Injection lipolysis: fat dissolving injections

face injection

Injection lipolysis, also known as intralipotherapy, is a minimally invasive medical procedure for targeted fat reduction. Commonly referred to as fat dissolving injections, intralipotherapy is a form of mesotherapy and one of the nonsurgical fat reduction options available in cosmetic medicine.

What is injection lipolysis?

Intralipotherapy refers to the injection of a broad range of different substances directly in the fat layer below the skin known as the hypodermis; after the injection, the fat cells are destroyed and are unable to store or accumulate fat anymore, consequently their debris are metabolized and eliminated permanently from the body.

Indications of fat dissolving injections

In the US and in Canada the only FDA-approved fat dissolving injection is deoxycholic acid and it is indicated only for the treatment of submental fat known as the double chin. This drug is marketed as Kybella® in the US and Belkyra® in Canada and in Europe.

This and other substances are also used on-label or off-label, depending on each country’s approval, for the treatment of other localized fat deposits. You should ask your treating physician for information specific to the country where you are receiving treatment. Common treatment areas are:

  • Submental fat a.k.a. double chin
  • Infraorbital fat pads a.k.a. eye bags
  • Jowls
  • Other facial fat deposits such as cheeks and jaw fat
  • Axillary fat pads a.k.a. armpit fat
  • Male gynecomastia
  • Upper back fat rolls
  • Bra fat rolls
  • Upper arm fat
  • Waistline fat
  • Abs and six pack definition
  • Male and female abdominal fat
  • Male and female flanks
  • Buttock fat and cellulite
  • Thighs fat and cellulite
  • Knee fat
  • Upper calf fat
  • Lipoma (benign fat tumor)

Types of fat dissolving injections

The main substances used for injection lipolysis are the following:

  • Deoxycholic acid – Kybella®, Belkyra®, GeoLysis®
  • Phosphatidylcholine – Lipostabil®

The main combinations of substances used for injection lipolysis are the following:

  • LipoDissolve®, Dermastabilon®, Aqualyx®

How does injection lipolysis work?

Deoxycholic acid – Kybella®, Belkyra®, GeoLysis®

Deoxycholic acid is a component of human bile, which is a fluid secreted by the liver and stored in the gallbladder to digest the lipids transiting in the small intestine. Deoxycholic acid disrupts the fat cell membrane causing the death of the fat cell which is then metabolized and eliminated from the body. 

Phosphatidylcholine – Lipostabil®

Phosphatidylcholine mechanism of action as fat dissolving injection is not yet well understood. Phosphatidylcholine is naturally found in the human body where it is involved in different body functions, such as being a component of the cellular membrane or metabolizing cholesterol. It is thought to cause the lysis of fat cell membranes. Phosphatidylcholine is extracted from soybean where it is abundant.

LipoDissolve®, Dermastabilon®, Aqualyx®

There are many mixes of substances, some of which have been registered as trademark, that are used for injection lipolysis.

LipoDissolve®, Dermastabilon®, Aqualyx® all contain a mix of two active ingredients: sodium deoxycholate (DC) and phosphatidylcholine (PC). Sodium deoxycholate is the sodium salt of deoxycholic acid and works similarly by disrupting the fat cell membrane causing its death. They are thought to work well in combination with DC breaking the fat cells and PC helping to metabolize them.

Other substances for injection lipolysis

Some clinics promote mesotherapy for facial rejuvenation, skin tightening, improving the tone and color of the skin and also for localized fat reduction. Mesotherapy is the injection of substances into the hypodermis, which is the layer of fat and connective tissue under the skin. There is scarce if not nonexistent evidence on both the efficacy and the safety of such treatments. Although most of the substances are FDA approved, they are used in mesotherapy for non-approved indications.

Many physicians and physician’s organizations such as the American Society of Plastic Surgeons (ASPS) advise against mesotherapy employing substances that have not been studied with safety and efficacy still not proven; they encourage further testing and research before recommending these treatments. Among the many substances advertised in mesotherapy for fat reduction there are:

  • L-Carnitine
  • Lecithin
  • Choline
  • Aminophyline
  • Isoproterenol
  • Vitamins
  • Collagenase
  • Hyaluronidase
  • And many more…

How long do fat dissolving injections last?

Fat is not stored in the body freely as a fat molecule in tissues. Fat is stored within specialized cells known as adipocytes which absorb triglycerides from the bloodstream and store them within their cell membrane. When fat is needed for energy or other body functions, fat cells can release their content back into the bloodstream.

As adults, when we gain weight, we don’t increase the number of fat cells, we just increase their size as they get bigger by storing more triglycerides. In the same way, when we lose weight, we don’t reduce the number of adipocytes, we just reduce their volume.

Fat dissolving injections break down fat cells. The destroyed fat cells will not grow back and will be gone forever. Only the remaining adipocytes in the treated area will still be able to store fat and increase in size, but this will happen only if you gain weight which will anyway be redistributed among all fat cells in the body (depending also on genetics and other factors some areas are privileged for fat storage). The treated area will have less capacity for fat storage which will result in long-term efficacy of the treatment.

This means that once you reach the desired results, treatment is expected to last indefinitely unless there is a great increase in bodyweight and fat mass.

How much does injection lipolysis cost?

Depending on the country where you receive treatment, the chosen clinic and doctor administering the treatment, the area to be treated and the number of sessions required to achieve the desired result, the cost of injection lipolysis varies greatly.

  • Kybella® and Belkyra® on average costs about 600-750 USD per vial.
  • LipoDissolve®, Dermastabilon®, Aqualyx® and Lipostabil® on average are cheaper treatments starting from 150 USD.

You should expect to save about 30-70% on the overall costs by undergoing treatment in a plastic surgery clinic in Thailand.

Risks and side effects of intralipotherapy

Fat dissolving injections are a minimally invasive and non-surgical option for targeted fat reduction. As any other medical or surgical procedure, injections lipolysis carries some risks and has possible side effects.

The most common side effects concern the treated area:

  • Swelling
  • Bruising
  • Pain or discomfort
  • Numbness
  • Redness
  • Hardness

These side effects last from a couple of hours to a couple of weeks.

The possible serious complications reported are:

  • Marginal mandibular nerve injury (with asymmetric smile or facial muscle weakness)
  • Dysphagia (trouble swallowing)

Both these complications resolved spontaneously, without medical treatment, in clinical trials.

Other serious but rare complications are:

  • Injection-site infection
  • Injection-site ulceration
  • Tissue necrosis
  • Alopecia

An expert and knowledgeable physician can minimize all the risks by following protocols such as using the proper injection technique, targeting the right areas, injecting the right amount of product, observing aseptic techniques, etc.

Ask your treating doctor for the specific risks, side effects and contraindications of the specific product you are interested in.

How long after treatment with fat dissolving injections to see results?

It takes about 4-8 weeks for results to be fully visible and sometimes further improvement is possible up to 12 weeks post-treatment.

On average, at least 2-4 treatment sessions are needed for satisfactory results, spaced at least 4 weeks apart.

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    DN Reeds, BS Mohammed, S Klein – Aesthetic Surgery Journal, Mar 2013
  • Injectable Treatments for Adipose Tissue: Terminology, Mechanism, and Tissue Interaction.
    AM Rotunda – Lasers in Surgery and Medicine, 2009
  • Injection Adipolysis: Mechanisms, Agents, and Future Directions.
    S Kamalpour, K Leblanc – Journal of Clinical and Aesthetic Dermatology, Dec 2016
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    DI Duncan – Aesthetic Surgery Journal, Sep 2005
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    N Scuderi, BA Toth – Springer 2016
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    AM Rotunda, H Suzuki, RL Moy – Dermatologic Surgery, Jul 2004
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    MK Thomas, JA D’Silva, AJ Borole – Journal of Cutaneous and Aesthetic Surgery, Oct 2018
  • Lipostabil: The Effect of Phosphatidylcholine on Subcutaneous Fat.
    VL Young – Aesthetic Surgery Journal, Sep 2003
    K Mahmud, CE Crutchfield – The Journal of Clinical and Aesthetic Dermatology, Oct 2012
  • Effectiveness of Local Fat-Dissolving Solution Injection
    GS Jung – Aesthetic Surgery Journal, Mar 2019
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    M El-Domyati, TS El-Ammawi, O Moawad – International Journal of Dermatology, Aug 2012
  • Dynamics of Fat Cell Turnover in Humans.
    KL Spalding, E Arner PO Westermark – Nature, Jun 2008
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    A El Kamshoushy, RA Maksoud, N El Mahdy – Journal of Clinical & Experimental Dermatology Research, 2012
  • American Society of Plastic Surgeons (ASPS)


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