How fat-dissolving injections model body contours

Jonathan J. Redeker, MD

September 6, 2024

What methods of fat removal do I offer?

The removal of subcutaneous fat using liposuction or injection lipolysis (fat-dissolving injections) are procedures that are used for body contouring. They target specific fat deposits that often cannot be reduced through diet and exercise alone. Although liposuction remains the most common cosmetic procedure, it is invasive and requires a recovery time that can vary depending on the extent. Fat dissolving injections, a non-surgical approach, are gaining popularity and offer an alternative for some patients. This method treats small, well-defined fat deposits over 3 to 5 sessions spaced 4 to 6 weeks apart.

What can be treated with the fat-dissolving injections?

Fat-dissolving injections are used to remove stubborn fat deposits by subcutaneous injection of a fat-dissolving substance. It is often used for smaller fat deposits such as the double chin and for small to medium-sized fat deposits in areas of the body such as the abdomen, hips, outer and inner thighs, knees, back, arms, male chest (pseudogynaecomastia) and neck (buffalo hump). Liposuction is often more suitable for larger or less-well localised fat deposits, as the result is easier to control. The cost of fat-dissolving injections can be higher than surgery due to the amount of product required. In addition, the results of fat-dissolving injections are more variable and only become visible after a longer period of time, as the safe dose per session is limited.

How do fat-dissolving injections work?

There are various fat-dissolving products for off-label use. “Off-label” means that doctors can legally use these treatments despite the lack of official approval for the specific use based on extensive clinical studies. This is true for many uses of botulinum toxin on facial muscles; It should be noted that botulinum toxin is probably one of the most thoroughly studied drugs on the market.

Deoxycholic acid

Most fat-dissolving injections contain deoxycholic acid, a bile acid. It was previously thought that phosphatidylcholine, an emulsifier and another ingredient in certain fat-dissolving injections, was responsible for fat loss because it is also used in the treatment of fat embolism. However, recent research shows that deoxycholic acid in fat removal injections is the primary substance for dissolving fat. This acid, a natural component of bile, aids in the digestion of fats in food. Deoxycholic acid works by destroying the cell membrane, after which the released fat is slowly broken down and absorbed over time. Phosphatidylcholine, an emulsifier and important component of the cell membrane, supports this process, but the exact mechanism is still unclear. With fat-dissolving injections, the product is safely injected directly into the subcutaneous fatty tissue using a cannula.

Can the dissolved fat cells come back?

After the fat cells are dissolved, they do not regenerate again, which results in a permanent reduction in the treated fat deposits. However, maintaining a stable body weight is crucial to the results of lipolysis, as the remaining fat cells can increase in size.

Recovery and result

Although “lunchtime” treatments are possible without any downtime, swelling, bruising, pain and redness may occur initially. Some areas of hardness and numbness may last a little longer before disappearing. Swelling may initially make the treated area appear larger, but this will reduce as the fat cells are broken down. Visible results can often be seen within 6 to 8 weeks of treatment. The results are usually permanent, provided there is no significant weight gain. As indications are selective and results vary from individual to individual, it is advisable to discuss all treatment options with a specialist who offers both non-surgical and surgical methods of fat removal.

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