Effective treatment of localized fat with non-invasive modalities is one of the most challenging issues of aesthetic dermatology.
A healthy diet and physical exercise remain the principal methods for loosing weight and localized fat.
For localized fat deposits that are resistant to diet and exercise, injection lipolysis is an effective treatment that aims to dissolve the accumulated subcutaneous fat.
There are two drugs known to have lipolytic action: phosphatidylocholine and deoxycholic acid. Phosphatidylocholine is a lipid belonging to the lecithin family. It is a structural component of the cell membrane in plant and animal cells. It takes part in the synthesis of the lung surfactant. Deoxycholic acid is a bile acid excreted in gall (bile).
There are many published scientific papers that demonstrate their fat dissolving capacity. In injection lipolysis these two substances may be used separately or in combination.
In April 2015, the first injectable lipolytic drug – Kybella by Kythera Biopharmaceuticals (deoxycholic acid 10 mg/ml) – has been formally approved in the USA and we hope it will be soon released on the European market as well.
Lipolytic drugs have to be injected directly into the subcutaneous fat tissue. The following techniques may be used:
1. Mesotherapy – multiple points of injection with thin 6 – 8 mm needles
2. Lipoinject – few points of entrance for long, thin needles or cannulas that glide into the subcutaneous tissue and deposit the drug
Both techniques require proper training and knowledge in order to avoid adverse events such as severe bruising, infections and inflammation of the skin.
1. Small fat deposits that are resistant to diet and exercise
- Lower back – love handles
- Double chin
3. Hypertrophic lower eyelid fat pad
Treatment is usually well tolerated. We take all precautions to make treatment painless, so we might apply numbing cream if necessary.
After the treatment there is a moderate swelling and mild irritation of the skin. During the following days the treated skin feels a little tender as there is a mild inflammatory response into the subcutaneous tissue. Fat cells are destroyed and fatty acids are absorbed into the blood stream and cleared away by the liver.
There is no downtime after the treatment. Drinking a lot of water is advisable. Walking is encouraged, but strenuous exercise should be avoided for about 3 days.
The improvement is gradual. It is quite obvious at one month after the treatment and continues for one additional month.
Treatment may be repeated at one or two mothS intervals, until the desired result is attained. In mild cases, only one treatment may suffice.
Results are long-lasting provided that no significant weight gain occurs.
In our practice we use only the best available lipolytic agents that are EU certified as class III medical devices.
We preferably use the lipoinject technique with thin flexible cannulas, in order to increase the tolerability and safety of the treatment.
Careful selection of cases with the right indication for injection lipolysis, has warranted a very high patient satisfaction rate in our practice.
Injection lipolysis may be combined with acoustic wave treatments in order to have more rapid improvements and impressive results.