Lipo Medicamentosa

Aplication of phosphatidilcoline as a lipolitic

Phosphatidilcoline is a membrane phospholipid that actively participates in the structure and in cell transportation. It is indicated, mainly, in the treatment of fatty embolia endovenously and hypercholesterolemia. Some years ago the empiric use of phosphatidilcoline was introduced for the subdermic treatment of palpebral bags, abdominal area, sides and throcanteric region showing excellent clinical results in the reduction of local fat.

Phosphatidilcoline

Phosphatidilcoline is the main phospholipid in mammals and it represents the largest proportion in the composition of the cell membranes. At the end of the 1980’s phosphatidilcoline began to be used in intrainjurial infiltrations in xalantelasms with satisfactory results.

These motivating results led to indiscriminate use of phosphatidilcoline in the brazilian aesthetic area without really knowing the biochemical mechanisms involved in the clinical effects and without necessary trials to confirm scientific findings.

Aesthetic applications of phosphatidilcoline

The aesthetic indications for the use of phosphatidilcoline are limited to small deposits of localized fat in patients with ideal weight or minimal overweight. In cases of moderate overweight and obesity we indicate phosphatidilcoline as a complement to diet and physical activity treatments.

It is important to notice that the isolated treatment with phosphatidilcoline does not make you lose weight, it only shapes the body contour.

This treatment should never be indicated to patients such as: children, pregnant women, women who are breastfeeding and diabetic patients with microangiopathy.

The body areas allowed for the treatment are: tummy, waist and sides, hips, lower part of thighs, inner side of thighs and knees, pre-axilar and inner sides of arms. Some regions require skillful and careful appliction such palpebral bags and underchin region.

Procedure

The application technique is the subcutaneous infiltration , not the subdermic one (mesotherapy); the substance is directly injected in the fatty tissue

The duration of the treatment varies and it depends on the patient’s response. In a body treatment 5 to 10 sessions may be necessary, in a chin treatment 2 to 4 sessions and in palpebral bags 2 to 4 sessions. In Body treatments, some professionals prefer to have fortnight sessions with a higher dose of phosphatidilcoline ( 4 250mg/5ml ampoules per session)

Adverse reactions and complications

Among adverse reactions, local reactions are the usual ones, some are immediate (rush, itching, heat or blushing) or after hours or days (intense edema, pain, bruises) they may persist for days or weeks (edema,esquimosis, nodules). Generally pain may last 3 to 4 days and edema may persist 1 to 3 weeks.

Eventually some colinergic sort of reactions may arise such as abdominal pain, diarrhea, salivation, nausea or excessive perspiration. Reactions at the central nervous system level such as anorexia or depression are rare.

Some cases of menstrual alterations or amenorrhea have been mentioned.

Serious sensitivity reactions are rare

Final considerations

Some guidelines may help the patient obtain a better respose to the treatment such as having a light diet and drinking plenty of fluids during the day of the treatment and the following ones, fastening for 1 hour before and after the treatment, the use of compressive pantyhose during 2 to 4 days after treatment (until the major edema is gone).

Lymphatic massage may have a satisfactory action eliminating edema the following two days after treatment.

After the second day other procedures such as ultrasound or tissue massage (Endermologie and others) may help in reducing fatty areas but they are not compulsory to have them along phosphatidilcoline.

Results

Results become visible after the first week ( if edema is gone) with a 0,5 to 2 cm loss in contour. Most patients rhave a good response except a small fraction (approximately 5%) that although they have no pathology associated, do not respond to the treatment satisfactorily.

The final evaluation of the results must be carried out 2 or 3 week after the last session when the edema is totally gone