The Lipodissolve Clinic Blog

Why chose a non-surgical procedure involving many injections that might involve a few visits over a single surgical procedure?

The answer is the risk/benefit ratio.

Liposuction, also known as lipoplasty or suction-assisted lipectomy, is cosmetic surgery performed to remove unwanted deposits of fat from under the skin. The doctor sculpts and recontours the patient's body by removing excess fat deposits that have been resistant to reduction by diet or exercise. The fat is permanently removed from under the skin with a suction device. The patients is typically under general anesthesia.

The morbidity and mortality from liposuction is reported from several studies to be on average, 20-100 deaths per 100,000 surgeries. Higher with general anesthesia and higher when combined with other procedures like a tummy tuck. Tummy tucks have a death rate of 1 per 600 procedures just by itself.

Lipodissolve is a non-surgical procedure where phosphatidyl choline (lecithin) and deoxycholate (bile salt) is injected directly into the subcutaneous storage fat. The fat cells are lysed open from the substances and the patient's immune system sends macrophages to the area to clean up the debris. Swelling ensues enabling many macrophages or clean up cells to enter the area and the body then eliminates the macrophages and dead fat cell debris via the lymphatic system and the intestinal tract. This procedure is performed for the same reason liposuction is performed and in the same areas.

There is a zero mortality risk from lipodissolve. Thousands of procedures have been performed world wide without any death risk. The morbidity is also close to nil. There have been a few cases of infection of the area treated, but these cases were not performed by medical personnel.

The results from lipodissolve can be remarkable. The skin shrinks over the area where the fat has been lysed as needles promote skin tightening and the fat disappears over a few weeks allowing the skin to shrink as well.

There is swelling and some bruising, this is part of the process and necessary for the process, but not a risky side effect.

Lipodissolve can be done in small areas such as the jowls, under the chin and on knee fat pads, liposuction is difficult in such small areas.

With a desirable outcome and little risk, lipodissolve is preferable to the surgical procedure liposuction.

Again, bad press is abounding over lipodissolve and mesotherapies.

Two forms of safe, aesthetic procedures which have been time tested to be so safe, that there have been no deaths or hospitalizations in relation to either of these procedures.

Clearly, these procedures threaten those that would have you believe that plastic surgery is the only way to achieve a reduction in fat, or tighter skin.

There have been medical spas that have behaved badly over the years:
Strong marketing campaigns
Forceful contract ploys
getting payments up front

These certainly have been bad for the industry, but they are in no way the majority, nor do they affect the actual reality of the procedures.

In fact, most individual medical offices that offer these procedures, do not engage in these marketing ploys, that has been only the behavior of corporate spa chains.

Lipodissolve does melt away external soft fat, but it is not a weight loss procedure, just a spot fat proedure.

Mesotherapy can be great for cellulite reduction, skin tightening, skin brightening and pain management. I do not recommend it for spot fat reduction, as lipodissolve is much better.

There will always be corporate entities willing to sacrifice ethical behavior for a quick buck, but this should not color the procedures, just the marketing methods.

Look for a doctor that doesn't have a hard sell. One that comes recommended and that will give you an honest answer regarding your outcome.

If you are very overweight, this is not an answer for you, with the exception of your chin or neck.

Any doctor that recommends lipodissolve on your belly when you are clearly obese, is too anxious for business to give you an honest answer.

There are two types of abdominal fat; visceral and subcutaneous.

While many studies cite the dangers of visceral fat because of it's association with heart disease and diabetes type two, subcutaneous fat can also pose some dangers.

All fat cells have the capability to transform cholesterol into hormones, particularly estrogen, and large amounts of subcutaneous fat can translate in to excessive estrogen.

Many patients visit my Chicago area office for lipodissolve but this can only eliminate subcutaneous fat. If they have visceral fat which is never good, I recommend dietary changes and either conjugated linoleic acid (CLA), or DHEA.

The studies on both of these supplements are very promising in reducing fat and increasing lean body mass.

The November 10 issue of The Journal of the American Medical Association (JAMA) published a study on the effects of DHEA on visceral and subcutaneous fat.

The study included the non-control group of elderly subjects taking 50mg per day of DHEA for six months.

The conclusion was that DHEA supplementation significantly reduced not only visceral fat, but subcutaneous fat as well. And, previous studies have shown an increase in bone density in subjects taking DHEA.

CLA has been studied and is associated with an increase in lean body mass and decrease in visceral fat. However, the studies were not as impressive as with DHEA. Non the less, many weight trainers body sculptors swear by CLA.

Lipodissolve is only good for someone with a medium to lean body weight who has stubborn fatty tissue in spot areas, like a mushy lower abdomen (women) and love handles (men and women).

Many patients come to my Evanston office expecting me to perform repeated sessions of lipodissolve for their weight problem. I won't and I don't. Lipodissolve is a localized fat loss procedure, not a weight loss procedure and is inappropriate as a treatment for obesity.

The exceptions are that I will treat a buffalo hump, double chin, or droopy jowls on an obese person, I just won't treat the body.

In these instances, I have the patient return for a one to two hour medical and nutritional evaluation. I examine closely the patients behaviors around food and choices. For patients with eating addiction, I recommend attending overeaters anonymous (OA). for patients making bad choices, I teach them how to reduce insulin levels.

Historically, we were all told that in order to lose weight, calories in had to be less than calories expended. and vice versa. now we know that not all calories are created equal.

When we eat something that turns to glucose quickly, we produce insulin. and if we don't utilize the glucose, we create storage fat via the insulin. the more carbs we eat, the more insulin we need. over time we become resistant to insulin and keep requiring more to deal with our glucose. This process creates more and more storage fat, or triglycerides.

If we eat half an avocado vs half of a bagel, we have no insulin stimulation although we've eaten the same amount of calories that the bagel might have. Over time, when we make smart choices, we become less insulin resistant, or more insulin sensitive. This enables us to feel more stable, less starved prior to meals and our triglyceride production is greatly reduced.

So remember, it's not the calories that ruin us, but our hormonal response to the calories.

Fraud of any kind is never a good thing, especially when it taints a whole community.
This past month, Lisa Madigan, the attorney general of Illinois filed a lawsuit against the Chicago area Nu U spas. This could actually be a very good thing as they had allegedly been practicing medical aesthetics without a physician.

They were presumably giving very "hard sells" to their clients by having them sign documents committing them to several treatments at thousands of dollars per contract.

I had heard a few times from patients coming to my office that they had seen an aesthetician at a NU U spa claiming she was going to be delivering the treatments herself. And, they reported feeling pressured into signing paperwork committing them to many treatments. So, I was very glad to hear that they were finally being called on suspicious behavior. However, I was very concerned to read the press release out of Madigan's office. It implied that lipodissolve itself was dangerous and illegal. They stated that the treatment was not FDA approved.

While technically, this is true, it is very misleading. The FDA has no jurisdiction over procedures, only drugs and medical devices.

It is true that phosphatidyl choline (lecithin) and deoxycholate (bile salts) are not FDA approved drugs. They are both naturally occurring and not patentable, just like a vitamin b 12 injection. It would be illegal to market them to the public as drugs.

Physicians that are trained and certified in lipodissolve perform the procedure with the aforementioned agents. This is not illegal. Nor is it dangerous. There has never been a single death, hospitalization or a serious side effect from the procedure being performed by a physician. There has a reported case of uneven fat removal under the eyes by a physician who was not trained in the procedure.

That is an amazing record. Compare that to allergy shots, which cause death by anaphylactic reaction in a handful of patients each year in the US, or to liposuction, that has the highest death rate among elective procedures.

Physicians in the plastic surgery department at UCLA performed an extensive study of outcomes and side effects of lipodissolve. The results and conclusions were overwhelmingly positive.

Both American Academies of Plastic Surgeons, view lipodissolve as an economic threat. Liposuction bookings have fallen drastically since news surfaced that liposuction has the highest death rate of any elective procedure. Lipodissolve's emergence as a safer, less expensive alternative to liposuction has made many plastic surgeons nervous.

In reality, many plastic surgery offices are now offering lipodissolve, and you can bet that the surgeons have the nurses performing the procedure, as it is not worth the surgeon's time in dollars.