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Injection lipolysis at Dr. Nüchel Aesthetik in Mönchengladbach

Injectables

Injection lipolysis

Injection lipolysis – colloquially known as the fat-dissolving injection – can selectively reduce small, stubborn fat deposits such as a double chin, entirely without surgery.

Treatable areas

  • Double chin
  • Chin–neck contour
  • Abdomen
  • Jawline
  • Hips
  • Saddlebags

Some fat deposits persist stubbornly – even with a healthy diet, a normal body weight and regular exercise. This particularly affects the area beneath the chin, the often constitutionally determined double chin. Injection lipolysis, colloquially the fat-dissolving injection, treats such small, clearly definable fat pads without surgery.

A fat-dissolving active substance solution is injected with fine needles into the fatty tissue and dissolves the fat cells; the breakdown products are processed by the metabolism. The result therefore develops gradually, usually over one to three sessions at intervals of about six to eight weeks. It is not a method for weight reduction and replaces neither diet nor exercise.

All information is provided for general guidance and does not replace personal medical advice. Treatment results can vary from one individual to another.

Indications

Who it is suitable for

Whether a treatment makes medical sense in your case is something we determine together in a personal consultation. Typical concerns include:

  • Double chin or fat deposit beneath the chin (submental fat) with an otherwise normal body weight
  • Small, clearly definable fat pads that do not recede despite exercise and diet
  • An indistinct chin-neck contour caused by a local fat deposit
  • Smaller fat deposits along the cheek or jaw line following individual medical assessment
  • Circumscribed deposits in body zones such as the hips, abdomen or saddlebags, provided they are small and well definable
  • Patients seeking an alternative to surgical liposuction in small areas
  • Constitutionally determined fat pads that disturb the harmonious overall appearance of the facial or body profile

Step by step

How the treatment works

This is how the treatment usually proceeds with us – from the first consultation through to aftercare.

  1. Consultation and information

    We assess the fat deposit, clarify your expectations and check whether injection lipolysis is suitable for you. You are informed about the mode of action, realistic results, possible side effects, alternatives and relevant pre-existing conditions.

  2. Preparation and treatment planning

    On the day of treatment the skin is cleansed and disinfected, the area is measured and the injection points are marked. On request, an anaesthetic cream can be applied.

  3. Injection of the active substance solution

    The fat-dissolving solution is injected in small amounts with very fine needles, specifically into the marked fatty tissue. The injection itself usually takes only a few minutes; a slight burning or feeling of pressure as a rule subsides quickly.

  4. Immediately after the treatment

    Swelling typically occurs afterwards, occasionally also redness, a feeling of pressure or small bruises – part of the intended reaction, which usually subsides within a few days.

  5. Progress monitoring

    The fat breakdown takes place gradually via the metabolism; an initial effect usually shows after a few weeks. At a follow-up appointment we assess the result and decide whether a further session is sensible.

Transparency

Prices

Kleiner Bereichz. B. Doppelkinn
250 €
Großer Bereichz. B. Bauch
450 €

All prices are guide values for initial orientation. Medical services are billed according to the German scale of fees for physicians (GOÄ); the final amount depends on the individual effort involved and is discussed transparently with you before treatment. For treatments without a listed price, we are happy to give you a guide value during your consultation.

Enquire about this treatmentView the full price list →

Patient information

Safety & patient information

Responsible treatment includes open information about possible risks and side effects – even when they occur only rarely.

  • Swelling

    Almost always, a marked swelling of the treated area occurs after the injection – part of the intended principle of action. It is most pronounced in the first two to three days and as a rule subsides within about a week; a residual feeling of tension can persist somewhat longer.

  • Redness, a feeling of warmth and pressure pain

    The treated area is frequently reddened, warm and pressure-sensitive – an expression of the local inflammatory reaction through which the fat breakdown is initiated. These complaints usually subside within a few days and respond well to cooling.

  • Bruises (haematomas)

    The injections can injure small blood vessels. Bruises are harmless but, depending on their extent, may remain visible for one to two weeks; when taking anticoagulant medication, the risk is increased.

  • Temporary numbness

    In the treated area, skin sensation can be reduced for a few days to weeks. Such sensory disturbances as a rule resolve completely.

  • Nodules and indurations

    In the course of the fat breakdown, palpable nodules or indurations may temporarily form. They are usually an expression of the remodelling process and resolve by themselves over weeks; occasionally a gentle lymphatic drainage or medically guided massage supports the regression.

  • Difficulty swallowing or a feeling of tension with chin treatment

    After treatment of the double chin, swelling and the feeling of tension may temporarily make swallowing or speaking seem uncomfortable. These complaints are as a rule mild and subside along with the swelling; in the case of pronounced difficulty swallowing, you should contact us without delay.

  • Infection

    As with any injection, there is a low risk of infection; through sterile working and careful skin disinfection it is very low. However, increasing redness, pain, warmth or fever after a few days are warning signs that should be medically clarified.

  • Temporary nerve irritation

    Rarely, in the chin area a small branch of the facial nerve (ramus marginalis mandibulae) can be irritated, which may lead to a temporary weakness of lower-lip movement with an asymmetric smile. According to the available data, this almost always resolves completely within weeks to a few months. Precise knowledge of the anatomy and a conservative injection technique minimise this risk.

  • Contour irregularities and very rare tissue damage

    Rarely, slight irregularities, asymmetries or – with pre-existing weak skin elasticity – a visible skin slackening may occur after the fat breakdown. Very rarely, with an unintended injection outside the fatty tissue, tissue damage up to circumscribed skin defects (necroses) as well as allergic reactions to components of the solution have been described. A careful determination of the indication, marking and injection technique by an experienced medical hand is therefore decisive.

When we do not treat

In certain situations we do not carry out a treatment, or only at a later time – for your safety.

  • Pregnancy and breastfeeding
  • Acute infections or inflammatory skin changes in the treatment area (e.g. herpes, purulent inflammation, active acne in the area)
  • Known hypersensitivity to deoxycholic acid or other components of the active substance solution
  • Severe liver or kidney disease, since the released fat components have to be broken down via the metabolism
  • Relevant coagulation disorders; the use of anticoagulant medication requires an individual medical assessment
  • Marked overweight or obesity – here injection lipolysis is not the suitable method; a structured weight management is more sensible first
  • Pronounced skin slackening in the treatment area, since excess skin may become visible after the fat breakdown
  • Lymphatic drainage disorders or pronounced lymphoedema in the treatment area
  • Pre-existing swallowing disorders (dysphagia) when treatment of the chin-neck area is planned
  • Severe general illnesses, acute febrile infections as well as inadequately controlled metabolic disorders – treatment only after stabilisation

This information does not replace a personal medical consultation. Before every treatment we inform you individually about the procedure, risks and alternatives.

In depth

Medical details & background

How it works & the evidence

Local fat deposits such as a double chin do not arise from body weight alone. The number and distribution of the fat cells (adipocytes) is to a large extent constitutionally determined and is additionally influenced by hormonal factors and age. When the body loses weight, the fat cells do shrink, but their number in a region largely remains – for this reason, circumscribed deposits can hardly recede despite exercise and diet.

Injection lipolysis targets these fat cells. The active substance solution used is, as a rule, based on deoxycholic acid, a substance modelled on the body’s own bile acid. Injected into the fatty tissue, it destabilises the cell membrane of the adipocytes, so that they are dissolved (in technical language, adipocytolysis). Specialised scavenger cells of the immune system (macrophages) take up the released fat components and channel them into the natural breakdown via the lymphatic system and liver metabolism. This intended inflammatory reaction explains the typical swelling, redness and pressure sensitivity – it is not a treatment error. A certain accompanying skin tightening is discussed in the specialist literature; a reliable tightening effect cannot, however, be derived from it.

Because breakdown via the metabolism takes time, the result develops gradually; only a limited, safely dosable amount of active substance is used per session. According to current knowledge, the dissolved fat cells do not form anew, but remaining cells can enlarge with a marked weight gain – a stable body weight is therefore the most important precondition for a satisfactory long-term result. Injection lipolysis shapes contours, it does not reduce body weight.

Injection lipolysis is best studied for submental fat, that is, the double chin. For deoxycholic acid in this indication, controlled approval studies and systematic reviews are available which show a measurable reduction of the fat deposit and a high level of patient satisfaction, with an overall manageable, predominantly temporary side-effect profile. On this basis, a deoxycholic acid preparation was approved – among others in the USA and at times in Europe – for the treatment of submental fat.

For other body areas such as the hips, abdomen or saddlebags, the evidence is considerably thinner and, on account of differing active substance compositions, dosages and protocols, only comparable to a limited extent; the individual response may turn out differently. Depending on the preparation, the treatment may moreover constitute an application beyond the terms of approval (off-label use) – widespread in aesthetic medicine, but with increased requirements for medical information. We disclose the status of the preparation used and discuss honestly what the evidence supports for your concern and where its limits lie.

Preparing for your treatment

A few simple measures before your appointment help you contribute to the best possible result with as few complications as possible.

  • Never stop anticoagulant medication (e.g. acetylsalicylic acid, other blood thinners) on your own initiative – discuss the use in advance with us and, where appropriate, with your prescribing physician.
  • In the 24–48 hours before the treatment, avoid alcohol as far as possible, as it can increase the tendency to bruising and swelling.
  • The treatment area should be free of irritation: no fresh sunburn, no acute skin inflammation, no fresh peel in the area; avoid intense sun and tanning beds in the days before the appointment.
  • Come to the appointment healthy and free of infection; in the case of febrile infections we postpone the treatment.
  • Where possible, arrive without make-up or creams in the treatment area and do not plan any important social occasions for the first few days after the appointment, as visible swelling is to be expected.
Aftercare

The right care after treatment supports healing and the result. You will receive individual recommendations from us – as a rule:

  • Cool the area gently in the first few hours (cooling pack wrapped in a cloth, never directly on the skin) – this relieves swelling and the feeling of tension.
  • In the first few days, avoid pressure, rubbing and vigorous massage in the treated area, unless we have discussed otherwise with you.
  • Refrain for about 5–7 days from intensive exercise, sauna, steam bath and hot full baths, as heat and circulatory strain can intensify the swelling.
  • Avoid direct sun exposure and tanning beds as long as the area is irritated, and consistently protect the treated skin with sun protection factor 50+.
  • Keep the injection sites clean in the first 24 hours and do not apply make-up to the area during this time.
  • Drink enough water and avoid alcohol as far as possible in the first few days – this can support the removal of the breakdown products.
  • Contact us without delay in the case of warning signs such as increasing pain, pronounced redness, warmth, fever, skin discolouration or persistent difficulty swallowing.
  • Attend the agreed follow-up appointment – only then can the result of the session be assessed and a decision made about a possible follow-up treatment.

FAQ

Frequently asked questions

Answers to questions we are asked particularly often about “Injection lipolysis”.

As the released fat components are broken down via the metabolism, the result develops gradually. Initial changes usually show after about four to six weeks; the final result of a session can as a rule be assessed after around eight weeks.

Injection lipolysis is carried out exclusively by a licensed physician with a dermatological background – from consultation and information through to injection and progress monitoring. Patient selection, knowledge of the anatomy and the safe handling of side effects are medical tasks.

We treat, as a matter of principle, only from the age of majority (18 years). There is no fixed upper age limit – decisive are the skin condition and individual suitability: with markedly slackened skin, excess skin may become visible after the fat breakdown, so that in individual cases other procedures are more sensible.

Liposuction is a surgical procedure that mechanically removes larger amounts of fat in one session – with anaesthesia, recovery time and surgical risks. Injection lipolysis manages without surgery, but is suitable only for small, circumscribed deposits and usually requires several sessions. For larger areas, a surgical solution may be more suitable.

Injection lipolysis can be carried out all year round. Many patients find the cooler months practical: direct sun on the area should be avoided at first, and temporary swelling at the chin can be bridged more inconspicuously in winter – for example with a scarf. Allow several months’ lead time for a particular occasion.

Sources & guidelines

  • Prescribing information for deoxycholic acid-containing medicines (approval documents of the European Medicines Agency (EMA) or the US Food and Drug Administration (FDA) for the treatment of submental fat)
  • Controlled studies and systematic reviews on injection lipolysis with deoxycholic acid in peer-reviewed dermatological and aesthetic-medical journals
  • AWMF guideline register – guidelines on aesthetic-dermatological procedures as well as the S3 guideline on the prevention and therapy of obesity (for the distinction between local contour treatment and weight reduction)
  • German Dermatological Society (DDG) – professional information on aesthetic-dermatological treatment procedures

Personal consultation

Arrange a personal consultation

In a confidential conversation on our practice floor at the Albertus Zentrum in Mönchengladbach, we take time for your questions and assess whether the treatment may be suitable for you.

Book a consultation

More treatments

You might also be interested in

If the concern is not a small, circumscribed fat deposit but the general weight situation, our medically supervised weight management is the more effective path; for larger or pronounced deposits, a surgical liposuction may be more suitable. An indistinct chin-neck contour can in some cases be improved with hyaluronic acid fillers, and where the skin is already slackened, a skin-tightening laser treatment (fractional CO₂ or Erbium:YAG laser) may be the more sensible option.

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