Noninvasive Submental Fat Compartment Treatment

Shamban, Ava

doi:10.1097/gox.0000000000001155

Cited by 22 publications

(28 citation statements)

References 9 publications

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“…Figure 5 summarizes the relationship of the MOA of ATX-101, the development of injection-site inflammation, and clinical efficacy. 5,21,22,26,28,[30][31][32] As described earlier, injection of ATX-101 results in adipocytolysis, with destroyed adipocytes no longer able to store or accumulate fat. 16,17,31 Adipocytolysis and the release of cell contents and membrane fragments elicit a mild, local inflammatory response, resulting in neutrophilic inflammation and attracting macrophages.…”

Section: The Links Between Mechanism Of Action Injection-site Inflamm...mentioning

confidence: 82%

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Submental Area Treatment with ATX-101: Relationship of Mechanism of Action, Tissue Response, and Efficacy

Humphrey¹,

Yoelin

Friedmann

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: ATX-101 is an injectable, synthetically derived formulation of deoxycholic acid used for submental fat reduction. Methods: A narrative review of references relevant to the mechanism of action of ATX-101 and its relationship to efficacy and inflammatory adverse events was conducted. Results: When injected into subcutaneous fat, deoxycholic acid physically disrupts adipocyte cell membranes, leading to local adipocytolysis, cell death, and a mild, local inflammatory reaction consisting of macrophage infiltration and fibroblast recruitment. At Day 28 postinjection, inflammation largely resolves, and key histologic features include fibrotic septal thickening, neovascularization, and atrophy of fat lobules. Based on the mechanism of action of ATX-101 and the demonstrated inflammatory response, localized inflammation and swelling are expected following treatment. Indeed, postinjection swelling and other local injection-site events, including pain, erythema, and bruising, are common during and after treatment. Because of inflammatory sequelae following injection, reduction in submental fat is gradual and may require months before the full response is apparent. Patients may also require multiple treatment sessions to achieve their treatment goals. Repeated treatments may result in less pain and swelling over time owing to a combination of factors, including less target tissue allowing for lower doses/injection volumes, persistent numbness, and greater tissue integrity from thickened fibrous septa. Conclusions: Physicians can manage expectations by counseling patients that, based on the mechanism of action of ATX-101 and data from pivotal clinical trials, ATX-101 treatment results in localized inflammation/swelling and gradual submental fat reduction. Patient education about common local adverse events is critical.

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Section: The Links Between Mechanism Of Action Injection-site Inflamm...mentioning

confidence: 82%

“…Relationship of mechanism of action, injection-site swelling, and clinical efficacy. 5,21,22,26,28,30–32 …”

Section: The Links Between Mechanism Of Action Injection-site Inflamm...mentioning

confidence: 99%

Submental Area Treatment with ATX-101: Relationship of Mechanism of Action, Tissue Response, and Efficacy

Humphrey¹,

Yoelin

Friedmann

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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“… 14 Reduced duration of swelling/edema was often seen with subsequent ATX-101 treatments 14 because of a lower amount of remaining SMF. 24 Although no formal study thus far has investigated peak severity, based on clinician observations, swelling tends to be greatest the day after treatment administration, with substantial swelling for the next three days. Photographs and/or videos showing what patients can expect in terms of swelling/edema over time can be helpful (see Fig.…”

Section: Managing Expectations Of Swelling/edema and Downtime Associated With Atx-101mentioning

confidence: 99%

Best Clinical Practices with ATX-101 for Submental Fat Reduction: Patient-related Factors and Physician Considerations

Teller

Chiu²,

Chesnut

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Background: Submental fat can be reduced with ATX-101 (deoxycholic acid injection), a customizable and minimally invasive alternative to liposuction. In the years since its approval, the treatment patterns of ATX-101 have evolved. Methods: A panel of experienced physicians from the United States gathered to generate best practices for the use of ATX-101 in submental contouring. Results: The expert panel provided their insights on appropriate patient selection, managing patient expectations of ATX-101 treatment outcomes, and adverse events, and guidance on ATX-101 administration for optimal outcomes are presented here. Conclusion: These best clinical practices on the use of ATX-101 for the reduction of submental fat should enable physicians to enhance the patient treatment experience and outcomes.

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“…3 Deoxycholate destroys adipocytes, and should be injected into the subcutaneous or preplatysmal fat, since adverse effects may occur when it is injected deeper than the platysma muscle. When deoxycholate is being injected, the practitioner is advised to pinch the neck skin, 4,5 but it is not known exactly what changes this procedure induces in the layers of the neck.…”

mentioning

confidence: 99%

Changes in the neck tissue layers during pinch manipulation: Implications for lipolytic deoxycholate injections for double chin

Kim

Hong³

et al. 2022

J of Cosmetic Dermatology

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Background The skin of the neck is often pinched during minimally invasive esthetic procedures for the double chin using a lipolytic agent in order to facilitate injecting into the subcutaneous fat layer rather than under the platysma muscle. However, how the neck tissue layers move during the pinch manipulation is not well understood. Aims To determine which layer of the neck is lifted during pinching and to evaluate the usefulness of the pinch manipulation during injection therapy. Methods The pinched submentum of a living person was scanned using MRI, and ultrasonography was also performed in the same area in both resting and pressed states. At four sites on a fresh cadaver, the skin of the neck was pinched and the elevated neck skin was excised. The exposed areas were grossly examined. Results MRI scanning revealed that the pinch manipulation extended the subcutaneous fat layer and moved the platysma muscle to a deeper location. Ultrasonography revealed that the thickness of each layer of the neck was reduced when pressing the neck. In the cadaver examination, pinching resulted in part of the subcutaneous fat lifting, and this was removed when the lifted skin was cut, leaving the platysma muscle intact. Conclusions When performing an esthetic procedure that involves injecting a lipolytic agent into the submental area, the pinch manipulation is a very useful technique for ensuring a safe procedure that avoids injecting into the deep layer under the platysma muscle.

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Noninvasive Submental Fat Compartment Treatment

Cited by 22 publications

References 9 publications

Submental Area Treatment with ATX-101: Relationship of Mechanism of Action, Tissue Response, and Efficacy

Submental Area Treatment with ATX-101: Relationship of Mechanism of Action, Tissue Response, and Efficacy

Best Clinical Practices with ATX-101 for Submental Fat Reduction: Patient-related Factors and Physician Considerations

Changes in the neck tissue layers during pinch manipulation: Implications for lipolytic deoxycholate injections for double chin

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