Quest for ‘thinner-ness’

Neither the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery condone it, nor does it have FDA approval, but lipolysis is the one of the fastest-growing cosmetic procedures in the country. According to the sales literature, with just few injections, fat is magically melted away. JFS first examined this phenomenon, including the science and safety concerns, in Lunchtime Lipo.

Fueling its popularity, said Marnell Jameson in an exemplary investigative report for the Los Angles Times, is “the insatiable quest for thinner-ness, a rise in noninvasive cosmetic procedures...and doctors who want to capitalize on both.” The largest lipodissolve provider in the country has done 170,000 procedures since opening its first center in September 2005 and now operates 17 centers in eight states. In this must-read article, Jameson again explains the procedure and boldly reveals what its critics and the science has to say about it:

Weighing in on lipolysis

...When performing the procedure, doctors — or, more often, nurses, assistants or aestheticians — inject PCDC, a mixture of phosphatidylcholine (a chemical found in soybeans) and sodium deoxycholate (derived from cattle bile) into the fat layer under the skin to break it down. They say it's not for the obese but, rather, for normal-weight men and women who want to resolve diet-resistant pockets of fat. 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 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."....

Richard D'Amico, assistant clinical professor of plastic surgery at the Mount Sinai School of Medicine in New York City and president of the ASPS, agrees with Kinney. “This is another example of hype and marketing getting ahead of science. Patient safety is at risk."...

“Right now we're seeing rampant human experimentation without oversight in uncontrolled settings instead of approved clinical trials that fastidiously extend knowledge piece by piece," [president of a biopharmaceutical company] said. “There is no standard formula for dosing, frequency of treatment or chemical strength. No one has determined the affect this might have on pregnancy or whether it could cause birth defects. That is not the right way to practice medicine."

Jameson then profiles the experiences of women who’ve had the procedure and some of their unimaginable adverse reactions. For consumers relying on lipo centers to learn of possible risks, she wrote, they hear there’s never been a complaint, but consumers don’t have to look far to find them:

On Realself.com, a website on which patients who've had cosmetic procedures describe their experiences and then report whether the procedure was worth it, out of 130 injection lipolysis reviews, 58% said it was not worth it. Many said it was far worse than not worth it and reported acute pain, allergic reactions, swelling, diarrhea, vomiting and more than a few trips to the emergency room in addition to no improvement. Of the 42% who reported positive results, many were found to be employees of Fig, or MedSculpt [lipo centers], another large lipodissolve provider, according to an internal audit of reviewers' Internet provider addresses....

“Some things women do in the name of beauty are really frightening," said Linda Wells, editor in chief of Allure magazine, which recently ran an article critical of injection lipolysis. “Everyone is in a dramatic hurry to look better, younger and thinner. That accelerated drive, combined with the profit motive of some healthcare professionals, can be [a] very dangerous combination. Lipolysis falls under that heading.

Despite the lack of safety and efficacy data or FDA approval, and even despite the horror stories, is it stopping women desperate for thinner thighs and tummies?