Redness and burning pain may occur in the treated areas. These side effects can last for 2-3 days.
Targeted fat burning
Targeted fat burning: Not possible without intervention
Patients who specifically want to get rid of their double chin or lose their abdominal fat, but are otherwise satisfied with their physical appearance, have long been faced with a dilemma.
After all, it is not possible to specifically boost fat burning in “target areas” such as chin, belly or hips.
It is true that you can force yourself into an energy deficit through diet and exercise and thus generally burn more fat.
But it is not possible to predict with certainty which fat pads the body will tap into in order to release stored energy, and whether you are more likely to lose belly fat, get rid of your excess double chin or whether thick upper arms will appear firmer.
However, for those who wanted to do just that, the only option left was liposuction, a quite severe surgical intervention with corresponding risks and hefty costs.
The alternative: fat removal by injection
For a long time, alternatives have therefore been researched and found in the non-surgical fat-removal by injection. The injection of fat dissolving agents can remove local fat without surgery.
Non-surgical fat reduction follows the same natural process that is behind the body’s own fat burning.
This explains why the fat-removal by injection has not led to any serious complications since its approval, and why I have had only positive experiences with the fat-removal injection in my practice in Munich since 2017.
In medical terms, the proper name for the procedure is “injection lipolysis”. Lipolysis (fat dissolution) describes the natural process of fat burning. It is normally controlled by the hormones insulin and adrenalin.
Lipostabil: Fat dissolving power made from soya beans
In fat-removal by injection, on the other hand, an active ingredient combination of lipostabil and deoxycholic acid is used.
The latter is a bile acid and first dissolves the fat cell membranes so that lipostabil, which is similar to lecitin and is extracted from soybeans, can bind to the exposed fat and transport it to the liver. Where it is then metabolized in the exact same way as in natural fat burning.
Natural fat dissolution takes time
B ecause fat-removal by injection mimics the natural process of lipolysis, it does not produce dramatic results overnight. For visible results, more than one session is required, usually between 2 and 4.
This may be seen as a disadvantage. However, you will realize that natural fat burning takes time. After all, you are spared a risky and costly surgical procedure. Especially for people of normal weight, the non-surgical alternative is an interesting option.
Injection lipolysis is suitable for various problem areas of the body: in addition to the double chin as a classic application, it can also be used to specifically lose abdominal fat, tighten thick upper arms or reduce lipomastia (male breasts) in men.
Getting rid of abdominal fat, removing a double chin
The possible applications of fat-removal by injection are versatile, as long as local fat tissues are concerned.
For example, while I have recently had good experience with treating patients on the mons pubis, the attempt to reduce fat across the entire lower abdomen would probably be an equally complex and unpromising undertaking.
This should make it clear that fat removal by injection is not always suitable to replace invasive techniques such as liposuction.
Instead, it is an excellent alternative for patients who want a minimally invasive treatment of localised body areas, as is the case with the double chin in particular.
My own experience with non-surgical fat removal
In my 3 years of personal, medical experience with fat-removal by injection, I treated mainly patients who wanted to get rid of their double chin.
In terms of numbers they are followed at a considerable distance by patients who want to get rid of excess abdominal fat (mainly men). Isolated cases involved thick upper arms (women) or lipomasty (men’s breasts).
I usually do not perform the procedure on larger problem areas because in my experience this is neither promising good results nor is it cost effective.
For example, extended forms of “saddle bags” are in my experience better treated with liposuction than with fat removal by injection.
There is no downtime involved. However, a frequently observed side effect consists in burning pain and/or itching in the treated areas. This can last for several hours or even 2-3 days, and as such could represent an obstacle in your undertakings.
Fat removal by injection costs around 190 euros per ampoule. This is a guideline value based on my professional experience with patients to date. Cost calculation of the individual case follows the rules of the German code of fees for physicians (GOÄ).
Fat-removal by injection is fast, simple and, according to all published experience, without major complications.
The two active ingredients, lipostabil and deoxycholic acid, are first drawn up in equal parts in a 10ml syringe.
The area to be treated is cleaned and disinfected. Usually it is also superficially anaesthetized with a local anaesthetic (lidocaine). The application time is about 20 minutes.
Afterwards, the mixture of active ingredients is injected directly into the fatty tissue using very fine needles. The injection itself takes only a few minutes. And then that’s it.
Additional fat burning after 10-14 days
Fat burning usually begins after 10-14 days. Fat loss reaches its peak in the 4th to 6th week after the treatment. Now the first results should be visible. Those for whom they are not enough and who want to lose even more abdominal fat or more clearly get rid of their double chin can now plan a follow-up treatment.
Cosmetic additional effect of the treatment: The injections and the resulting micro injuries of the tissue cause an artificial inflammation. It stimulates the new formation of collagen fibres and thus additionally contributes to the tightening of the skin.
Burning fat in a natural way takes time. For an optimal result, therefore, up to 4 treatments at intervals of 6-8 weeks are usually necessary. According to recent findings, shorter intervals are not worthwhile.
Lipostabil and deoxycholic acid, the active ingredient combination used in fat-removal injections. Here still in separate ampoules.
The active ingredients
Fat-removal by injection involves a combination of 2 active ingredients, the so-called “Network Compound”.
The main component is the active ingredient Lipostabil (trade name), chemically known as phosphatidylcholine.
Deoxycholic acid opens the fat cells
Additionally, there a substance called deoxycholic acid gets injected. This is a bile acid.
In the combination of active substances it has the task of dissolving the membrane of the fat cells, so that the other ingredient lipostabil can penetrate the cell and transport the fat into the liver.
Deoxycholic acid has many other applications outside this procedure, for instance the dissolution of gallstones or the treatment of certain liver diseases. It is also said to have an anti-inflammatory effect.
Deoxycholic acid is the main component of Kybella, an FDA approved product for fat-removal by injection in the USA.
Lipostabil transports fat from the cells into the liver
Lipostabil was discovered as a natural drug as early as 1959 and was soon used for a variety of therapeutic purposes involving accelerated fat burning.
Main applications of Lipostabil are still today the use as liver protection preparation, cholesterol reducer or for the prevention of fat embolism.
The substance phosphatidylcholine is registered in 53 countries as a drug or food additive. The raw material for its production are soybeans.
Since lipostabil has a cholesterol-lowering effect, fears that the fat-removal injection would increase cholesterol levels were unfounded from the outset and eventually dispelled in studies.
Instead, the exact opposite was observed: subjects who entered the study with a (slightly) increased cholesterol level showed a decrease after treatment.
Lipostabil is chemically related to lecithin. In the human body, phosphatidylcholine is the most important essential phospholipid besides the sphingolipids. It is a major component of all human cell membranes and the lipoproteins circulating in the blood.
Also used in cosmetic products
Its excellent ability to form stable lipid membranes makes phosphatidylcholine a substance that is also indispensable in numerous cosmetic products, especially skin creams.
There it forms so-called liposomes, microscopically small vesicles consisting of several lipid layers which are stored around an aqueous core. Liposomes provide cosmetic products with particularly skin-friendly and caring properties.
For fat reduction in the lipolysis treatment, the active agent combination of lipostable and deoxycholic acid initially causes the dissolution of the membranes of the fat cells.
Then the lipostabil binds to the fatty acids stored in them, thus creating the smallest fat droplets which are transported out of the cell and then metabolized in the liver.
Overweight? Better follow a nutrition plan for sustained fat loss
The answer clearly is: No. Fat removal by injection is not a substitute for a diet.
If you want to reduce weight in the long term, for medical or other reasons, then you must use a dietary plan to reduce fat.
Whatever the plan is, whether you want to reduce fat quickly or slowly, whether it follows a certain diet philosophy (low carb, mediterranean, keto, etc) or simply focuses on a general reduction in food intake: The only important thing is that a permanent reduction in calorie intake is achieved.
Injection lipolysis only for reduction of local fat tissue
With injection lipolysis, you can have local fat tissue successfully removed. Such as belly fat or double chin. No more and no less.
But if you want to achieve sustained fat loss, you will have to change your eating habits and adopt a healthy lifestyle in general.
Otherwise, the excess calories that you continue to supply to your body will simply be stored in other fat deposits than the ones dissolved by injection and you will have gained nothing.
Boosting fat burning with sport
From a medical point of view, the best alternative if you want to get rid of your abdominal fat in the long term is therefore always more exercise and a healthy diet.
This is also generally true if you are already slim but have further aesthetic ambitions.
So the athletic men in my gym always say: “Six-packs are made in the kitchen and not in the gym”. In other words: a reasonable diet is the key to getting to the point where it pays to have residual excess fat removed by medical intervention. Only then should it be really considered.
Injection lipolysis is an excellent way to get rid of the last traces of excess belly fat that might still be bothering you. Or get rid of the annoying double chin, which stubbornly resists even the strictest diet.
Getting rid of lots of belly fat cheaper with a diet plan
Ultimately, fat reduction is of course also a question of cost. Because for every gram of fat that you lose through diet or exercise, you don’t have to pay the cost of medical intervention.
And if you want to get rid of several kilos of abdominal fat, then fat removal by injection would definitely be an expensive undertaking. Losing larger amounts of fat through a diet is not only more effective but also much cheaper. If you do some exercise on top to boost your fat burning, then all the better.
Reduce fat with a suitable nutrition plan
Although this website is not a place for dietary recommendations, I would like to encourage all those who think that diets do not promise success, take too long or cannot be kept up with. You would be surprised at how little calorie reduction it takes per day to lose considerable amounts of fat in the long run. Often not more than 200-300 calories per day -that is just 1-2 rolls!
Likewise, diets need not last long if you follow them consistently. In my gym there are men and women who burn fat extremely fast with radical protein diets. Within 2-3 months. Regularly every year, before the summer season.
I don’t suggest that this would be healthy and a sensible thing to do. But if that is what you want, than certainly a diet of such kind will produce much better results than fat removal by injection and even liposuction.
Thus, if your goal is to get rid of your belly fat as quickly as possible, a strict dietary regimen is certainly an interesting option to look at.
You shouldn’t kid yourself: Losing fat in a process that mimics natural dissolution takes time.
Therefore, fat loss by means of injection lipolysis takes longer than the mechanical removal of fat cells in a liposuction.
After each treatment, it takes 1-2 weeks until the active ingredients yield first results. Only then is the fat reduction in full swing. And it will take another 3-4 weeks until results become fully visible.
Repeated treatments for best results
Moreover, one single treatment usually is not enough. Optimal results with the fat away injection typically require 2-4 sessions at intervals of 6-8 weeks. With only one treatment you will neither get rid of a double chin nor of abdominal fat.
However, even with liposuction, it takes about 6 months before the results are fully visible. In a similar period of time, comparable results can also be achieved with the fat removal injection. Especially in sensitive areas of the body, where liposuction may not be an option anyway.
The Lipolysis Network is an international association of physicians who have been instrumental in the development of the therapy.
The network was formed during the early days of lipolysis, when the active substance lipostabil, already known from other medical applications, was applied to fat dissolution for aesthetic purposes.
The experts of the network are still working on the further development of the therapy today.
In addition, they are doing research on several fields of therapeutical applications and document their results for statistical purposes. Furthermore, they also organise training and certification for interested medical professionals.
The roots of the Lipolysis Network can be traced back to the origins of the therapy, as briefly shown in the following review:
In 1988 the Italian physician Dr. Maggiore reported for the first time on the dissolution of fat cells (lipolysis) with the help of the drug Lipostabil.
In 1995 the Brazilian dermatologist Dr. Patricia Rittes followed, who successfully reduced fat in her eye region in a self-experiment using lipolysis.
More recent research and studies with phosphatidylcholine began in Europe in 2001. The first treatments with the fat-removal injection were carried out on a large scale from the end of 2002.
Since then, the fat-removal injection has been successfully used to reduce fat in thousands of people, especially in South America. Since about 2000, the procedure has also been widely used in Europe.
In 2003, doctors from several countries joined together to form the Lipolysis Network in order to jointly promote the development of the procedure and to offer training and further education measures.
I have also been a member of the Lipolysis Network since 2017 and contribute my practical experience with the fat-removal injection on a regular basis.
The experience of the Lipolysis Network in hundreds of thousands of applications has been consistently positive.
The active ingredient combination of lipostabil and deoxycholic acid generally proves to be reliable and largely free of side effects.
However, each individual patient is a complex psycho-physical system in itself. As with any other treatment, the individual effect of the procedure can therefore neither be 100% predicted nor guaranteed.
The success of the treatment depends very much on the consistency of the treated fat pads.
About 85% of the treated patients are very satisfied with the result of the treatment after 2-3 sessions. They were actually able to visibly get rid of their double chin or lower abdominal fat as they were told they would.
In contrast, few patients (approx. 5%) showed little or no reaction. The doctors of the Lipolysis Network are continuously investigating these therapy failures and adjusting the protocol where necessary.
My own experiences with injection lipolysis since 2017 have also been consistently positive. The success rate of the treatment for my patients in Munich is almost 100%. All my patients were satisfied with the results, mostly after 3 sessions, in a few cases after 4.
However, I also only treat cases that involve locally isolated fat deposits. My main applications are double chin, fat on the upper arms, lower abdominal fat and mons pubis. In these zones with clear definition and limitation, injection lipolysis has proven to be very effective.
However, I can also never give a 100% treatment guarantee for the reasons mentioned above.
In the following regions, the Lipolysis Network has spoken out against treatment with injection lipolysis:
Face: lachrymal sacs Body: Inside knees, ankle
However, a survey among members of the Lipolysis Network showed that a significant number of them perform treatments on the knee. And apparently with success.
It is still open whether this will lead to a change in the Lipolysis Network’s therapy recommendations for the future.
As far as the upper face is concerned, the use of fat removal interventions requires a sense of proportion and special caution. The fat pads of the face contribute significantly to a fresh appearance and a healthy overall look.
Fat removal by injection is generally a very safe procedure.
According to statistics, only 0-1 per thousand patients treated have complications, almost all of which are reversible.
Principle risks: Abscesses and necroses
The principal risk of injection lipolysis is the formation of abscesses and necroses.
However, abscesses have only been observed when a very large number of injections had been administered without proper hygienic precautionary measures (such as working strictly in sterile conditions).
In the reality of regular treatments, however, the risk of abscesses seems rather negligible. Routine treatment of the double chin, for example, does not require more than 20 injections, which is far below the number where complications were observed.
The principal risk of necrosis is that the active ingredients in the fat-removal injection are not only effective in fatty tissue. They can also destroy neighbouring skin cells. However, necroses occur even less frequently than abscesses: in one of 10-20,000 patients.
No tight clothing and no sports after the fat removal injection
Obstacles in the blood’s microcirculation have been identified as a major cause of necrosis. Patients who wore tight jeans after the treatment or were driving for several hours in a car were among those primarily affected.
Another cause of necrosis can be statistically determined as physical overexertion after treatment. For example, those affected had gone on long walks or went directly from the doctor’s office to the gym.
In summary, it can be said that serious complications with the fat-removal injection are extremely rare, and if they do occur, they can be attributed to irrationality on the part of the patients or a lack of information on the part of their therapists.
In my own previous practice with injection lipolysis, there has never been a single case of complications.
What does fat removal by injection cost?
The approximate cost for a treatment with injection lipolysis (10ml of active ingredients) is around 190 euros (incl. VAT).
According to my experience with patients to date, this translates into the following, exemplary reference values (per session, incl. VAT):
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