Dr.Grace
23-11-2006, 01:21 PM
Hello all,
The choice of active ingredient used in lipodissolve has been a hot topic recently both in the forum and at our medical spa. This is the reply I posted to one of the comments: that deoxycholate was a superior lipodissolve active ingredient (based on a study they found).
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In the field of medical research you’ll always be able to find a paper to support almost everything. Was this the paper you found (Dermatol Surg. 2004 Jul;30(7):1001-8 Detergent effects of sodium deoxycholate are a major feature of an injectable phosphatidylcholine formulation used for localized fat dissolution)?
What we do know is the weight of the evidence lies with phosphatidylcholine. Hundreds of published papers support phosphatidylcholine vs. a small handful for deoxycholate. Phosphatidylcholine is overwhelmingly the most commonly used active ingredient used by medical practitioners for good reasons
1. It is safe. In other fields of medicine phosphatidylcholin has been used in Cardiology since the 1070s to lower blood cholesterol, and to assist liver function. No long term toxicity has been shown.
2. It is effective. Phosphatidylcholine has been widely used in Europe, USA, Latin America for fat reduction with good results. Hundreds of papers have been published (granted, not gold-standard evidence) describing the clinical observation of fat reduction with minimal side effects (redness and itching). Eg:
The use of phosphatidylcholine for correction of localized fat deposits. Aesthetic Plastic Surgery 2003 Jul-Aug;27(4):315-8
Histological changes associated with mesotherapy for fat dissolution. J Cosmetic Laser Ther 2005 Mar;7(1):17-9.
3. The most likely mechanism of fat reduction is that phosphatidylcholine acts as a mild emulsifier, damaging the fat cell membranes. This stimulates inflammatory-mediated fat necrosis and resorption. It’s not a case of simply “melting” the fat – the fat cells have to be resorbed and taken away. In fact, liquefying more fat cells than the immune system can handle can be disastrous (causing fevers, muscle pain and infections).
The inflammatory-mediated fat resorption is biopsy proven in both test animals and humans. Fat biopsies following phosphatidylcholine and deoxycholate injection show mixed septal and lobular panniculitis. The fat lobules are infiltrated by increased numbers of lymphocytes and macrophages (consisting of foam cells and multinucleated fat-containing giant cells). The inflammation was associated with serous atrophy and microcyst formation. This leads to the localised reduction in fat tissue.
--> In plain English, we use chemicals to irritate/damage the fat cells, stimulating your own white blood cells to come into the area and remove the damaged fat cells. That’s the theory on how fat cells are removed without physically suctioning them out using surgery.
4. Sodium deoxycholate is simply a surfactant, one of many used in phosphatidylcholine preparations (which all contain phosphatidylcholine, a surfactant and water). The phosphatidylcholine preparation used at Kiora Medical Spas contains around 8.8% sodium deoxycholate.
Is it possible that the deoxycholate helps the phosphatidylcholine? Sure. But will using deoxycholate alone achieve good results? (It would certainly be cheaper for us!) Until there are as many studies in favour of it I would go on the existing evidence and use phosphatidylcholine (with or without the sodium deoxycholate).
Cheers, thanks for bring up this interesting point for discussion!
_____________________________________________
Dr. Grace Lin
Clinical Director Kiora Medical Spas
T 1300 55 98 96
www.kiora.com.au
The choice of active ingredient used in lipodissolve has been a hot topic recently both in the forum and at our medical spa. This is the reply I posted to one of the comments: that deoxycholate was a superior lipodissolve active ingredient (based on a study they found).
_______________________________________________
In the field of medical research you’ll always be able to find a paper to support almost everything. Was this the paper you found (Dermatol Surg. 2004 Jul;30(7):1001-8 Detergent effects of sodium deoxycholate are a major feature of an injectable phosphatidylcholine formulation used for localized fat dissolution)?
What we do know is the weight of the evidence lies with phosphatidylcholine. Hundreds of published papers support phosphatidylcholine vs. a small handful for deoxycholate. Phosphatidylcholine is overwhelmingly the most commonly used active ingredient used by medical practitioners for good reasons
1. It is safe. In other fields of medicine phosphatidylcholin has been used in Cardiology since the 1070s to lower blood cholesterol, and to assist liver function. No long term toxicity has been shown.
2. It is effective. Phosphatidylcholine has been widely used in Europe, USA, Latin America for fat reduction with good results. Hundreds of papers have been published (granted, not gold-standard evidence) describing the clinical observation of fat reduction with minimal side effects (redness and itching). Eg:
The use of phosphatidylcholine for correction of localized fat deposits. Aesthetic Plastic Surgery 2003 Jul-Aug;27(4):315-8
Histological changes associated with mesotherapy for fat dissolution. J Cosmetic Laser Ther 2005 Mar;7(1):17-9.
3. The most likely mechanism of fat reduction is that phosphatidylcholine acts as a mild emulsifier, damaging the fat cell membranes. This stimulates inflammatory-mediated fat necrosis and resorption. It’s not a case of simply “melting” the fat – the fat cells have to be resorbed and taken away. In fact, liquefying more fat cells than the immune system can handle can be disastrous (causing fevers, muscle pain and infections).
The inflammatory-mediated fat resorption is biopsy proven in both test animals and humans. Fat biopsies following phosphatidylcholine and deoxycholate injection show mixed septal and lobular panniculitis. The fat lobules are infiltrated by increased numbers of lymphocytes and macrophages (consisting of foam cells and multinucleated fat-containing giant cells). The inflammation was associated with serous atrophy and microcyst formation. This leads to the localised reduction in fat tissue.
--> In plain English, we use chemicals to irritate/damage the fat cells, stimulating your own white blood cells to come into the area and remove the damaged fat cells. That’s the theory on how fat cells are removed without physically suctioning them out using surgery.
4. Sodium deoxycholate is simply a surfactant, one of many used in phosphatidylcholine preparations (which all contain phosphatidylcholine, a surfactant and water). The phosphatidylcholine preparation used at Kiora Medical Spas contains around 8.8% sodium deoxycholate.
Is it possible that the deoxycholate helps the phosphatidylcholine? Sure. But will using deoxycholate alone achieve good results? (It would certainly be cheaper for us!) Until there are as many studies in favour of it I would go on the existing evidence and use phosphatidylcholine (with or without the sodium deoxycholate).
Cheers, thanks for bring up this interesting point for discussion!
_____________________________________________
Dr. Grace Lin
Clinical Director Kiora Medical Spas
T 1300 55 98 96
www.kiora.com.au