Aspen, Colo. – At the summer Cosmetic Bootcamp (CBC), Chytra V. Anand, M.D., said that best practices for injectable lipolysis include injecting subcutaneously and performing combination procedures. She is a celebrity cosmetic dermatologist at Bangalore and Chennai-based Kosmoderma Clinics in India.
In India, physicians use a combination of phosphatidylcholine (PC) and deoxycholate (DC). When injecting, “You must stay subcutaneous. PC widens the cell membrane, then the DC penetrates through and allows the fat to be cut from the cell,” before being dissolved and transported away.
In India, “We also add L-carnitine. You advise the patient to stick to a diet, and often it’s not happening. For every 20 mL of PC-DC, we add 5 mL of liquid L-carnitine.”
With injectable lipolysis, said Dr. Anand, physicians must caution patients about bruising. “For bruising and edema, up to 5 days is great, but 2 weeks is typical.” She showed a patient photo revealing postinflammatory hyperpigmentation in the thigh area post-procedure. “PIH can happen, especially if patients have cellulite in this area.”
The typical Indian patient requires combination therapy, she said. In one patient who had significant hypertrophy, “I used PC-DC in the submental area, then radiofrequency microneedling for skin texturing and to give a lift to that bulky tissue.”
She also injected hyaluronic acid in the submalar area for chin augmentation, and into the malar area for subtle cheek lifting. Additionally, she used low-dose neuromodulators for the parotid area and masseters. “We normally use 30 to 40 units per side for masseter reduction. But I would use something like 10 units per side because I want to soften the masseter, not take it away and leave a lot of jowling and bulking of the tissue into the central face.”
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