PCDC

Phosphatidylcholine and deoxycholate (PC-DC) injections have been used as nonsurgical alternatives to liposuction. DC as a constituent for lipolysis has recently been approved by the US Food and Drug Administration.

PC and DC have independently been used in lipolysis. We hereby present a systematic review of literature on injection lipolysis and share our experience of using DC in combination with PC for injection lipolysis. We have retrospectively evaluated the effects of PC-DC treatments in varied age groups, both sexes, and over different target areas.

This study spans over 14 years wherein 1269 patients of different age groups and sex were treated with injection lipolysis with PC-DC combination. The PC-DC cocktail injection was given to all patients for an average four sessions every 4 weeks, and the results were assessed after 8 weeks from the last session.

The effects were best appreciated over the face (malar, jawline, and submental areas) and upper arm, whereas average effect was observed on the thighs and around the knees. We have also used lipolysis as a primary modality as well as a touch-up modality following liposuction. The results are better appreciated in primary lipolysis. The need for follow-up sessions (1-2 sessions) of lipolysis and the quantification of results in subsequent sessions reveal that maximal improvement is achieved in the first session.

PC-DC cocktail used for lipolysis as a local administration is effective for reducing unwanted fat. It shows great efficacy in treating localized fat, especially over the face and bra roll in the women of younger age group (20-30 years).

In their article entitled, “Metabolic and Structural Effects of Phosphatidylcholine and Deoxycholate Injections on Subcutaneous Fat: A Randomized, Controlled Trial,” Reeds et al analyzed the effects of phosphatidylcholine and deoxycholate (PC-DC) treatments on body composition, adipocyte function, and mechanisms responsible for fat loss. Thirteen women were enrolled; only 7 completed the study. This small sample size renders statistically significant calculations virtually impossible. The authors maintain that PC-DC injections have become increasingly popular. This may be true in Seoul, Korea, where over 6000 vials of Lipobean1 are injected monthly into human subcutaneous fat for the purpose of fat reduction. However, in many countries around the world, the practice of injection lipolysis has been banned.2 Popularity of these injections in the United States has dwindled,3 in part due to the lack of a US Food and Drug Administration (FDA)–approved agent and also due to the lack of efficacy in treating larger body regions.4 The side effects, although not morbid, are unpleasant. Noninvasive treatments such as Liposonix (Solta Medical, Inc, Bothell, Washington) and Tite FX (Invasix, Richmond Hill, Ontario, Canada)5,6 offer much more fat reduction without the cholinergic side effects that can be seen with higher-dose PC-DC injections. Despite the shortcomings of injection lipolysis as currently practiced, there has been a resurgence of interest in the topic,7 especially in Europe and Asia. There are many reasons for this, including the expansion of the practice of aesthetic medicine and the desire of practitioners who mainly perform injections to have an injectable solution for reduction of protrusions. If aesthetic practitioners can fill hollow regions, they may also want to reduce or take away volume. The ability to do this precisely with an injection would be an excellent addition to the …