What it means for a patient
- The only FDA-approved fat-dissolving injection, deoxycholic acid, is approved for fat under the chin. Its use in other body areas is still being studied.
- Most studies reported less fat in the treated area, and side effects were mostly mild and short-lived.
- Satisfaction varied widely between studies, from 57.1% to 86%.
- Several sessions are needed, and the total cost was higher than one liposuction procedure.
- The authors call for more trials to standardize treatment, measure long-term results and assess cost-effectiveness.
Why this paper matters
It gathered the evidence on fat-dissolving injections outside the chin, including cost comparisons with liposuction and cryolipolysis. The authors name expanded FDA approval as a possible future direction.
Overview
Injectable lipolytic agents are used as a noninvasive way to reduce localized fat. Deoxycholic acid is the only U.S. Food and Drug Administration (FDA)-approved agent for fat under the chin, and its use in other body areas is an emerging area of interest. The authors reviewed studies of injectable lipolytic agents outside the submental region. They searched PubMed, MEDLINE, Embase, Scopus and the Cochrane Central Register of Controlled Trials, and assessed bias with ROBINS-I and RoB 2.
Findings
- 25 studies with 3178 patients were included.
- Agents: deoxycholic acid, phosphatidylcholine, and newer formulations such as CBL-514 and caffeine-hyaluronic acid.
- Studies reporting significant reductions in localized fat: 93.75%.
- Studies reaching statistical significance: 37.5%.
- Adverse events were generally mild and transient.
- Patient satisfaction ranged from 57.1% to 86%.
- Injectables required multiple sessions, which made them costlier than single-session surgical liposuction.
- Their cost was competitive with noninvasive methods such as cryolipolysis.
Terms
- Lipolytic agent: a substance that breaks down fat.
- Deoxycholic acid: a bile acid injected to destroy fat cells.
- Phosphatidylcholine: a compound found in cell membranes, used in fat-dissolving injections.
- Submental: under the chin; nonsubmental means any other body area.
- CBL-514: an investigational injectable for fat reduction.
- Cryolipolysis: fat reduction by controlled cooling.
- Liposuction: surgical removal of fat by suction.
- ROBINS-I: a tool for rating risk of bias in nonrandomized studies.
- RoB 2: a tool for rating risk of bias in randomized trials.