Fat Dissolving Injections: HOW TO

Before and after jawline fat dissolving
Jawline definition injections

Fat Dissolving Injections

We are able to use fat dissolving injections to remove body fat. The most common area for use is the double chin.

What is the Indication and aim of treatment?

It is indicated for the treatment of submental fat (ie under chin fat).

The fat dissolver works to reduce the amount of sub mental fat underneath the chin.
sub mental fullness can detract form a balanced and harmonious appearance.

Submental Fat

Can lead to an older and heavier look.

It affects both men and women.

Submental fat affects both lean and those individuals with higher body fat percentages.

It may be influenced by ageing, genetics and weight gain, and unfortunately is often resistant to diet and exercise.

Treatment options for SMF (Submental Fullness)

It is important to take a holistic approach. There are multiple options:

Surgical options

  • Neck lift
  • Neck or submental liposuction

Energy Based Devices

  • Cryolipolysis ( freeze and damage fat cells, the inflammatory response clears the cells)

Injectables options

  • Fat dissolving injections

The Science Behind Fat-Dissolving Injections

Fat dissolver is an injectable product that causes adipolysis when injected subcutaneously into fat.

There are 3 types of Human Fat

Brown Fat

Dissipates energy as heat during cold or diet induced thermogenesis ( dissipation of energy through production of heat) It is distributed in interscapular, paravertebral, axillary and perirenal.

It is turned on or activated when you et cold, it produces heat to help maintain body temperature.

White fat

Is distributed throughout the body. Subcutaneous white fat serves to provide insulation while visceral white fat that surrounds organs provides protective padding,

Beige Fat

Beige resides within white adipose tissue and shares characteristics of both white and brown adipose
cells. Adaptive thermogenesis.

Fat Cells

Adipocyte cells number and size fluctuate during human development. Adipose tissue can increase by hypertrophy ( an increase in size of the individual adipocyte) or hyperplasia ( an increase in number).

At birth adipocytes are small and the number declines over the first 2 -3 years life, before gradually increasing. The numbers expand through puberty.

The difference in adipocytes numbers between lean individuals is established in childhood. Once established the total number of adipocyte for each weight category remains constant throughout adulthood, even after marked weightloss. Fat mass is determined by both adipocyte numbers and size.

Fat cell turnover is approximately 10% annually regardless of age or BMI.

Mechanisms of fat reduction

Lipolysis occurs when there is an enzymatic degradation of fatty acids into their constituent building block. This is a reversible metabolic process.

Adipocytolysis is the disruption of adipocyte cell membranes, resulting in irreversible cell destruction.

How do fat dissolving injections work?

Fat dissolving injections exploit the process of adipocytolysis. Fat dissolving injections are made of a chemically synthesised non-human, non- animal formulation of deoxycholic acid (DC).
When injected sub mentally into subcutaneous fat, the DC disrupts the membranes of the adipocytes resulting in irreversible cellular breakdown.
The inflammatory response takes roughly 28 days, this inflammatory response from the fat dissolving injections causes
the destruction of the membrane of the adipocyte, followed by fibroblast proliferation which then produces new collagen within the subcutaneous tissue. Within days after the DC is injected, macrophages recruit into the area, they then engulf the cellular debris and lipids that are left over from the adipocytolysis process. Swelling is to be expected due to the inflammatory macrophage response. The swelling is most significant in the first 3-8 days.

Who is the ideal patient

Ideal patients will have moderate to severe submental fullness associated with a submental fat pad and good skin quality and minimal laxity.

Fat Anatomy

Sub mental fat is located both pre and post platysmal fat compartments. Pre platysmal fat is located superficial to the platysma muscle – this fat is the target of the fat dissolving injection treatment.

However post platsymal fat is located deep to the platysmal muscle, this fat is not the targeted tissue for fat dissolving injections.

How to Evaluate the Patient

  • Pinch & Palpate the sub mental area to ensure there is sufficient SMF for treatment.
  • Pull the sub mental skin, give careful consideration to patients with excessive skin laxity for whom the reduction of SMF may result in an aesthetically undesirable outcome.
  • Grimace to isolate the pre platysmal fat and define the target treatment area, palpate the submental area while the patient tenses the platysma.
  • Marking up and treatment zone Treatment zone is between the hyoid bone and the sub mental crease. Trace the inferior border of the mandible, and mark up approx 1-1.5cm below the inferior border of the mandible. Surrounding this placement is a no treatment zone which protects and reduces injury to the marginal mandibular nerve.

The Treatment

  • Local lignocaine 5% inject with long needle into the treatment area
  • Have the patient tense the playstma
  • Pinch the smf between fingers
  • Inject perpendicular to the skin until needle is midway into the pre playsmal fat
  • Inject 0.2ml adjacent to each dot – then wipe of dot
  • it should not be injected in close proximity to the marginal mandibular branch of the facial nerve to avoid motor neuropraxia.
  • 30g needles
  • If resistance is met when injecting, with the needle to an approbate depth before injecting.
  • when withdrawing the needle take your finger off the plunger first to avoid injecting outside the
    sub mental fat.
  • get client to ice immediately post treatment for 5-15 minutes.


Injections that are too superficial ( into the dermis) may result in skin ulceration and necrosis.

Nerve damage that may result in a lopsided smile – this damage is most likely temporary.


  • NSAIDS such as ibuprofen
  • ice both pre treatment and when at home.
  • numbness, redness, bruising and swelling and even small firm areas.
  • most significant swelling occurs between 3-8 days – remind patients that this means it is working!
    its the inflammatory response of the macrophages ( the eating cells) clearing lips and cellular
    debris after adipocyte lysis is caused.
  • avoid exercise for the week, ice, keep head elevated if possible, minimise salt and alcohol.
    Average treatment 2 vials per session 2-4 treatments. 6 weeks apart, takes 4-6 weeks to start
    seeing results.