Tissue-Toxic Effects of Phosphatidylcholine/Deoxycholate after Subcutaneous Injection for Fat Dissolution in Rats and a Human Volunteer

doi:10.1111/j.1524-4725.2008.34128.x

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Wiley InterScience

Dermatologic Surgery

Volume 34 Issue 4, Pages 529 - 543

Published Online: 26 Mar 2008

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Tissue-Toxic Effects of Phosphatidylcholine/Deoxycholate after Subcutaneous Injection for Fat Dissolution in Rats and a Human Volunteer

SANJA SCHULLER-PETROVIC, MD ^*† , GERALD WÖLKART ^‡ , GERALD HÖFLER, MD ^§ , NIKOLAUS NEUHOLD, MD ^¶ , FRANZ FREISINGER, MD ^∥ , AND FRIEDRICH BRUNNER, PHD ^‡

^* Venex-Vein Center, Vienna; ^† Department of Dermatology; and ^‡ Department of Pharmacology and Toxicology, University of Graz, Graz, Austria; ^§ Department of Pathology, Medical University of Graz, Graz; ^¶ Department of Histopathology, Rudolfinerhaus, Vienna, Austria; ^∥ Clinical Institute for Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria

Address correspondence and reprint requests to: Friedrich Brunner, PhD, Department of Pharmacology and Toxicology, Universität Graz, Universitätsplatz 2, A-8010 Graz, Austria, or e-mail: friedrich.brunner@kfunigraz.ac.at

The authors have indicated no significant interest with commercial supporters.

ABSTRACT

BACKGROUND The safety of the lipodissolution procedure for the cosmetic treatment of fat is unknown.

OBJECTIVES The objective was to determine the subcutaneous tissue effects of phosphatidylcholine solubilized with deoxycholate (PC/DC) in rats and a human volunteer.

METHODS Rats were treated subcutaneously three times with 50, 300, or 600 μL of PC/DC formula on the abdomen in a chronic study (30 days). A human volunteer undergoing elective liposuction was similarly treated. Cell membrane lysis, cell viability, and histologic status were determined on fresh biopsies of subcutaneous fat from the injection sites.

RESULTS PC/DC dose-dependently reduced membrane integrity and cell viability. Histologic alterations induced by PC/DC included fibroplasia, bandlike fibrosis in the region of the cutaneous muscle, and partial muscle loss. The highest dose caused widespread fat necrosis, fat cyst formation, and necrotic changes of the walls of small blood vessels. Histologic sections of subcutaneous tissue from the human volunteer showed dose-dependent panniculitis, fat cysts, and vessel necrosis. DC (2.5%), tested for comparison in the rat, exerted membrane and histologic effects similar to those of PC/DC. Solvent controls caused negligible alterations.

CONCLUSIONS Injection lipolysis with PC/DC causes tissue fibrosis and necrosis of adipose and vascular tissues in rat and man, making the long-term safety of PC/DC for nonsurgical treatment of subcutaneous fat deposits uncertain.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1524-4725.2008.34128.x About DOI