It wasn’t all that long ago that the fat injection treatment, Lipodissolve, was tremendously popular. While used in many other countries before being introduced in the U.S. almost ten years ago, it achieved quick notoriety amongst numerous practitioners. Because it offered a non-surgical method of fat reduction, the public was equally if not more enamored with it. Before long courses were being taught in its injection technique and even Lipodissolve centers around the country emerged. While controversial in the established medical community, its popularity could not be denied.
But as quickly as Lipodissolve fat treatments appeared, they soon came crashing down. Before long, the Lipodissolve centers folded and the fat injection method dissolved into the background. This occurred largely because the treatments were overhyped and oversold, promising to remove more fat than was realistically possible. But even if they had remained popular and effective, it would have not been much longer until the FDA appeared…and they still would have gone away. The chemical solutions used in Lipodissolve, variable as they were, had never gone through FDA evaluation and were being used off-label.
Sold through compounding pharmacies in various concoctions, the fundamental elements of Lipodissolve were phosphatidylcholine and deoxycholic acid. These chemicals have known effects on fat cell membranes by causing them to become disrupted and spill their fatty acid contents, thus their fat reduction capabilities. Such solutions can be effective but not in large fat areas. This capability was realized and one company (Kythera Biopharmaceuticals) decided to go through a formal FDA process even though this would be a predicate drug scenario, an FDA process that would take many years of safety and clinical testing.
Now known as ATX-101, it is being tested in FDA-sanctioned clinical trials for reducing fatty deposits under the chin as a non-surgical approach in neck reshaping. In test findings presented at a recent Dermatology meeting, it was shown to reduce submental fat safely without recurrence in follow-ups out to over two years. In two separate double-blinded studies, over 150 patients who had an average age of 46 years old underwent four injection sessions spaced a month apart. Those that received the actual drug showed significant visual improvement and patient satisfaction over those that just received a placebo. More than 90% of those who responded 27 months after their last treatment showed continued or even greater improvement. Some mild inflammatory events occurred such as swelling and injection site inflammation, all which cleared within one month of the treatment.
I also participated in a market survey today from an independent research firm that clearly was conducting a market analysis on ATX-101. In looking at their before and after photos and a video of the injection technique, these findings were essentially identical to what my neck experience was with Lipodissolve in its heyday five years ago.
It may be a few more years but I would expect ATX-101 to eventually receive FDA approval for neck fat reduction. It will have a useful role in the right patient who has neck fat but not a large amount of excess skin. While these current clinical studies are not evaluating it, the fat reduction effectiveness of these injections may be enhanced when combined with other heat-generating skin tightening treatments such as Exilis and Skin Tyte. That was part of my treatment protocol for small fat collections in the neck and body in the Lipodissolve era which I found to be very effective.
Dr. Barry Eppley
Indianapolis, Indiana