One of the treatments that I think works well is Lipodissolve. I have looked at the scientific evidence and attended a couple of training courses and been impressed. Someone sent me a link to an article in the LA Times that is pretty skeptical about Lipodissolve so let’s discuss what the article says.

First, let me summarize what Lipodissolve is, at least the compound I use, from the NETWORK-Lipolysis group based in Europe. The active ingredients are phosphatidylcholine (PC) and deoxycholate (DC). PC is the same thing as lecithin, an accepted nutritional supplement, and is a component of every cell in your body. Deoxycholate is a bile salt.

When I was a teenager, everyone was taking lecithin as a cure-all for everything from memory loss to an overworked liver.

When PC and DC (let’s shorten that to PCDC) are mixed together and injected into the fat under your skin, they cause the fat cells to rupture, killing the fat cells or shrinking them. The loss of volume of fat from these injections has been confirmed with studies, measurements of patients, ultrasounds of the skin and fat and biopsy studies.

The injections also cause inflammation which stimulates the treatment area to tighten up so that the skin appears smooth rather than like an empty sac after the fat has melted.

I’ll put a slideshow up on this page in the next day or 2 so you can see some before and after pictures.

Let’s get back to the LA Times article. I’m skipping the first paragraph because I have issues with just about every sentence and I think my comments below will address them.

The article was inaccurate about the number of injections and the frequency.

Treatments involve a series of six to nine injections every few weeks to the same area, commonly the abdomen, love handles, chin and thighs. Most centers,
including Fig, charge around $1,500 per treatment area.

The author was probably vague here because she was aggregating different protocols for fat-melting.

A full treatment dose of PCDC according to the NETWORK-Lipolysis standards is 2.5 grams of PC diluted to 110 mL, and given as 1/2 mL injections. That means 210 injections for one treatment. The injections are 1.5 cm apart so you can cover a maximum area of 15 cm x 30 cm (6″ x 12″) in one treatment. Treatments should be spaced at least 8 weeks apart.

The article quotes a couple of plastic surgeons who don’t appear to have any specific knowledge about Lipodissolve.

“The doctors doing this are driving ahead of their headlights,” said Los Angeles plastic surgeon Brian Kinney, immediate past president of the Plastic Surgery Educational Foundation of the United States and clinical assistant professor of plastic surgery at USC. “They are practicing way outside the bounds of science, which is why some of us are uncomfortable. There’s a lot we don’t know about these chemicals, including how they affect nerves, tissue and blood vessels. We don’t know what happens to the fat once it’s dissolved, whether it enters the bloodstream or the lymphatic system.”

Dr. Kinney may not know anything about PCDC but lots of other doctors do. For instance, PCDC was used for decades in Europe. If you had a fat embolism (akin to a blood clot but made of fat), as sometimes occurs after breaking a bone, they used to treat you with 4.5 grams of PCDC intravenously. An injection into the bloodstream is more dangerous than an injection into the skin so they had to have confidence that such a high dose was safe.

In Europe, doctors know a lot about what these chemicals do to nerves (nothing), tissue (melt fat and stimulate collagen production) and blood vessels (nothing).

We do know what happens to the fat once it is dissolved: it is handled the same way that the body handles the fat you ingest in your diet.

I find it interesting that plastic surgeons are warning against this treatment. It seems to me that they are the most threatened by it because it will cut into their liposuction business. There are plastic surgeons who do both liposuction and Lipodissolve and they seem satisfied that each treatment has its place.

Some interpret the trend as the point where patient vanity meets physician greed. “It saddens me that physicians would place patient safety in jeopardy for the sake of making a profit,” said Joel Schlessinger, president of the American Society of Cosmetic Dermatology and Aesthetic Surgery.

It saddens me also that physicians would place patient safety in jeopardy for the sake of making a profit but I don’t think it is fair to place this accusation on everyone who provides Lipodissolve. For instance, cosmetic surgery is much riskier than Lipodissolve. I hear of people dying every year as a result of cosmetic procedures like face lifts and liposuction. I belong to a forum that discusses every adverse reaction to Lipodissolve and no one has ever come close to death.

I personally offer Lipodissolve because I believe in less risky alternatives to surgery. I reduce the risk of Lipodissolve by carefully assessing each client who asks for it with a detailed history and a physical examination. I give every client reading material that outlines in detail who is and who isn’t a good candidate, and what will happen after the injections. No one gets the injections on the same day as the initial consultation so they have lots of time to think it over.

“They come in with pain, swelling, bruising and bloating in the treatment areas, irregular dimpling and divots in the skin. Some complain of feeling ill and have nausea, diarrhea and fatigue.”

This raises 2 issues for me.

First of all, I warn everyone about pain, swelling, bruising and bloating, nausea, diarrhea, lightheadedness, and so on. My clients say that the injections weren’t as bad as they expected because I had prepared them so well.

Secondly, would you not have all of those symptoms after an anesthetic and liposuction? Have you ever seen anyone on the day of surgery, any surgery?

Irregular dimpling and divots in the skin are much more common with liposuction than with fat-melting injections.

A big part of the problem when discussing Lipodissolve is comparing apples with oranges.

Lipodissolve is part of mesotherapy, which refers to any treatment that involves multiple small injections under the skin. Mesotherapy can be used for any number of indications, including to improve energy, treat depression and so on. Classic mesotherapy is a tool of homeopathic doctors who mix up to several hundred ingredients at low concentration into injectable solutions.

Lipodissolve itself is an umbrella term for different compounds that are used for the purpose of melting fat. Some compounds contain varying concentrations of PC and DC, some contain DC alone, and some contain something entirely different.

I follow the NETWORK-Lipolysis group’s guidelines because they are very methodical, collect data on every treatment, do research and publish thoughtful guidelines. The NETWORK recommends that the treatment only be performed by a physician. This makes sense to me because there are lots of little decisions and adjustments that I make during a treatment based on my medical knowledge.

Here’s an example of how the NETWORK advances knowledge about Lipodissolve. There was a question about whether it was the PC component or the DC component that causes the fat-melting results. NETWORK members compared the 2 treatments and found that both components could melt fat but DC alone was a lot more painful and didn’t give as good results as the PCDC combination. The PC component has other beneficial effects such as turning on enzymes in the body that regulate how the body handles fat.

Prior to this work being done, the NETWORK was willing to consider changing its compound to DC alone if it was shown to be better but now they know that PCDC is better.

The LA Times also gives examples of people having bad outcomes with Lipodissolve from clinics in beauty salons or gyms. My best advice here is that you go to a clinic that has a doctor on site, gives you lots of information and doesn’t pressure you into having the treatment. If you feel that the clinic doesn’t really have your best interests at heart, go somewhere else. You can find NETWORK-Lipolysis for many different countries here.