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Updating for the treatment of localized adiposities and cellulites:
Phosphatidylcholine. Lights and shadows!

Dr. Redaelli Alessio mail@docredaelli.com

The treatment of reduction of localized adiposities, as belly, double chin, hips, back and typical areas as culottes de cheval, found in Phosphatidylcholine a new medicine, which allows the reduction for many people.
Phosphatidylcholine is a phospholipid able to reduce the volume of fat cells to which it gets in contact with. It is injected with a particular method, called “INTRALIPOTHERAPY”, in the areas that require a treatment and it is done deep under the skin. We use very thin and long needles, that directly reach the under skin.
Risks do not basically exist (except for the usual allergy).
In fact Phosphatidylcholine has been used not far long ago just to take care of fat embolisms, which sometime take place after serious trauma: the fat gets into the vein and becomes an embolus which closes the vessel.
Phosphatidylcholine, in these cases, was injected with high dosages to dissolve the fat embolus.
Beside, it has a great action against cholesterol and toxins.
So, it is good for the body even in this way.
The treatment requires the same amount of time of a common mesotherapy. It is done outpatiently, and afterwards the patient can immediately do the usual things, as happened with mesotherapy. Truly, in many patients phosphotidilcoline provokes a sort of local inflammation and swelling. But they are always transient and slightly.
What is “Phosphatidylcholine”?
It is one of the most abundant phospholipids in human tissues, and it is the main constituent of cellular membranes.
It is part of the composition of lectin and phosphatidylinositol.
It is used in cosmetic field for its capacity to bound with water, and it is a very interesting molecule as a carrier of other active principles, promoting the cutaneous penetration.
Beside, it is an emulsifier of fat and it favors the dispersion as energy. Probably this last aspect is the true mechanism of action. In fact, in its composition we find deoxycholate sodium. This last one provokes the breaking of fat cells, and the Phosphatidylcholine provokes the reabsorption. Studies have been conducted on each substance, which do not have the same results. We do understand how important is the preparation formula, and the firm that produces the medicine. Sometime I hear that some patients, who have already tried the medicine, had bad results.
This could be the reason: the formula is not a perfect cocktail, or the used Phosphatidylcholine is not the right one, the one from the original Netterman’s formula.
How does the treatment take place?
The patient is treated outpatiently, and the Phosphatidylcholine is injected pure at the level of the decided zones.
Not all the colleagues do it in this way, but some of them dilute it with physiological or glucosan, many others add other substances. Together with many other users, I prefer the pure use.
First of all, we study the patient while he/she is standing to well evaluate the spots we need to treat.
Often, these zones can be drawn with eyeliner, for a better precision.
Then the patient lays down and through needles of adequate length, average 10,12 cm for 27G, we proceed with the injection.
So, for every spot, we proceed with one injection and through it to the distribution of the active principle.
We usually treat two spots at the same time, but sometime we do more according to different situations. Do not ever use more than a phial every 15 kilograms of weight. I personally do not inject more than three of them per session. Sessions take place once a month.
Some authors say that few sessions are enough, average of 4-5 sessions, but in my experience I obtained the best results with some more sessions. Even thought, the result is variable from patient to patient, and so sometime fewer sessions are required.
Beside, in my opinion, there are some non-responders patients who do not react to the treatment, but the
number is limited.
The treatment is very quick, and it takes only fifteen minute to end the session. After the application of an eventual lenitive lotion, the patient can leave the room and go back to his/her usual activities.
A painful sensation is frequent for a half an hour, and a sensation of burning for about an hour.
Beside, a clear swelling appears right after the injection and it lasts for 1-2 days. Haematomas may occur, a little bit less compared to mesotherapy.
Which are the best indications?
In my opinion, the best indications can be summed up in localized adiposities.
So, bellies, hips, arms, double chin and eyelid’s bags respond well.
We can find fat everywhere.
In the images above you can see the results after two sessions.
In the pictures it is possible to see some patients treated for a lipoma of the elbow, for inner thighs and arms, all good indications.
In literature there are more and more frequent positive results even for cellulites, which means on legs, culottes de cheval, knees and so on.
To underline the fact that the first job edited about Phosphatidylcholine was about its application for eyelid’s bags and it was written by a Brazilian doctor (Patricia Rittes) who talked about very interesting results.
(The Use of Phosphatidylcholine for Correction of Lower Lid Bulging Due to Prominent Fat Pads Patrícia Guedes Rittes, MD Clínica Patrícia Rittes, São Paulo, Brazil (Presented at the 54th Brazilian Dermatology Congress, Belo Horizonte, Brazil, September 1999)
Then, in 2003, Professor Motolese adjusted this technique, called “Intralipotherapy”, which is the one I
follow.
According to some authors we could actually get to the point where we substitute the operation of lipoaspiration!
In my opinion, it is not a surgical operation, but it is surely a treatment both for the maintenance of results and for the treatment of minor entities. Beside, it can be used for case of post operation irregularities, to make the tissue fit.
Are there any collateral effects?
In literature, there are not any collateral effects reported, and personally I have never had particular problems.
The only problem that takes place, but not always, is a slight swelling and modest irritation of the treated zone which last for 1 or 2 days.
The treatment is completely non traumatic.
No allergic tests are needed, because the medicine is not particularly allergic.
However, at the first meeting, the anamnesis, which has always to take place, will clear if a patient is allergic, and in these cases the first treatment will be very prudential.
Redaelli, 2008

 

Informed Consent–Intralipotherapy with phosphotidilcoline