NEWSLETTER December 2008
Medical Director of the NETWORK, MR Dr. Franz Hasengschwandtner,
reviews the current status of research...|
As a therapy, injection lipolysis (IL) has developed
enormously since 2003 thanks to the activities of our members and the
work of several universities.
This review has the aim of
briefly summarizing the current state of the art.
- The protocol developed by NETWORK-Lipolysis has been
list of contra-indications has been adjusted each year in line with the
latest insights; the patient anamnesis form is now in Version 8.
list of indications is acquiring clearer form,
thanks also to the feedback from our members. Today, we can describe
the indications for liploysis as follows:
indications that produce particularly good results:
indications with variable results:
- Nasolabial groove
- Axillary folds
- Saddle Bags
- Upper arms
- Pseudogynaecomasty (lipomasty)
- Skin tightening
NETWORK maintains a hotline for dealing with urgent questions and also
a complications management system, even through our rate of
complications is very low (0.00175%).
- 3 publications on the issue of safety based on
retrospective studies by NETWORK members and by the NETWORK itself have
already been published. A further publication is currently in
- The compound developed by the NETWORK has proved
its efficacy. The side-effects have been reduced.
- Publications and studies
A total of 12
publications have appeared in prestigious medical journals in the
course of the last 3 years.
the topic of lipoma, a team at Bochum University around senior
physician Dr. Hoffmann and Dr. Falk Bechara has already produced 2
publications; a 3rd publication is due to appear in the near future.
- It should be noted at this point that there is 1
study published by Prof. Daisy Kopera of Graz which comes to the
conclusion that lipolysis does not work. Both at the NETWORK and in
university circles there are serious doubts concerning this study – not
because the outcome doesn’t suit us but because in our opinion the
study design was such that it would inevitably produce redundant
- In contrast to this, an as yet unpublished study by
Prof. Schuller-Petrovich of Vienna states that the active substances,
polyenylphosphatidylcholin (PPC) and desoxycholic acid (DOC), massively destroy
all the cells. Also in the case of this study, we suspect that the
design does not meet the necessary standards. However, it will only be
possible to say more once the study has been published.
- In an animal study involving New Zealand rabbits,
S.Klein, L. Prantl et al. of Regensburg University have demonstrated
that Lipostabil can reduce fat. The results of the study have already
been published. (Note: PPC and DOC are the correct chemical abbreviatians, PC and DC are often used in literature and in US)
- In cooperation with the Institute for
Pharmaceutical Technology (Dr. T. Blunk, A.Seitz), S.Klein, L.Prantl et
al investigated both the individual substances and the combination of
active substances contained in Lipostabil on live fat cells in vitro.
The study is already completed, and a publication with the results has
been submitted. Without wishing to anticipate the results, it can be
stated that for the first time they furnish evidence-based proof of
study on the subject of cellulite by Prof. Nor El-Din of Cairo
University is currently in progress. The goal of the study is to
further improve the results of the IL 3-step therapy through
- Already completed and due
for publication in the near future is a study by Prof. Hanan Elkahki of
Shams University in Egypt on the topic of skin tightening using IL
- 2 further studies have not yet started but have
either been already approved by the Ethics Commissions or are due for
assessment by the responsible Ethics Commission. One, under Prof. Roy
de Vita of Rome University, relates to the treatment of buffalo hump in
HIV patients, the other, conducted by Regensburg University under the
leadership of Dr. Lukas Prantl, investigates the treatment of smaller
cushions of fat in vivo.
- Summary of
the current state of the art
evidence, we can state today that the cell membrane of adipocytes is
destroyed by certain substances and substance combinations; we can also
state what those substances are. It should, however, be noted that by
no means all of the processes that take place have already undergone
evidence-based analysis. We can see this from the feedback of our
members concerning unusual results. These take the form of questions on
specific results to which we are not yet able to provide answers. I
would like to present these open questions at this point, also as a way
of showing that a great deal of work still awaits the NETWORK and its
members and that there are still many mysteries waiting to be
the cell membrane is dissolved, why do different patients respond at
different speeds – some already after only 1 treatment, others only
after 2-5? If no reduction in volume can be determined after the 1st
treatment, is this because the fat that has been released simply stays
put in the region until a certain limit (dosage?) is exceeded that
triggers the impulse for the loose fat to be transported away. The
question also arises concerning the extent to which the substances
employed, as well as destroying the membrane, also have an influence on
removal of the fat through detergent effects.
- Sensitivity to pain varies from patient to patient.
Nevertheless, the pain must be kept within a certain limit that the
patient is well able to tolerate. In a very small number of patients,
however, this limit is exceeded, and we have to ask ourselves why that
is the case and what we can do to prevent it.
- A further issue is the non-responder rate. Our goal
must be to reduce this figure to a minimum. To this end, we need
unequivocal answers to the question as to what factors are responsible
for non-response: the experience of the treating physician, the choice
of patient, mental or physiological factors, diagnosis and anamnesis,
consistency of the fat, or simply the number of treatments given, i.e.
whether these patients really are non-responders or “simply” therapy
- The process of metabolization is also theoretically
understood, but so far there have been no enzymatic studies on the
process whatsoever. Such studies could also shed further light on many
of the questions raised here.
- The search for new combinations of active
substances is in full swing. We firmly believe that although the
results are already very good, they could be improved still further,
either through reduction in the side-effects or through enhanced
- To what extent the treatment intervals could be
shortened through combination therapies is also a subject of discussion
within the NETWORK.
now has an Online Shop for medical aids and products......
An online shop with interesting aids – now also for
We would like to take this opportunity to present 2 product
lines that are needed by very many physicians offering aesthetic or
multi-injector from meso-relle®
handy aid can be used not only in injection lipolysis and mesotherapy
but also in any other injection treatment in which a larger number of
injections have to be given. The patient feels only “one” prick for up
to 7 injections at the same time. The multi-injector enables the
treatment time to be reduced by more than 50%.
multi-injector is available in several versions:
» 3 way out, linear, for 3 needles
5 way out, linear,
for 5 needles
5 way out, circular, for 5 needles
7 way out, circular, for 7 needles
needles for aesthetic treatments
thinness of the wall and the special shape of the point of these
needles in combination with an extremely smooth surface and very fine
silicon coating reduces the pain for the patients significantly.
The needles are available in various lengths and diameters,
from 4 mm to 25 mm in length and from 27 G to 32 G (0.4 mm – 0.26 mm)
These needles can especially optimize botulinum
toxin A treatments
El Kahky of Egypt recently concluded a study into the subject of skin
tightening through injection lipolysis. The study is due for publication
in the near future...|
||We only very
recently incorporated skin tightening into the spectrum of NETWORK
indications after being informed by many members that skin tightening
treatment using IL can bring highly successful results provided the
correct technique is used. |
We are therefore all the more pleased that a study on this
topic has already been conducted by Prof. Hanan El Kahki of Ain Shams
University in Egypt. We will report on Prof. El Kahki’s results after
publication of the study.
NETWORK protocol is being increasingly opened towards combinations with
The boom in new treatment apparatuses for skin tightening or
body contouring is continuing unabated. We receive offers involving new
devices almost every day. We are no longer able to assess all these new
We have therefore adopted the following attitude
towards the introduction of new products:
like at this point to briefly clarify our NETWORK philosophy and
approach towards equipment manufacturers. In view of the rapid
development in the medical apparatus sector, it has become very
difficult, if not indeed impossible, for the NETWORK to make
unequivocal recommendations either for or against.
therefore adopted the following course, which in the last few months we
have consistently pursued: We are fundamentally prepared to enter into
cooperation if we can obtain special terms from the manufacturer for
our members or if, as a result of recommendations by members, we
believe a product probably offers a certain benefit for all members.
Not every device is suited for every medical practice and every range
of treatment; our aim is, therefore, to provide the individual members
with carefully compiled information that will enable them to decide for
themselves what combination is best for their particular situation.
We therefore appeal to our members to send us user reports
with the relevant treatment protocols.
new Lipolysis Report is in progress, first results.....|
3 months ago, we released an extensive questionnaire for our
members relating to the outcomes of injection lipolysis treatment. So
far, over 100 members have completed the questionnaire, and in so doing
documented over 55,000 individual treatments. However, this volume of
treatments is still not sufficient for us. Our goal is to be able to
document 100,000 treatments worldwide. This target is not unrealistic
if it is considered that there are over 900 members actively
cooperating within NETWORK-Lipolysis. The aim of the survey is to
obtain statistical data on safety aspects, but also on the efficacy of
the therapy, complications that have been found to occur, etc.
is planned through a number of members of the Medical Advisory Board.
you would like to get to know the lipolysis therapy better, you have
the opportunity at many congresses all over the world to learn
something about it....|
Master Course on Aging Skin
11th Annual Meeting - 8-11th January 2009
MR Dr. Franz
Prof. Hanan El Kahky, Egypt
Bernard Mole, France
and Dermatology Conference
11–13th of January 2009 - Abu Dhabi,
Birthe Sauter-Jenne, Germany
7th ANTI-AGING MEDICINE WORLD CONGRESS
to 21st March 2009 - Monte-Carlo, Monaco
MR Dr. Franz
|... to be continued.|
congress programmes are updated from time to time. Take a look in now
and again and download the latest version. THANK YOU!
For programs and registration
please contact our Registrations Manager,
+49 (0)25 06 / 30 61 922
Injection Lipolysis Therapy
Germany (German language)
France (French language)
Frankfurt/Main, Germany (English language)
Germany (German language)
Seoul, Korea (English language)
Pitoach, Israel (English language)
Frankfurt/Main, Germany (German language)
City, Mexico (Spanish language)
... and more to come (visit our "Workshops"
|In case of questions
please send us an e-mail
or call us at +49 (0)2506 / 3061901.
You are also welcome to visit our website.