Abstract
Purpose: Jowl fat overhang can reduce jawline definition and is a component of the aging face. The most common treatment to reduce jowl fat is liposuction. ATX-101 (deoxycholic acid) injection, a minimally-invasive treatment approved for submental fat reduction, may also be an effective treatment for jowl fat. This study evaluates the efficacy and safety of ATX-101 treatment for reducing jowl fat and provides an update to a previous study, accounting for longer-term follow-up and a larger cohort of patients. Methods: In this ongoing, prospective, single-site study, 125 patients were treated for excess jowl fat with ATX-101 (area-adjusted dose: 2 mg/cm2). Eligible patients had pinchable fat on the jawline and relatively minimal skin laxity in the jowl. Depending on the size of the treatment area, ATX-101 injections of 0.2 ml spaced 1.0 cm apart or 0.1 ml spaced 0.50 to 0.75 cm apart were administered. Improvement in jowl appearance was assessed in-person by the clinician ≥6 months after last treatment. Independent assessments were also made by the patient and two blinded plastic surgeons using standardized pre- and post-treatment photography. Safety was evaluated via adverse events (AEs). Results: Since the previous report, 59 additional patients underwent treatment (N = 125). Patients underwent a mean of 2.3 treatments to the bilateral jowls. Mean injection volume administered per treatment was 0.8 ml/jowl. The majority of patients (98%) experienced an improvement in jowl appearance. Common AEs were injection-site edema, numbness, tenderness, and bruising. Injection-site marginal mandibular nerve paresis and alopecia were experienced by three patients each; all events resolved without sequelae. Conclusion: ATX-101 effectively reduced jowl fat and was well-tolerated in this cohort. Notably, several patients received ATX-101 injection to the jowls in isolation of submental fullness. Care should be taken when injecting ATX-101 into jowl fat to avoid underlying anatomic structures such as the marginal mandibular nerve.
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