LipoDissolve, or the introduction of a chemical formulation by injection to treat spot areas of undesired fat for cosmetic purposes, remains a controversial and non-FDA approved procedure at this point in time. Despite these issues, I have found in the past 3 years in my practice a role for LipoDissolve if it is used judiciously and with good patient selection. I have not experienced any of the complications or problems that I have read about on the internet and I suspect that rigid patient selection, keeping the injections less than 100 per session, and good sterile technique are the reasons why. One application that I have found LipoDissolve injections particularly useful is in the treatment of lipomas.
Lipomas are fatty tumors that can appear anywhere on the body from the scalp to the legs. They are soft, easily moveable (non-adherent) masses beneath the skin that are always round in diameter. They are usually right under the skin and are very slow growing. Most patients seen usually just have one in isolation. There are, however, some patients who have a familial lipomatosis syndrome in which they develop many lipomas throughout their body continously over their lifetime. Lipomas are traditionally treated by excision which removes them in their entirety, establishes their pathology by visual and microscopic examination (if sent to a pathologist) and leaves a residual scar.
In some locations, and at the desire of some patients, a scar is not wanted nor is any type of surgical procedure if possible. LipoDissolve offers a non-surgical alternative to traditional excision for some lipomas. If the excision will leave a scar over a prominent area (e.g., the shoulder of a woman) and you are fairly certain that the mass is a lipoma by examination and history, then injection treatment are an option. I have found that full-strength LipoDissolve injections can work quite well in the nearly 15 lipomas that I have treated thus far in the past two years.
The concept is that it is a series of injections, spaced four to six weeks apart, to either reduce the size of the lipoma or completely remove it. In the nine patients (14 lipomas) that I have treated, the average number of injection sessions is nearly 5 (4.8) per patient.
This does not take into account that the largest of the lipomas that I have treated (14 x 10 cms) took eight injection sessions while very small ones (2 x 2 cms) may take only one or two injections. Patients will experience a large amount of swelling for the first week and some discomfort which is typical but not lifestyle-limiting. Since lipomas represent a concentrated nucleus of fat, it is not surprising that LipoDissolve injections can be effective.
Its use, however, is not as efficient as surgery (and insurance does not cover the procedure) but it does save a scar and, in large lipomas, the risk of a fluid build-up after surgery or the need for postoperative drains. Before treatment, one has to be fairly certain that the mass is indeed a lipoma. An MRI may be done if necessary to establish the diagnosis in larger lipomas.
I have not yet seen a recurrence in any lipomas that I have treated but it is too early to be absolutely certain of that in my present patient series.
Dr Barry Eppley, board-certified plastic surgeon of Indianapolis, operates a private practice at Clarian North and West Medical Centers in suburban Indianapolis. He writes a daily blogs on topics and trends in plastic surgery at http://www.exploreplasticsurgery.com
