. Those that experience skin discoloration after treatment may want to consult a dermatologist for an analysis (e.g. to rule out allergic reactions) and management strategies. Typically, skin discoloration appears as redness resulting from needle-induced irritation and/or a reaction to the deoxycholic acid. As swelling decreases and the area recovers after injections, redness will diminish and coloring of skin will normalize. Some evidence indicates that Kybella could cause hyperpigmentation in which patches of skin appear darker than the surrounding skin. If you notice splotches of darkness across your skin, you may be experiencing treatment-induced hyperpigmentation. Ear pounding : An unusual, yet reported side effect of Kybella is the sensation of pounding within the ears. It is unclear as to how and/or why pounding within the ears would result from injections of deoxycholic acid beneath the chin. One possibility is that, since the ears are connected to the throat, inflammation in the throat area has a downstream effect upon the ears, resulting in increased ear pressure or pounding. Those that experience ear pounding will want to be sure that the pounding does not lead to any form of hearing loss and/or ear damage. If you notice that your hearing has been detrimentally affected after receiving treatment, it is recommended to consult an otolaryngologist (or ENT). A medical professional should help you make sense of the ear pounding and help you come up with strategies to mitigate this pounding and protect your hearing. Fainting : It is thought that a small percentage of individuals receiving Kybella will faint prior to treatment or while receiving injections. Fainting, medically termed syncope is often preceded by signs such as: anxiety, paleness, nausea, sweating, rapid heartbeat, and/or lightheadedness. The fainting may be triggered by a fear of needles ( needle phobia ) or the possibility that blood may drip down a person s neck after needle insertion. If you are afraid of needles, are concerned about possibly bleeding, or have a history of fainting episodes be sure to let your doctor know before initiating Kybella treatment. Since Kybella is generally administered while a patient is lying down in a comfortable position (rather than standing upright), the likelihood of fainting remains low. Non-pharmacological strategies to reduce odds of fainting include: cognitive behavioral therapy, counterpressure maneuvers (e.g. deliberately tensing certain muscles), and drinking enough water. Hardness of skin : In clinical trials, a reported 23% of patients receiving Kybella experienced a hardening of skin within the submental region. This hardness is referred to as induration and may occur as a result of increased inflammation whereby fibrous elements in tissue are increased and elasticity of the skin is decreased. For some patients, hardening of the neck, throat, and/or chin will occur within the first few days after treatment. By the fourth or fifth day after receiving Kybella, some patients mention that the area feels softer and/or like a gel. The emergence of the gel-like sensation will eventually solidify fat and the solidified fat will harden. Thereafter, the fat will be broken into smaller pieces referred to as nodules which are often internally felt by the patient but remain unseen. It is thought that an immune response is triggered in which macrophages devour the dead fat that has accumulated in hardened nodules. They transport the dead fat stores to be eliminated from the body, but this doesn t occur overnight. Usually the hardened nodules are no longer noticeable after 3 months post-treatment. Headache : A fairly common Kybella side effect reported in around 8% of individuals is headache. Some think that the headache experienced by patients may be unrelated to the actual treatment and more related to anxiety associated with receiving injections. That said, injections into the submental area may lead to inflammation and/or increased muscle tension within the face, which could provoke a headache. To counteract a treatment-induced headache, it may be best to engage in relaxation exercises (to decrease muscle tension), avoid strenuous physical activity (e.g. lifting weights), and apply ice to inflamed areas. You may also want to ask your doctor whether taking an over-the-counter headache relief medication would be recommended for your headache. Fortunately, most severe headaches subside within a few days after treatment and most mild-to-moderate headaches aren t overly bothersome. Heart rate changes : Some individuals may notice changes in their heart rate while receiving Kybella, or after treatment. Since the drug isn t understood to exert any effect upon the central nervous system, most heart rate changes are likely a result of anxiety. The anxiety may be related to a sighting of the needle (especially among those with needle phobias), fear of bleeding (or feeling blood), and/or feeling as if you re in a vulnerable position while receiving Kybella injections (near your neck). Assuming you end up experiencing anxiety, your heart rate is most likely to accelerate. There s also a possibility that you ll experience palpitations, characterized as your heart fluttering (or skipping a beat), beating loudly, and/or feeling funny within your chest. Acceleration and palpitation of the heart occur when anxiety primes the sympathetic nervous system, triggering a freeze-fight-flight response, releasing catecholamines, and increasing blood pressure. If you happen to experience a slower heart rate than usual, it could be related to hypotension possibly preceding syncope (fainting). Slow heart rate may also be a result of post-procedural orthostatic hypotension resulting from a quick transition from a supine to standing position. In the event that your heart rate feels irregular after Kybella, talk to a medical professional to rule out possible allergic reactions and/or unrelated cardiac abnormalities. Hypertension : Data from clinical trials indicates that an estimated 3% of Kybella recipients experience hypertension. Based on the fact that Kybella is unlikely to modulate activity in the central nervous system (CNS), it remains puzzling as to how the drug could provoke hypertension or even a spike in blood pressure. Knowing that the drug itself is unlikely to induce hypertension, it s more likely that the cause of high blood pressure is treatment-related anxiety. A subset of patients may become anxious worrying about aspects of treatment such as: injection pain, needles, post-procedural swelling, etc. Though there s no evidence suggesting that anxiety is a cause of long-term hypertension, it is widely documented that acute anxiety attacks can transiently spike a person s blood pressure. Those who exhibit high blood pressure before and/or after treatment may be dealing with unmanaged treatment-related anxiety. Any unmanaged anxiety can activate the sympathetic nervous system, whereby peripheral blood vessels are contracted and blood pressure increases. Make a conscious effort to reduce your anxiety through exercises such as: deep breathing, meditation, and getting proper sleep. Should you have a history of high blood pressure and/or cardiac events, it is best to work with your doctor to monitor your blood pressure to ensure that it stays within a normative range both before and after Kybella administration. Infection : Knowing that Kybella has undergone extensive testing, is formally approved by the FDA, and can only be administered by a medical professional the risk of any infection is extremely low. Needles for injecting Kybella will have been unused (and clean), the submental area will have been sterilized before treatment, and patients will be informed of proper post-procedural care (to reduce odds of an infection). Nonetheless, it is possible that a medical professional may fail to properly prepare for treatment and/or that a patient may end up with post-treatment wounds, making it easier for bacteria to infiltrate needle-induced wounds within the submental region. In extremely rare cases, it is possible that someone may end up with an atypical mycobacterial infection near an injection site. Anyone suspecting that they may have sustained an infection from treatment should consult a dermatologist for a compressive analysis. To decrease your risk of an infection, be sure to have your doctor assess any wounds that you may have sustained during treatment for possible infection. If you were bleeding (during or after treatment), make sure the area is properly sterilized and that the bleeding has fully stopped. It is also important to refrain from scratching unhealed, irritated wounds as this could reopen them and increase risk of post-procedural infections. Fortunately, this is an extremely uncommon adverse reaction that most Kybella recipients will never experience. Itchiness : An estimated 12% of patients receiving Kybella treatment will experience pruritus or severe itching of the skin. There are numerous potential causes of itching as a side effect of Kybella including: an allergic reaction, the deoxycholic acid burning fat cells, or skin irritation from subcutaneous injections. If you develop severe itchiness accompanied by a skin rash that doesn t seem to subside within a week or two after your injections, it may be best to seek dermatological evaluation for a possible allergy or infection. In most cases, patients experience itchiness as a result of procedural-induced skin irritation and/or small wounds. As the skin irritation and/or small wounds heal after the procedure, the itchiness is likely to diminish in severity and eventually abate. It may be difficult to resist the urge to scratch and claw the itchy area, but the more you can resist scratching it, the quicker it is likely to heal (and the faster the itchiness will decline). Lumps : Before Kybella, you may have had lump of fat hanging below your chin that you wanted to eliminate. However, after receiving the injections, many recipients will notice lumps near the throat, thyroid, and/or neck. Some of these lumps may be nothing more than inflammation near the site of injection, and once the inflammation decreases, the lumpy appearance tends to subside. For a majority of patients, the lumpiness that is felt in the throat/neck area is not a result of inflammation, rather it s from the body responding to deoxycholic acid. Within the first few days following deoxycholic acid injections, patients will perceive a jellylike texture within the submental region. By the third or fourth day after injections, the jellylike texture begins to solidify, eventually breaking into tinier pieces of dead [hardened] fat called nodules. Some individuals will have visible nodules, whereas most patients will only be able to feel their nodules internally. You may be concerned over these lumpy nodules and dislike how they feel, however, they will eventually be cleared from your body. It usually takes several months for the nodules to fully disappear following Kybella treatment. Nausea : A side effect that occurs in 2% of those receiving Kybella is nausea, or feeling sick and as though you re on the verge of vomiting. The nausea may be related to the fact that you re receiving a series of injections near your throat, which could stimulate your gag-reflex to provoke feeling nauseated. It is also possible that the nausea may be related to a phobia of needles, blood, or treatment-related anxiety. If you suspect that your nausea is triggered by anxiety, it is recommended to practice relaxation exercises such as deep breathing. Also consider that your doctor may be able to prescribe an anxiolytic to take the edge off while receiving Kybella injections. Moreover, you may want to ask your doctor whether he/she would recommend taking an over-the-counter antiemetic agent to counteract the bouts of nausea that you experience during treatment. Necrosis : While the purpose of receiving Kybella injections is to eliminate fat cells culpable for a double chin, it is possible that some individuals will experience necrosis as a side effect. Necrosis refers to the disorganized, non-apoptotic death of cells, often resulting from severe inflammation, infection, or serious injury. When cells normally die, they signal for phagocytes to clean them up upon death, whereas during necrosis the phagocytes are not signaled. Anyone experiencing necrosis may appear to have significant dead skin or tissue, in the submental area. A medical professional will be able to recognize necrosis, as well as help patients manage any complications resulting from Kybella-induced necrosis. In extreme cases, if left neglected and left unmanaged, necrosis could cause permanent damage to bodily tissue. Nerve injury : Around 4% of Kybella recipients will sustain nerve injuries from the process of Kybella administration and/or as an adverse reaction to treatment. The most common form of nerve injury is to the marginal mandibular branch of the facial nerve. The marginal mandibular nerve functions through regulation of muscles within the lower lip, chin, and face. Injury to the marginal mandibular nerve is most often sustained as a result of poor administration technique and/or failure to elucidate patient-specific anatomical features prior to treatment. In the event that the marginal mandibular nerve is injured or damaged upon injection of Kybella, a person may struggle to properly control his/her facial expressions (e.g. smiling, grimacing, etc.) and/or neck movements. Another adverse response to a marginal mandibular nerve injury is salivary incontinence or frequent, uncontrollable drooling. If you sustained a nerve injury from injections of Kybella, talk to a medical professional for further guidance as to how it can be repaired. In extreme cases, correction of mandibular nerve injuries may require advanced forms of surgery. Working with a medical professional experienced with Kybella should help reduce your odds of a treatment-induced nerve injury. Numbness : One of the most common Kybella side effects is the sensation of numbness after receiving injections. Numbness occurs in around 66% of all Kybella-treated patients and is usually localized to the submental region (the area targeted during treatment). If you happen to experience numbness as a side effect, there are numerous possible causes including reactions to needle injections and/or the deoxycholic acid. It is also possible that some numbness may have been induced by post-procedural inflammation. In rarer cases, a patient may end up numb following Kybella treatment as a result of an allergic reaction, injection-site infection, or nerve injury. Assuming that the numbness was not a reaction to allergies, infections, or injuries it will most likely diminish significantly within a few weeks after treatment and fully cease within 2 months. In most cases, the best way to reduce numbness is to take steps to minimize post-procedural inflammation. Minimizing inflammation may involve applying ice to the area or utilizing anti-inflammatory drugs (as approved by your doctor). All that said, you may want to consider that your numbness may have been more related to administration of a local anesthetic such as lidocaine [prior to Kybella injections]. Pain : Another of the most common Kybella side effects that 70% of patients experience, is pain in the submental space. Pain at submental injection sites is common due to the fact that needles pierce the skin to deliver the deoxycholic acid. Not only is the piercing of skin painful for some individuals, but the process by which deoxycholic acid enters and kills fat cells may cause pain and/or burning sensations. It is understood that various genes encode for pain sensitivity and nociception. Anyone with a low pain threshold (highly sensitive to pain) based on their genetic predisposition may find Kybella administration to be painful. That said, other factors such as administration technique (e.g. gentle or aggressive), anatomy of the patient, and concurrent usage of pain relievers could dictate whether severe pain is experienced as a side effect. The pain reported by most patients usually affects the jaw, chin, neck, throat, or mouth and is often accompanied by inflammation and swelling. Pain is most severe within the first 12 hours after the procedure and tends to significantly decrease within 24 hours post-procedure. If you re experiencing pain from Kybella, ask your doctor about things you can to do decrease the pain such as applying an ice pack and/or taking analgesics. Pressure sensations : After receiving injections some recipients of Kybella will report significant pressure in their throat, face, chin, or neck region. The increased pressure is likely related to injection of an exogenous substance (deoxycholic acid) directly into fat tissue. Though the deoxycholic acid destroys fat cells rapidly, it doesn t happen instantly, meaning the cells must harbor both the fat and deoxycholic acid simultaneously causing pressure and corresponding pressure sensations. The pressure resulting from deoxycholic acid should only last up to 20 minutes and regress thereafter. That said, it is possible that pressure in the submental area also occurs as a result of inflammation and/or swelling. If your pressure sensations were caused by inflammation, you should expect the pressure to decrease as inflammation subsides [which usually takes several weeks]. Redness : It is fairly common to observe skin redness or erythema after Kybella is administered. Reports suggest that 27% of patients experience superficial reddening of the skin, most often in patches, as a result of injury or irritation (from the needles or deoxycholic acid). The reddening of your skin after receiving Kybella is generated from the dilation of your blood capillaries. Any redness that appears after your deoxycholic acid injections is likely to be most noticeable within 1-week post-administration. As inflammation decreases and wounds in the submental region heal, any lingering redness should fade and your skin color should normalize. Only in cases of an allergic reaction, infection, or injury is redness likely to linger for an extended duration. Scarring : Some individuals may end up with scarring as an adverse reaction to Kybella injections. Scarring is most likely to occur as an adverse reaction among patients that receive treatment from a professional who is unskilled or unexperienced with Kybella injections. Injecting the drug too quickly, too deeply, using too large of a needle, and/or being unintentionally rough (from lacking dexterity) could damage the submental area and lead to the formation of a scar. When the dermis is damaged from a needle and collagen fibers repair the damage, a scar may emerge. It should also be considered that scarring may also be a side effect among patients who ve recently undergone surgery, have acne in the area, and/or sustained an injury to the submental area especially if it hadn t fully healed prior to receiving Kybella. To reduce your risk of scars, be sure to keep in close touch with your doctor and follow his/her advice to ensure that skin irritation and/or damage properly recovers after Kybella injections. Skin rash : An unlucky 12% of Kybella recipients may develop a skin rash or hives, medically referred to as urticaria. The skin rash may develop from needle-induced irritation or the drug itself, and appear as welts on the surface of the skin. The welts may appear in clusters or patches, may be red in color (but also could be skin-colored), and could be extremely itchy. If you appear to have developed a rash after receiving Kybella, it is probably a smart idea to avoid scratching it, as this may prevent the area from properly healing. Any minor skin rashes resulting from treatment are thought to diminish within a week or two after treatment. That said, if the rash doesn t seem to diminish, is worsening, and/or spreads throughout your entire body it is recommended to contact a dermatologist to rule out allergic reactions and infections. Skin loss : A small percentage of patients receiving Kybella may experience the adverse reaction of skin loss. It is speculated that skin loss is more likely to occur among individuals that are injected with too much of the deoxycholic acid formula. Excessive deoxycholic acid within the submental region will kill the fat cells that it enters, but may also damage healthy cells near the surface of the skin. Damage to healthy cells could lead to the disconcerting reaction of skin loss, possibly accompanied by discoloration of the area. It is possible that losing a modest amount of skin may be nothing more than a benign reaction, however, losing a significant amount of skin may be the sign of something serious. If you notice skin loss after receiving your Kybella injections, be sure to ask your doctor for an explanation. Soreness : It is very common for recipients to report significant soreness in the submental region as a side effect of Kybella. Soreness typically e an additional
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