Treatment of Neck Fat with Injectable Adipolytic Therapy

Abstract

Adipolytic therapy is a novel technique that uses subcutaneous injections of pharmacologically active, natural detergents to chemically ablate adipose tissue. The technique has been notoriously described as mesotherapy or Lipodissolve ^®, and its popularity can be attributed due in large part to direct consumer adver­tising and controversy rather than rigorous scientific investigation. However, the following chapter describes what is perhaps best described as adipolytic therapy or lipodissolution, which is increasingly recognized in the literature as a novel method to treat fat, using injections rather than surgery or energy devices. Phosphatidyl-choline (PC), a phospholipid derived from lecithin, has been historically incorporated with its solvent, the ionic detergent sodium deoxycholate (DC), as the two primary injected medications. Recently, numerous reports attribute the fat ablation effects of this treatment to DC, which is a bile salt possessing potent cell lytic activity, and so this chapter will describe primarily the author’s experience with this compound. It is imperative to note that as of this writing, DC is not approved by any regulatory authority and therefore must be obtained from compounding pharmacies. Physicians are advised to inquire about the status of this procedure with their malpractice carrier, and become informed (and likewise appropriately consent patients) of the literature, risks, benefits, and alternatives of this technique.