Injection Lipolysis Research Articles

Success Rate of Buccal Fat Pad Removal in Cases of Previous Injection Lipolysis of the Cheeks: A Comparative Analysis.

Although buccal fat pad removal for facial slimming has a high success rate, fibrosis in patients with a history of cheek injection lipolysis may pose challenges. Therefore, we evaluated the success rate and procedure-related complications of buccal fat pad removal in patients with a history of cheek injection lipolysis. Patients who underwent buccal fat pad removal between September 2016 and February 2020 were categorized according to a history of lipolysis (injection lipolysis group versus control group). The primary and secondary outcomes were the success rate of buccal fat pad removal and the incidence of procedure-related complications, respectively. The study sample comprised 100 patients (14 men; 86 women; mean age, 27.49 ± 6.26 years; mean follow-up duration, 7.41 months), with 61 patients (nine men; 52 women) in the injection lipolysis group and 39 patients (five men; 34 women) in the control group. The mean buccal fat pad weight did not differ significantly between the two groups. However, the success rate was 91.8% (56/61 patients) and 100% (39/39 patients) in the injection lipolysis and control groups, respectively. Complications were exclusively observed in the injection lipolysis group [8/122 cheeks (6.6%); control group, 0/78 cheeks (0%)]. Buccal fat pad removal effectively enhances the aesthetic appearance of the lower face. However, in patients with a history of cheek injection lipolysis, the success rate of buccal fat pad removal is lower, and the incidence of complications is significantly higher. Consequently, caution should be exercised when performing this procedure in specific patient populations.

Modern and Non-Invasive Methods of Fat Removal.

Adipocytes accumulate triacylglycerols as an energy store, thereby causing an increase in the adipose tissue volume. Weight gain can be prevented through damage to the adipocyte structure or an increase in the body's metabolic rate. Commonly used methods to disintegrate the cell membrane of adipocytes include injection lipolysis, cryolipolysis, ultrasonic lipolysis, radiofrequency lipolysis, laser lipolysis, carboxytherapy, and lipolysis using an electromagnetic field. The names of these methods suggest which substances are being used, and their main advantages are a very low invasiveness, as well as effectiveness. However, new discoveries in medicine, along with individuals' desire to improve their appearance, have resulted in numerous studies on more ways of reducing body fat. Great potential is seen in beige adipocytes, which can be transformed, i.e., "recruited" from white adipocytes, or synthesized de novo; they also show thermogenic properties. One of the stimuli inducing the formation of beige adipocytes is cold and B3-adrenergic stimulation. Based on these findings, the researchers created, for example, cooling clothing. Additionally, curcumin and natural anthocyanins have proven to be helpful in the treatment of obesity and diabetes, by stimulating the secretion of glucagon-like peptide-1, and inducing the formation of beige adipocytes. Another study showed that the conversion of white adipose tissue is indirectly influenced by interleukin-6 secreted by the muscles, the expression of which is increased in people actively exercising. Moreover, there is potential in adenosine analogs, fenoldopam, rhubarb, the herbal extract Ephedra sinica Stapf, electroacupuncture simulation, and the drug CBL-514. Despite knowledge and experience, the ideal method for a quick and noticeable, but safe and non-invasive reduction of body fat has not been found yet. The research conducted nowadays may bring us closer to the development of a universal method, and turn out to be a breakthrough in the fight against overweight and obesity.

Skin and soft tissue infection of Nontuberculous mycobacterium after injection lipolysis.

Injection lipolysis is used for body and face contouring due to its minimal invasiveness and cost-effectiveness, but related complications such as nontuberculous mycobacterium infection significantly affect its clinical application. This study aimed to review the literature on NTM infection after injection lipolysis. We conducted a literature review of scientific journals published in Medline and PubMed up to September 2022 on patients with NTM skin and soft tissue infections. We used the keywords: nontuberculous mycobacterium, infection, injection lipolysis, and lipolytic solution in various combinations with the Boolean operators AND, OR, and NOT. Only articles available in English and full version publications were considered for this review. Here, we reviewed the relevant mechanisms and drugs for injectable lipolysis and analyzed the possible correlation between NTM infection and injection lipolysis. We also summarize methods for the diagnosis and treatment of NTM infections and present some perspectives on this therapy. Many patients with NTM infections had a history of fat-related surgery or therapy. NTM infection after injection lipolysis may be related to inadequate disinfection and sterilization of injection equipment and clinical procedures, the unqualified medication itself and free fatty acids released during injection lipolysis. Currently, diagnosis and treatment of NTM infection after lipolysis injections remains challenging. Injection lipolysis represents a helpful option for local fat reduction. Doctors should strictly abide by the aseptic operation standards and use qualified products for there is a correlation between skin and soft tissue infection of nontuberculous mycobacterium and injection lipolysis. Providers should understand the mechanism, indications, and associated risks of injection lipolysis when injecting fat-dissolving drugs to reduce localized fat.

Clinical case of fatal panniculitis resulting from administration of lipolytic

The article describes a clinical case of a five-fold administration of a direct lipolytic–phosphatidylcholine / deoxycholic acid for cosmetic purposes, which resulted in widespread septal panniculitis, systemic inflammatory reaction, secondary myositis, thrombotic microangiopathic syndrome, fatty necrosis of the pancreatic head, necrotic nephrosis and multiple organ failure, which led to death of the patient.Materials and methods. Analysis of medical records, histological examination of autopsy material.Conclusions. Injection lipolysis using phosphatidylcholine / deoxycholate causes uncontrolled necrosis of adipose and vascular tissue, fibrosis, which makes the indefinitely long-term consequences of the administration of drugs for the non-surgical treatment of subcutaneous fat deposits. Phosphatidylcholine / sodium deoxycholate is not recommended for use in the presence of general obesity, somatic pathology, or in elderly patients.

Grading of "Back Rolls": Guide to Treatment Options.

“Back Rolls,” as the term indicates, are basically fat deposits on the back in the form of rolls. This is a common deformity in women, and concerns were encountered by cosmetic surgeons the world over, especially in patients with massive weight loss due to diet or bariatric surgery and who would like to wear a form hugging costume. The skin–fat envelope of the back normally adheres tightly to the underlying musculoskeletal anatomy of the rib cage. This envelope is held in place by facial attachments that are akin to the “zones of adherence” described by Rohrich et al.1 The extent of fat deposits and number of back rolls, as well as skin laxicity, varies from person to person and also from one side to the other. The rolls surely have a zone of adherence inferiorly over which the tissue fold hangs and medially in the midline. Treatment modalities for back rolls depend on the above-mentioned variables and involve three general approaches: Injection lipolysis in association with weight loss2; Ultrasound-assisted lipectomy with or without skin tightening3; Direct surgical excision of the skin fold4 as an upper back lift. The choice of treatment depends on the specific characteristic of the back roll; hence, a classification to grade the extent of back roll would help in guiding the surgeon to choose the best possible option. Fat deposits in the saddle bag area, abdomen, chest, and submental area have been classified clinically to guide the treatment modality, but unfortunately, we have not come across any published classification system (whether anatomical or clinical) to categorize back rolls. After retrospectively going through the photographs and surgical details of more than 1800 Indian women who have undergone back contouring in the last 17 years, we propose the following classification for categorizing back rolls (Fig. 1):Fig. 1.: Grading of back rolls as seen clinically. A, Left side shows Grade II back roll with a single incomplete indentation, whereas the right side (Grade III) shows two indentations: the lower is complete, whereas the upper is incomplete. Please note that the maximum protrusion of skin fold (yellow arrow) is higher than the inferior indentation (black arrow). B, Grade IV back roll. The maximum protrusion of skin fold (yellow arrow) is lower than the inferior indentation (black arrow). Grade I: Back rolls that appear when the arms are kept by the side and disappear when the arms are raised. Grade II: Back rolls having a single indentation (partial or complete) that reduces when the arm is raised. Grade III: Back rolls with two or more skin indentations with skin pinch of more than 2 cm. The skin fold should not be lower than the inferior tethering point. Grade IV: Back rolls secondary to massive weight loss that have multiple folds with skin pinch less than 2 cm and skin fold lower than the tethering point, or in patients who have undergone prior surgical treatment. A lack of a comprehensive and clinically appropriate classification system prevents an accurate diagnosis, limits the use of treatment algorithm, and makes it difficult to compare treatment outcomes. We believe that this categorization can be used to guide the most appropriate treatment modality for a specific type of back roll that would be ideal. Additional studies are required to validate this classification system in other parts of the world. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article. No funding has been received for this study.

Pharmacopuncture of Taraxacum platycarpum extract reduces localized fat by regulating the lipolytic pathway

Localized fat deposits are associated with health and aesthetic problems that mainly affect a large proportion of individuals. Recently, bioactive constituents of TP have been reported to affect lipid metabolism. In this study, we performed a network pharmacological analysis to assume potential lipolytic effects of TP and investigated the actual lipolytic effects of TP extract injection on local body fat and its underlying mechanism. Using the genes related to active compounds of TP, the network was constructed. Through the Functional Enrichment Analysis, Lipid Metabolism and Fatty Acid Metabolism were expected to be affiliated with the network, which implied possible lipolytic effects of TP. On the comparison between TP network and Obesity-related Gene Sets, about three-fourths of elements were in common with the gene sets, which indicated a high relevance between TP and obesity. Based on the genes in lipolysis-related pathways, Perilipin, CGI-58, ATGL, HSL and MGL were selected to identify the actual lipolytic effects of TP. TP injection reduced the inguinal fat weight. Also, the diameter of the adipocytes was decreased by the TP treatment in HFD-induced obese mice. In addition, TP suppressed lipid accumulation in differentiated 3T3-L1 adipocytes. Moreover, because the expression of Perilipin was increased, CGI-58, ATGL, HSL and MGL were markedly decreased. Furthermore, glycerol release was down-regulated by the TP treatment. TP exerted its lipolytic effects by regulating the lipolysis machinery through stimulation of lipases. Based on the present findings, TP is expected to be a potent component of injection lipolysis for removing localized body fat.

The beneficial effect of glycerophosphocholine to local fat accumulation: a comparative study with phosphatidylcholine and aminophylline.

Injection lipolysis or mesotherapy gained popularity for local fat dissolve as an alternative to surgical liposuction. Phosphatidylcholine (PPC) and aminophylline (AMPL) are commonly used compounds for mesotherapy, but their efficacy and safety as lipolytic agents have been controversial. Glycerophosphocholine (GPC) is a choline precursor structurally similar to PPC, and thus introduced in aesthetics as an alternative for PPC. This study aimed to evaluate the effects of GPC on adipocytes differentiation and lipolysis and compared those effects with PPC and AMPL using in vitro and in vivo models. Adipogenesis in 3T3-L1 was measured by Oil Red O staining. Lipolysis was assessed by measuring the amount of glycerol released in the culture media. To evaluate the lipolytic activity of GPC on a physiological condition, GPC was subcutaneously injected to one side of inguinal fat pads for 3 days. Lipolytic activity of GPC was assessed by hematoxylin and eosin staining in adipose tissue. GPC significantly suppressed adipocyte differentiation of 3T3-L1 in a concentration-dependent manner (22.3% inhibition at 4 mM of GPC compared to control). Moreover, when lipolysis was assessed by glycerol release in 3T3-L1 adipocytes, 6 mM of GPC stimulated glycerol release by two-fold over control. Subcutaneous injection of GPC into the inguinal fat pad of mice significantly reduced the mass of fat pad and the size of adipocytes of injected site, and these effects of GPC were more prominent over PPC and AMPL. Taken together, these results suggest that GPC is the potential therapeutic agent as a local fat reducer.

Infection with Mycobacterium immunogenum after an injection lipolysis procedure.

Infection with Mycobacterium immunogenum after an injection lipolysis procedure.

The efficacy of high-frequency ultrasound-guided injection lipolysis in reducing fat deposits located on the inside of the knees.

IntroductionMany women consider local fat deposits unacceptable for aesthetic reasons as they have negative impact on appearance and thus, contribute to reduced self-esteem. Injection lipolysis (intralipotherapy) may be an alternative for conventional liposuction in reducing fat deposits.AimThe aim of this paper was to assess the efficacy of high-frequency ultrasound-guided injection of deoxycholic acid (intralipotherapy) to remove fat deposits on the inner side of knees.Materials and methodsThe procedure was performed in 7 women (14 inner sides of knees). The formulation was administered under high-frequency ultrasound guidance. The procedure was performed twice at 4-week intervals in each patient. High-frequency ultrasound guidance was used to monitor such parameters as the thickness of the dermis (DermaMed, Dramiński S.A.) or the subcutaneous tissue (Philips Epiq 5, USA). Ultrasound was performed both before and after treatment. Additionally, anthropometric measurements were taken, a questionnaire was performed, and a photographic documentation was recorded.ResultsReduction in knee circumference and subcutaneous tissue occurred in 71.42% of patients.ConclusionsIntralipolysis with deoxycholic acid formulation is an effective method for reducing fat deposits on the inner part of the knees. Ultrasonography proved to be a useful method to monitor the procedure (correct administration of the preparation) and to assess treatment outcomes. A small sample size was a limitation of our study; therefore further studies are needed.

Injection lipolysis: A systematic review of literature and our experience with a combination of phosphatidylcholine and deoxycholate over a period of 14 years in 1269 patients of Indian and South East Asian origin

Background:Phosphatidylcholine and deoxycholate (PC–DC) injections have been used as nonsurgical alternatives to liposuction. DC as a constituent for lipolysis has recently been approved by the US Food and Drug Administration.Aim:PC and DC have independently been used in lipolysis. We hereby present a systematic review of literature on injection lipolysis and share our experience of using DC in combination with PC for injection lipolysis. We have retrospectively evaluated the effects of PC–DC treatments in varied age groups, both sexes, and over different target areas.Materials and Methods:This study spans over 14 years wherein 1269 patients of different age groups and sex were treated with injection lipolysis with PC–DC combination. The PC–DC cocktail injection was given to all patients for an average four sessions every 4 weeks, and the results were assessed after 8 weeks from the last session.Results:The effects were best appreciated over the face (malar, jawline, and submental areas) and upper arm, whereas average effect was observed on the thighs and around the knees. We have also used lipolysis as a primary modality as well as a touch-up modality following liposuction. The results are better appreciated in primary lipolysis. The need for follow-up sessions (1–2 sessions) of lipolysis and the quantification of results in subsequent sessions reveal that maximal improvement is achieved in the first session.Conclusion:PC–DC cocktail used for lipolysis as a local administration is effective for reducing unwanted fat. It shows great efficacy in treating localized fat, especially over the face and bra roll in the women of younger age group (20–30 years).

Fat busters: Lipolysis for face and neck

Persistence and hypertrophy of fat pads particularly of the face and neck region disturb beauty proportions, thus demand treatments. Phosphatidylcholine and deoxycholic acid are the most commonly used solutions for injection lipolysis. As we stand today, sodium deoxycholate preparation is approved by the US Food and Drug Administration for the same. This article describes the correct use of solution to achieve fat reduction and ensure safety. Complete details of patient selection, assessment, dosing, and injection techniques are described in this article. A brief note on posttreatment care and complications is also provided.

Clinical outcomes of subcutaneous multiple inflammation and calluses induced by facial injection lipolysis

Objective To explore the treatment protocols and the occurrence and developmental rule of subcutaneous multiple inflammation and indurations by facial injection lipolysis, and to summarize the treatment experience. Methods Six cases of subcutaneous indurations were females patients with facial injection lipolysis, and the lesions increased slowly after about one month. The local temperature raised and pinching pain appeared in the facial area. The other secondary post-traumatic swelling and scleroma areas were treated with piercing or cutting, spread to the surrounding tissues. Red scleroma became osmosis, by local open decompression, debridement, irrigation and drainage lasting almost 3 months. The area had burst out mucoid funicular materials gradually. Results The facial injection lipolysis caused regionally red swelling and scleroma gradually with 1 month of continuous irrigation drainage. The red scleroma area was limited with debridement again after maturation, closed incision after discharge mucus-shape substance by its organization. In the redness induration period, pathological results showed the homogeneous materials without structure could be seen in the fibrous tissue, with surrounding hyperemia, hemorrhage associated with inflammation. Festering burst period showed that local tissue presented suppurative inflammation, multiple abscesses and granuloma formation. Conclusions Conservative treatment can lead to swelling, bursting and developing into deep tissues. Surgical treatment can spread redness scleroma area and lead to a large area of skin depression, soft tissue scar and deformity. Key words: Injection lipolysis; Induratum; Suppuration; Complications

Injection Lipolysis with a Cocktail of Phosphatidylcholine and Deoxycholate: An Indian Experience.

Injection Lipolysis with a Cocktail of Phosphatidylcholine and Deoxycholate: An Indian Experience.

Non-invasive body contouring treatments: manage your client's expectations with care

Because non-invasive body contouring treatments, such as cryolipolysis, radiofrequency and injection lipolysis, involve no wounds, there is no risk of infection and no downtime, meaning the client can return to work right away. As a result, the insurance exposure of your clinic is low. Naomi Di-Scala explores some of these treatments, their potential side effects and their long-term impact on insurance policies

Histopathological and ultra-structural characterization of local neuromuscular damage induced by repeated phosphatidylcholine/deoxycholate injection

Phosphatidylcholine/deoxycholate (PC/DC) combination is frequently used for injection lipolysis in body contouring and size reduction of subcutaneous lipomas. Nonetheless, studies that assess possible injurious effects of PC/DC combination on tissues at injection sites are inadequate. The current work attempts to evaluate the effects of repeated PC/DC injection on skeletal muscles and neural tissues at the injection site. For this purpose, female Wistar rats were randomly assigned into 2 groups, 10 rats each, and injected percutaneously via either normal saline (control group) or PC/DC (treated group) in the groin area for 4 consecutive days. Biopsies were harvested on the 4th day for histopathological studies. The results of the present work demonstrated that repeated injection of PC/DC caused neural damage and intense inflammation at the injection site leading to skeletal muscle degeneration, necrosis and fibrosis. Electron microscopic examination of the neural tissues in the injected area showed intra-neural fibroblasts, deposition of intra-neural collagen fibers and marked myelin degeneration. In addition, PC/DC injection caused thickening of intra-neural blood vessel walls and evident endo-neural mast cells. The current data highlight the attendant risk of neuromuscular injury associated with repeated PC/DC injection during the treatment of undesirable fat deposits and lipomas.

Very high frequency ultrasound: New therapeutic method in aesthetic medicine and dermatology

Very high frequency ultrasound (VHF-US) is new therapy method with a broad application spectrum in dermatology and aesthetic medicine. In this method, ultrasound waves with frequencies over 10 MHz, which were for a long time only used in ultrasound diagnostics, are applied for therapeutic purposes. Such US waves demonstrate specific biophysical efficiencies which warrant their application for the treatment of the skin efflorescences, chronic wounds and hypertrophic scars as well as in anti-aging and skin improvement procedures in aesthetic medicine. VHF-US can be applied not only for stand-alone treatments, but also as a supportive pre- and posttreatment method in combination with laser, radiofrequency currents, injection lipolysis, etc. as well as in aesthetic plastic surgery.

A review of the aesthetic treatment of abdominal subcutaneous adipose tissue: background, implications, and therapeutic options.

The demand for aesthetic body sculpting procedures has expanded precipitously in recent years. Subcutaneous adipose tissue (SAT) deposits of the central abdomen are especially common areas of concern for both males and females. To review the available literature regarding the underlying pathophysiology of subcutaneous fat accumulation in the abdominal area and available treatment options. A MEDLINE and Google Scholar search was performed accordingly. The preferential accumulation of SAT in the central abdomen is attributable to the reduced lipolytic sensitivity of its adipocytes. A number of therapeutic options are available for the treatment of central abdominal adiposity. Cryolipolysis, high-intensity focused ultrasound, nonthermal ultrasound, radiofrequency, and injection adipolysis lead to adipocyte destruction through multiple different mechanisms. Nonablative modalities such as injection lipolysis mobilize fat stores from viable adipocytes, although its effects may be curtailed in obese patients. Liposuction through tumescent technique, however, mechanically extricates SAT. Although tumescent liposuction remains the gold standard for SAT removal, less invasive ablative and nonablative options for targeting localized deposits of adipose tissue now permeate the aesthetic marketplace. Limited results associated with these modalities mandate multiple sessions or combination treatment paradigms.

Comments on "Injection Lipolysis With Phosphatidylcholine and Deoxycholate"

In a previous letter to the editor, Hasengschwandtner and Gundermann1 raised the question of sodium deoxycholate's (DC) unselective action when injected subcutaneously during nonsurgical, localized fat reduction, to support their theory that phosphatidylcholine (PC) provides an indispensable adjunct to reduce DC toxicity. Although DC's efficacy on cell lysis has been scientifically2,3 and clinically4,5 proven, its unselective action5–8 has been widely debated. When assessed at various DC:PC ratios, PC demonstrates antilipolytic action,9 with the ability to reduce DC's aggressiveness (Figure 1) (A. Rotunda, personal communication, 2006). Figure 1 Cytolytic activity of sodium deoxycholate in adipocytes attenuated by phosphatidylcholine. Sodium deoxycholate is indicated …

Facial skin and soft tissue infection caused by Mycobacterium wolinskyi associated with cosmetic procedures

BackgroundMycobacteirum wolinskyi is a member of the Mycobacterium smegmatis group, which is less frequently found in clinical settings than other nontuberculous mycobacterium (NTM) species. However, its clinical significance has recently increased in opportunistic infections. This case is the first report of facial skin and soft tissue infection by M. wolinskyi complicating cosmetic procedures.Case presentationA 56-year-old Asian female patient with a history of receiving multiple facial cosmetic procedures over the preceding 2 years was admitted to our institution with swelling, local pain, and erythema on the right cheek. Mycobacteirum fortuitum complex isolated from a pus culture was identified as M. wolinskyi by rpoB sequencing. Metallic foreign bodies and abscess were detected by radiologic imaging. The pus was incised and drained. Treatment comprised clarithromycin (500 mg every 12 h), amikacin (200 mg every 8 h), and ciprofloxacin (400 mg every 6 h).ConclusionWe report the first case of facial skin and soft tissue infection with M. wolinskyi after multiple cosmetic procedures of filler injection and laser lipolysis. Increased occurrence of NTM infection in nosocomial settings suggests the importance of appropriate treatment including culturing and rpoB gene sequencing when patients who have undergone cosmetic procedures display symptoms and signs of soft tissue infection indicative of NTM infection.

Response to “Injection Lipolysis With Phosphatidylcholine and Deoxycholate”

I am writing this commentary to caution surgeons not to overinterpret the results mentioned in the original Reeds et al1 study (of which I was an author, and which was referenced in the Letter to the Editor from Drs Hasengschwandtner and Gundermann) and assume that the results offer proof that injection lipolysis using drugs from compounding pharmacies is safe and efficacious. The purpose of my response is not to rebut the comments from Hasengschwandtner and Gundermann. The original article by Reeds et al1 was an institutional review board–approved study in …