Today Plastic Surgery offers many options to address body contouring. I believe that as knowledge, technology and new pharmaceuticals continue to improve we will see many more avenues available to address these issues. A qualified surgeon must be able to offer a variety of modalities to address patients’ concerns: from liposuction to skin and muscle tightening to lipodissolve. He should be diversified and have more than one tool (a hammer) in his toolbox so that not all problems will be a “nail”.

Lipodissolve: a specific protocol for using a mixture of chemical in a specific pattern in a specific concentration and amount in order to achieve a lipolysis.

Lipolysis injection:  the injection of a chemical in the area where fat is present in order to induce the destruction of the fat cell and resorption of the fat layer.

Lipostabil: the brand name a German company uses for the chemical (Phosphatidylcholine) most frequently used in order to achieve lipolysis.

Phosphatidylcholine: the most common chemical used for destruction of fat cell and it is the one used in lipodissolve.

Deoxycholate: the chemical that is used to render phosphatidylcholine soluble.

Mesotherapy: this”therapy” is a technique to introduce various chemicals into the subcutaneous tissue. It lends itself to a variety of pharmacologic agents, not all with the purpose of dissolving fat.

Let us now concentrate on lipodissolve.

 Let us identify the chemicals.  The chemicals are phosphatidylcholine, deoxycholate, a vasodilator, vitamin B complex, and sodium chloride.

Is this procedure new?
As of 2006 over 50,000 treatments have been recorded in the United States and even larger numbers have been recorded in the rest of the World.

Are there complications?
There are very few complications.  Most of them are mild and benign in nature.  The more significant complication has been pain for two weeks after the procedure.
There are immediate sequelae to the procedure that we consider an inherent tradeoff.  These are bruising, redness, swelling and discomfort.
Side effects have included hematoma at the site of injection, nausea, malaise, dizziness, lightheadedness, diarrhea, and pain that lasted up to two weeks.  The most significant complication has been pain for two weeks after the procedure.

How does it work?
The fat cell wall is digested by phosphatidylcholine.  The fat leaks and is absorbed through an inflammatory process.  Hence some pain and induration will occur, and we will have to wait for the resolution of the inflammatory process.  That takes eight weeks.  By four to six weeks post injection, most patients will able to see an improvement.

How is the procedure done?
The procedure is done under topical anesthesia.  Multiple injections will be required in order to deliver the product to the various areas of the skin.  It is important for us to make certain that everybody understands that this is a procedure, which in order to deliver the expected result, will need to have an impact on the skin.

The postoperative care is straightforward and simple. Two days of rest and no social activity for one week are needed.

Lipodissolve is an exciting procedure for small amounts of fat deposit. Its place and role in our armamentarium is growing, not as much in replacing other procedures, but in treating areas of the body or specific problems other techniques did not address well or provided a less dramatic result.

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