The number of patients seeking fat dissolving injections as part of aesthetic treatments has been increasing. It is necessary to seek treatment because the persistence and hypertrophy of fat pads, particularly in the face and neck region, disturb the perceived beauty proportions of the body. A successful reduction of this fat will assist individuals in achieving a more pleasing appearance and the desired contouring of their face and neck.

Phosphatidylcholine and deoxycholic acid are the two types of solutions utilized most frequently in fat dissolving injections. Both treatments have received clearance from the Food and Drug Administration in the United States for dissolving unwanted fat. But before you put any of these potential treatments to the test, you should probably educate yourself about what each one entails and its risks. 

Primary Fat-Dissolving Solutions

Phosphatidylcholine

The most significant and necessary phospholipid in the human body is phosphatidylcholine. It makes it easier for fat to be emulsified into the smallest particles possible inside the nanosphere, allowing fat assimilation and transportation. Phosphatidylcholine causes the adipocytes to burst and increases the secretion of triacylglycerol-rich lipoproteins after being injected subcutaneously into fat tissue.

Deoxycholic Acid

Human bile acid, which contains deoxycholic acid, is essential for emulsifying and digesting fat in the intestine. Researchers established that deoxycholic acid produced externally physically damages adipocytes’ cell membranes, leading to cell death and that relatively protein-poor tissue, like fat, is more vulnerable to deoxycholic acid’s cytolytic effects than relatively protein-rich tissue, like skin and muscle. Numerous studies have confirmed deoxycholic acid’s clinical efficacy and safety.

In 2015, deoxycholic acid injection (marketed as Kybella in the US) received approval as a first-in-class injectable medication for reducing the appearance of a double chin brought on by submental fat.

How These Solutions Work

When fat dissolving injection formulas are applied, the fat cell wall is torn down, which sets off a chain reaction of inflammatory necrosis and shrinkage of the fat tissue. Additionally, the inflammatory cascade induces fibroblast movement and stimulation, promoting more collagen production.

The fat tissue death is permanent, so the fat cells won’t ever return. 

How Fat Dissolving Injections Are Applied

A 1-mL tuberculin syringe and thin needle inject deoxycholic acid with phosphatidylcholine into the submental fat (usually 30 G and 13mm). Here’s how it will happen:

1. The injection site is marked after the patient is well informed about the details. 
2. While injecting, strict aseptic precautions are observed. We believe that because fat is injected deeply, topical anesthesia does not affect lessening discomfort; however, it may be used on patients who are particularly sensitive to pain.
3. Deoxycholic acid with phosphatidylcholine is typically injected in sessions in doses ranging from 3 to 5 mL, with each injection prick containing about 0.2 to 0.3 mL. As a result, 30–50 mg of deoxycholic acid with phosphatidylcholine are delivered each session over a wide area.
4. Your provider will pinch the submental fat with a hand to ensure the proper injection application. As the fat is deeply seated, the prick must be between 6 and 10 mm deep.
5. Usually, three to five sessions are typically needed, with a four-week gap between sessions. In our experience, fewer sessions can be required by extending the time between sessions to eight weeks.
6. Following injections, topical antibiotics are applied.
7. Following injection, patients will feel discomfort and pain that will last for two days to two weeks before their fat decreases.

Aftercare

From two days to two weeks after the injection, patients may experience mild swelling, discomfort, and pain as an indication of inflammation. Patients can use cold compresses to relieve pain. Anti-inflammatory medications taken orally are rarely used.

For the following 48 hours, patients are advised not to massage the treated area. After four weeks, patients can typically be followed up to evaluate the results and schedule additional sessions based on their needs.

Risks And Complications

While both phosphatidylcholine and deoxycholic acid are very effective at addressing submental fat, they are not without risks. So before you try out the treatment, here are some risks that you should know about:

1. The most frequent symptoms are discomfort, pain, and swelling, which will pass with time. When deoxycholic acid is administered alone, swelling and pain can last 10 to 14 days. Still, when deoxycholic acid and phosphatidylcholine are combined, the discomfort can last for as little as a week.
2. The marginal mandibular nerve damage can happen due to a sizeable deoxycholic acid injection close to the nerve. Clinically, it might cause an unbalanced smile. In most cases, it can be avoided by seeking an experienced provider that knows the proper injection technique. 
3. Bruises or ecchymosis can also happen, but these are very localized, result from damage to nearby blood vessels, and go away in a few days.
4. Dysphagia is a rare occurrence but can still happen. 
5. Skin ulceration may happen if the injection isn’t applied deep enough. This can be avoided by picking an experienced provider. 

Precautions

Read and understand the medication label and package carefully before using. Inform all your providers about your medical conditions, allergies, and medications before trying out fat dissolving injections. 

Before Trying Out Fat Dissolving Injections

If you have any of the following conditions, fat dissolving injections are not recommended for you:

• infection in or around the target area
• allergic reactions to phosphatidylcholine or deoxycholic acid

Inform your provider if you’ve ever had the following: 

• thyroid disorder
• trouble swallowing
• surgery or other aesthetic treatments on your face, neck, or chin (or if you have plans to do so)
• swollen lymph glands in your neck
• bleeding or blood clotting disorder such as hemophilia

There are no studies on the effects of fat dissolving injections on pregnant or nursing women, so best avoid them if you fit in this category. 

Takeaway

Fat-dissolving injections offer a minimally invasive and customizable alternative to liposuction and surgery for patients with moderate to severe submental fullness. This method can effectively and safely reduce submental fat, often without additional skin-tightening procedures. Contact Skin Deep Cosmetics & Aesthetics if you’re interested in the procedure. Other services are also available to help with other aesthetic concerns.