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    Lipolysis News

    07.11.06 15:21

    Publications of the last year, Oct. 2005 to Oct 2006

    Publications of the last year commented by Dr. Franz Hasengschwndtner

    Since the foundation of the NETWORK-Lipolysis there has been – compared to previous years – nothing short of a boom in new publications on the subject of injection lipolysis.
    As an aid to our readers, I will make an attempt below to describe and comment on these publications. Especially NETWORK members have made a key contribution towards dispelling the uncertainty and mistrust on the part of many colleagues. When our NETWORK started, I made a demand for data and facts to be allowed to speak for or against this new form of therapy, rather than the polemics of its supporters and opponents, and now – some 2 years later – am able to note with pleasure that a good to very good data base has been generated in the meantime. As well as individual studies, there have also been 3 statistical surveys, some of which have already been published.
    However, I am far from wishing to arouse the impression that everything there is to say about injection lipolysis has already been said. The coming years will certainly not see us left with nothing to do. Quite the contrary: We have just initiated a new round of scientific research, whose results we await with enormous interest and which we expect to be able to present in public for the first time at the next congress in September 2007. I also have to express thanks for the many and varied activities of our members, who have concerned themselves with the subject matter on a very high level and, despite hostility from various of colleagues and institutions, have not allowed themselves to be deflected from the route I proposed of gathering hard data material.

    So here, now, are my comments on the publications of 2005 and 2006:

    Publications of the last year, Oct. 2005 to Oct 2006

    • Hasengschwandtner F., Injektionslipolyse heute, Injection-Lipolysis - State of the art, DERMAforum, Oct. 2006, 10:1-2
    • Treacy P.; Goldberg D., Use of phosphatidylcholine for the correction of lower lid bulging due to prominent fat pads, J. of Cosm Laser Ther., Sept 2006; 8:129-32
    • Rein P.: Injektionslipolyse mit Phosphatidylcholin – Erfahrungen mit der “Fett-weg-Spritze“, Der deutsche Dermatologe – Cosmetic Corner, Sept. 2006
    • Salles A., Valler C., Ferreira M, Histologic Response to Injected Phosphatidylcholine in Fat Tissue: Experimental study in a New Rabbit Model Aesth. Plastic surgery Journal, July 06 – 19,
    • Rittes P., Rittes J., Amary M.; Injection of Phosphatidylcholine in Fat Tissue: Experimental study of Local Action in Rabbits. Aesth. plastic surgery Journal, July 06 – 20,
    • Myers P., The Cosmetic Use of Phosphatidylcholine in the Treatment of Localized Fat Deposits , Cosmetic Dermatology, June 2006, Vol. 19.NO 6.
    • Palmer M., Curran J., Bowler P., Clinical experience and safety using phosphatidylcholine injections for the localized reduction of subcutaneous fat: a multicentre, retrospective UK study, JCD 2006, 5, 218-226
    • Hasengschwandtner F., Injection Lipolysis for Effective Reduction of Localized Fat in Place of Minor Surgical Lipoplasty, Aesthetic Surgery Journal 2006;26:125-130
    • Rotunda A., Kolodney M., Mesotherapy and phosphatitylcholine injections: historical clarification and review. Dermatol Surg April 2006, 32:465-80
    • Hasengschwandtner F. Die subc. Injektion von Phosphatidylcholin zum Zwecke der Lipolyse, Akt. Dermatol 2005;31:549-552
    • Duncan D., Hasengschwandtner F. Lipodissolve for Subcutaneous Fat Reduction and Skin Retraction Aesthetic Surg J 2005; 25:530-543.


    Publications in chronological sequence

    • Hasengschwandtner F., Injektionslipolyse heute, Injection-Lipolysis-State of the art, DERMAforum, Oct. 2006, 10:1-2

    Aims: to give a summary of the situation of research and acknowledgement of the medical society - the state of the art of injectable lipolysis with reference to what do we know about how it works.

    Critical concentration of PPC (250 ตM) is required to cause a change in the physical properties of cell membranes which is important for cell bursting and emulsification [S.N. Mathur et al. Biochem. Journal 314-569-565]

    Definition of Lipases (Esterases): they are dismantling emulsified neutral lipids into glycerol and fatty acids by hydrolysis. [Pschyrembel 259.Ed]

    Protection of nerves in lipolysis:
    Sphingomyelin
    exhibits greatly enhanced protection against detergent bile salts (Deoxycholic acid) compared with egg yolk phosphatidylcholine
    Journal of Lipid research 2000; 41:916-24.


    • Patrick J. Treacy, David J. Goldberg, Use of phosphatidylcholine for the correction of lower lid bulging due to prominent fat pads.
    J. of Cosmetic Laser Therapy, 2006, Sept; 8: 129-32

    Objective: An open-label study was conducted in 21 subjects with the goal of reducing the infraorbital fat pad size.

    Methods: Twenty-one subjects were injected with 0.4 ml of PPT every 6 weeks to reduce prominent infraorbital fat pads.

    Results: In all, 74% of the subjects showed significant improvement after two to three treatments. Five of the enrolled subjects (23%) were non-responsive after two or more procedures and their treatment was discontinued. None of the patients had adverse side effects other than mild burning, erythema and swelling at the injection site. Nearly every patient maintained the results with no evidence of tissue damage after 6 months.

    Conclusion: PPc injection into infraorbital fat pads resulted in a satisfactory cosmetic effect in most treated subjects. Most subjects required more than one treatment. This simple, office-based treatment provides a non-surgical alternative to patients with prominent infraorbital fat pads


    • Rein P.: Injektionslipolyse mit Phosphatidylcholin – Erfahrungen mir der “ Fett – weg – Spritze “ Der deutsche Dermatologe – Cosmetic Corner, Sept. 2006
    Injecting-Lipolysis, experience with fat melting injections

    Aim: To show the medical public the history of phosphatidylcholine, the active agents, the network protocol and the different treatment protocols - P. Rittes, F. Hasengschwandtner and others.

    Cosmetic results: over 90% of patients are satisfied with the cosmetic result, reduction of belly-circumference between 4 and 8cm per session.

    Conclusion: because of good results and no side effects, lipolysis will become a standard method for cosmetic fat reducing procedures for the future. Unwanted side effects only could be seen after self treatments of laymen.


    • Allessandra Salles, Constante Valler, Marcus Castro Ferreira. Histologic response to injected Phosphatidylcholine in Fat Tissue: Experimental study in a New Rabbit Model. - Aesth. Plastic Surgery J. 2006, Jul 19

    The authors developed a new experimental model to study injection of substances in fat tissue in rabbits. The objective of this particular study was to verify the possible effects of phosphatidylcholine injected in the animals. Two groups of rabbits received five weekly applications to the dorsal fat pad.
    The removed fat tissue was evaluated 3, 7, 14, and 21 days after the fifth application was completed.
    Necrosis was not observed in any animal.
    On the basis of this study, the injection of phosphatidylcholine is relatively safe, but no effect was observed regarding the reduction of fat tissue volume. New studies with higher doses are needed to justify the clinical use of this substance. (Dosage of that study was not declared?)


    • Patricia Rittes, Jos้ Rittes, Maria Amary. Injection of Phosphatidylcholine in Fat Tissue: Experimental study of local Action in Rabbits. Aesthetic Plastic Surgery Journal 2006, Jul 20

    This study aimed to compare the local action of a phosphatidylcholine formulation with that of a physiologic saline solution in a histologic study investigating the fat tissue of rabbits.

    Methods: Using a randomized, blind approach, 10 rabbits were injected with an experimental assay of phosphatidylcholine (the biologic model), and another 10 rabbits were injected with physiologic saline. A histologic study was conducted, and the Mann-Whitney test was applied.

    Results: A marked difference was observed between the two groups with respect to necrosis, inflammatory exudation, and fibrosis.

    Conclusion:
    Necrosis of the fat cells in all the phosphatidylcholine-injected animals was observed. Further studies should be performed to clarify and determine the mechanisms of action.


    • Paul Myers, MBBS, FRGCP - GB; The cosmetic use of Phosphatidylcholine in the treatment of localized fat deposits, Cosmetic Dermatology, June 2006, Volume 19, No 6.

    Study with 100 patients from November 2004 to April 2005 who underwent lipolytic treatments according to NETWORK-Lipolysis protocol. Injected was pure PPC in a depth of 1cm, 1.5cm apart. Highest dosage 10 vials PPC-2500mg.

    Method: Undiluted PPC was injected; follow up visits at day 30, 60, 90 and 120. Three caliper measurements were undertaken and patients and physicians used a 10 point scale (0 =no improvement, 10 = marked improvement). Areas: face 21%, abdomen 36%, legs 23%, rest other areas.

    Results: Fat thickness reduction 22.8%, improvement score patients – 7.3; improvement score physicians – 7.5;

    Conclusions: It has been shown a relatively safe and effective treatment for reducing localized fat deposits alternative to surgical procedures for fat reduction


    • Palmer M., Curran J., Bowler P., Clinical experience and safety using phosphatidylcholine injections for the localized reduction of subcutaneous fat: a multicentre, retrospective UK study, JCD 2006, 5, 218-226

    Aims of the study: to assess retrospectively treatment outcomes and adverse effects associated with subcutaneous phosphatidylcholine use

    Method: 39 UK and Irish doctors, especially trained and experienced in this treatment completed questionnaires, focusing on outcome and adverse effects experienced by patients.

    Results: 10581 treatments had been administered over a mean duration of 13.1 months. Localized reactions as swelling, reddening etc. were described mostly very mild or mild. Incidence of systemic side effects like diarrhoea, nausea, intermenstrual bleeding was 3%. Only 0.14% unexpected, unusually severe or prolonged reactions were reported. All were self limiting and none were judged as serious.

    Conclusions: The treatment appears to be associated with minimal risks when used by specifically trained and experienced doctors.


    • Hasengschwandtner F., Injection Lipolysis for Effective Reduction of Localized Fat in Place of Minor Surgical Lipoplasty, - Aesthetic Surgery Journal 2006;26:125-130

    The objective of this study was to demonstrate the efficacy of Lipodissolve injections in the reduction of localised fat deposits.

    Methods: 441 patients were included in the study. They received 1-4 treatments of localized fat deposits in various areas using the Network Compound containing phosphatidylcholine, NaCl 0.9%, Buflomedil and Vitamines B.

    Results: fat deposits showed an average circumferential reduction per application f.i. upper belly 3.7 cm, lower belly 3.9 cm, thighs 1.9 cm, upper arms 1.6 cm. Very good success was seen in facial treatments. No patient showed irregularities, dimples or any serious side effect after treatment. No reenlargement of fat deposits was reported during the time of the study.

    Conclusion:
    All patients showed remarkable reductions of the fat deposits treated with Lipodissolve. Using the correct technique, Lipodissolve injections is a safe and efficacious alternative to liposuction on smaller areas for patients objecting surgery. It is not a replacement for a necessary change of life-style, it is no means of weight reduction and is not a therapy to treat obesity in general. The ideal patient is the one with smaller fat deposits which cannot be reduced by exercise and a change of nutritional habits.


    • A.M. Rotunda, M. S. Kolodney; Mesotherapy and phosphatidylcholine injections: historical clarification and review, Dermatol. Surgery, Apr. 2006, 32:465-80

    Objective: To distinguish mesotherapy from phosphatidylcholine injections by reviewing their history and the relevant experimental or clinical findings.

    Methods: A comprehensive search of Medline indexed literature and conference proceedings.

    Results: All the published studies evaluating the clinical efficacy of traditional mesotherapy currently originate from Europe. These reports focus primarily on musculoskeletal pain and vascular disease, rather than cosmetic applications. Although experimental data suggest that a number of traditional mesotherapy ingredients may theoretically reduce fat, these effects have not been supported in peer-reviewed studies.

    Conclusions: An increasing number of reports demonstrate that subcutaneous injections of a formula containing phosphatidylcholine combined with its emulsifier, deoxycholate, are effective in removing small collections of adipose tissue. Mesotherapy is distinct from a method of treating adipose tissue with subcutaneous injections of phosphatidylcholine.


    • Hasengschwandtner F. Die subc. Injektion von Phosphatidylcholin zum Zwecke der Lipolyse,
    • The Subcutaneous Injection of Phosphatidylcholine for Means of Lipolysis; Akt. Dermatol 2005 Nov. ;31:549-552

    Aim of the publication was to prove the efficacy of the treatment in the reduction of volume of smaller fat deposits.

    Method: Explanation of phosphatidylcholine, explanation of the formula and the role of unsaturated fatty acids, explanation of the possible mechanism.

    Conclusion: The non responder rate lies at the beginning at about 5%, the more experienced the administering physician, the better the results. NETWORK-Lipolysis controls at the time of that study about 18.000 treatments without any serious or non expected side effects.
    Lipolysis seems to be a safe and costs-saving method to reduce smaller localized fat deposits.


    • Duncan D., Hasengschwandtner F. Lipodissolve for Subcutaneous Fat Reduction and Skin Retraction; Aesthetic Surg J 2005; 25:530-543.

    The primary goal was to determine the efficacy and safety of the Lipodissolve formula and technique in achieving both, fat reduction and smooth skin retraction in areas of localized fat deposition.

    Method: 43 patients have been injected in a total of 117 injection sites, all but one was within 15% of ideal body weight, none was obese.

    Results: Documented reduction in localized fat deposits and/or accompanying skin retraction was seen in 42 of the 43 treated patients. The best results were achieved in patients who were close to their ideal weight and needed improvement in a small, focused area. Surprisingly good results were obtained in patients who had a combination of subcutaneous fat and skin laxity.


    Current studies:

    University of Regensburg:
    • Aim
    of the study is to investigate the last secrets behind the fat melting effect with scientific methods.

    • Thesis paid by NETWORK members
    Step one has started, first results are known.
    Scientific research on three dimensional fat cell structures, exploration of the most effective substances and mixtures for fat-melting. Investigations about the biochemical mechanism of fat melting after phosphatidylcholine injections.
    Step two: based on the findings of step one – animal trials
    Step three: study on human beings controlled by ethic commission. Publication of intermediate findings


    University of Bochum
    Prof. Altmeyer, Dr. Hoffmann, Dr. Bechara

    1st study about the efficacy on lipomas – is ready and will be published soon
    The 2nd study is a comprehensive histological and immuno-histochemical investigation of human fat-tissue and the reaction of it after Lipostabil injections. Will be published soon as well.


    • University of Cairo, Prof. Nour El Din
    Cellulite treatments – study just beginning


    • University of Rome, Prof. Roy de Vita
    Study about the possibility of reduction of deformities of lipodystrophies after antiviral therapies (Buffalo hump) on AIDS patients.


    • Safety study in the USA for FDA acknowledgement - is ready and will soon be published


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    Pictures Congress 2006









    Chinese Impression




    Dirk Brandl, Dr. Carey Lee and Dr. Swapan Chowdhury (AUS) in front of the clinic of Dr. Lee

    First scientific theory on injection lipolysis:

    Title:
    Evidenced Based Practice: Phosphatidylcholine

    A Review of Evidence for the Mode of Action in Injection Lipolysis

    Author:
    Ninian Peckitt, M.D.

    Injection Lipolysis is a popular cosmetic procedure involving the subcutaneous injection of phosphatidylcholine (PC) - Lipostabil N ฎ. This publication is an independent review of applied phospholipid biochemistry, plasma membranes, cell lysis and apoptosis.

    For further information click here.

    Type:
    Paperback - 246 x 189mm - 160 pages colour

    Price:
    128.00 € + shipping

    To order:
    please click at the cover



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