1.
Deoxycholic Acid: A Review in Submental Fat Contouring.
Deeks, ED
American journal of clinical dermatology. 2016;(6):701-707
Abstract
Deoxycholic acid is a secondary bile acid involved in dietary fat emulsification/solubilization that causes adipocyte lysis when injected into subcutaneous fat tissue. A 10 mg/mL injectable solution of synthetic deoxycholic acid (Kybella™; Belkyra™) is indicated in various countries, including the USA and several within Europe/the EU, to improve the appearance of moderate to severe convexity or fullness associated with submental fat (SMF) in adults, where it is currently the only approved treatment for fat below the chin. In several phase III trials conducted in this setting, injecting deoxycholic acid 2 mg/cm2 into the SMF reduced the convexity/fullness of moderate to severe SMF relative to placebo (with a single treatment comprising up to 50 injections, and up to six treatments given at least 1 month apart). These SMF benefits (which were measured subjectively by clinicians and recipients, as well as objectively, 12 weeks after the last treatment session) generally occurred without detriment to skin laxity and were largely maintained over extended follow-up (e.g. 2 years after treatment). Deoxycholic acid injections are generally well tolerated, with adverse events usually involving the treatment area, being mild to moderate in severity and resolving within approximately one treatment interval. However, not all patients with SMF may be suitable for deoxycholic acid therapy, making patient selection key to achieving desired aesthetic outcomes. Thus, deoxycholic acid injections are an effective and generally well tolerated, minimally invasive option for the treatment of moderate to severe SMF in select adults.
2.
Blindness caused by cosmetic filler injection: a review of cause and therapy.
Carruthers, JDA, Fagien, S, Rohrich, RJ, Weinkle, S, Carruthers, A
Plastic and reconstructive surgery. 2014;(6):1197-1201
Abstract
Vascular occlusion causing blindness is a rare yet greatly feared complication of the use of facial aesthetic fillers. The authors performed a review of the aesthetic literature to ascertain the reported cases of blindness and the literature reporting variations in the vascular anatomy of the human face. The authors suggest a small but potentially helpful addition to the accepted management of the acute case. Cases of blindness, mostly irreversible, from aesthetic filler injections have been reported from Asia, Europe, and North America. Autologous fat appears to be the most frequent filler causing blindness. Some cases of partial visual recovery have been reported with hyaluronic acid and calcium hydroxylapatite fillers. The sudden profusion of new medical and nonmedical aesthetic filler injectors raises a new cause for alarm about patient safety. The published reports in the medical literature are made by experienced aesthetic surgeons and thus the actual incidence may be even higher. Also, newer injectors may not be aware of the variations in the pattern of facial vascular arborization. The authors present a summary of the relevant literature to date and a suggested helpful addition to the protocols for urgent management.