Article Medically reviewed by Dr. Gavin Chan (MBBS, cosmetic physician, liposuctionist)
Templestowe Lower and Berwick Clinics
Dr. Gavin Chan has a background in intensive care, anaesthesia, and emergency medicine. Since 2004, Dr. Chan has provided cosmetic procedures, including anti-wrinkle injections, dermal fillers, liposuction, fat transfer, skin needling, and laser treatments. He is a doctor trainer for various dermal fillers and anti-wrinkle injections.
- Fat accumulation under the chin is due to both genetic factors and body weight.
- Traditionally, submental fat (double chin fat) has been removed with liposuction.
- Liposuction still remains the gold standard for removing submental fat.
- People do not always want to have surgery and many prefer non-surgical alternatives for removing submental fat.
- In 2017 a new fat dissolving injection was released to dissolve submental fat. This contains an active ingredient called DC. The brand name and the ingredient of these products cannot be fully named here due to TGA regulations.
- Another fat dissolving injection has been available for over a decade and contains both DC and PPC together.
- Generally, double chin fat dissolving injections are for those looking for a non-surgical alternative to liposuction, or for those with smaller amounts of submental fat and no significant skin laxity.
Submental fat - what is it?
Submental fat, colloquially known as a ‘double chin’, is the fat that lies under the jawline and chin. It is often an area of concern for those with an excess amount of fat in this area. Weight loss, although helpful in many cases, may not reduce fat in this area to a significant degree as often fat deposition in this area is genetically determined. This is often seen in cases where submental fat is present despite an acceptable body weight.
Fat in this area can contribute to an ill-defined jawline and a blunted angle between the jawline and the neck rather than a more favourable angle of 90 to 100 degrees.
The fat addressed by liposuction or fat dissolving injections is the pre-platysmal fat. This is the fat that lies superficial to the platysma muscle or the large superficial sheet muscle of the neck. This fat is separated from the major blood vessels in the neck and the airway by the platysma muscle.
Am I a suitable candidate for fat dissolving injections for my neck?
The two limiting factors for this treatment are the skin and the amount of fat.
Generally, this treatment is suited for those who have good skin (not lose, crepey or wrinkly neck skin), and smaller fat deposits. These rules also apply for those contemplating liposuction, however, it is possible to remove a significantly larger amount of fat during liposuction.
For loose skin, usually surgical treatments such as a neck lift is indicated rather than simply fat removal alone.
Fat Dissolving Injections Vs Liposuction
Liposuction has traditionally been the treatment for removing fat accumulation in genetically predisposed areas. It is mostly done under general anaesthetic or intravenous sedation. Small incisions are made in the skin (usually just under the chin, and behind the ears) to allow the administration of local anaesthetic as well as the removal of fat by a metal cannula with suction. Recovery is typically about a week. Despite the advent of non-surgical methods for fat removal, liposuction still remains the gold standard treatment. The fat definitely removed rather than relying on the slower process of fat cell destruction with injections. It is also possible with liposuction to measure the exact amount of fat removed. Also, during the procedure, the thickness of the skin and fat can be assessed to see if enough has been removed. With fat-dissolving injections, it is not possible to predetermine the amount of fat that will be removed in each case.
Fat-dissolving injections do however provide a non-surgical alternative to liposuction. They are and have been used for both submental (neck) fat as well as body fat. The exact names of the brands of these fat dissolving injections cannot be mentioned due to TGA regulations. They induce adipocytolysis or destruction of the fat cells. The results from these injections are permanent, as fat cells once destructed cannot regenerate.
Over a decade ago, the first type of fat-dissolving injection was released. They quickly gained popularity as the notion of being able to shape the body without liposuction was appealing for many. The injections were made from a combination of PPC, DC and other substances that helped with fat removal. These substances induce lysis or destruction of fat cells when injected into areas of fat. It was and is used as a treatment for removing fat on any part of the body, including submental fat. The effect on body fat was, in our opinion, not particularly dramatic. The treatments were particularly painful when used on larger body areas, had fairly long recovery times (similar to liposuction!), and caused a significant amount of swelling and often hard lumps (that stayed for several weeks).
Submental fat treatment with fat dissolving injections tends to be more effective than body treatments due to the smaller amount of fat in the neck. Less product needs to be injected also which reduces the amount of pain and swelling with the treatment in comparison to the body treatments.
Dr. Adam Rotunda, a dermatologist, began investigating the effects of DC in 2003 for the destruction of fat cells and found that the primary effect of the combined PPC and DC injections were from the DC. In 2017, Allergan, the company that makes a well-known brand of anti-wrinkle injections, released a brand of fat dissolving injections that contain only DC. This treatment has been designed specifically for submental neck fat treatment, and not for body treatments. Along with this also came stricter protocols for treatment, including a temporary tattoo template for the injections that is placed on the skin, and a standardised volume per injection site. Fat dissolving injections have since seen a resurgence since its release.
What should I expect after fat dissolving injections treatment?
This will depend on the size of the treatment performed. In most cases, there is a significant degree of swelling that lasts for a week. Tendnerness of the area treated is also present for that time. In some cases, hard lumps form, and these can take some time to reduce in size. Bruising is also a common side-effect and can last up to 2 weeks.
Pain management for double chin fat injections
Although the protocol for pain management outlined by Allergan only involves cooling the area before and after the injections, most patients do experience a significant amount of pain if only this method is used. The discomfort from the treatment is due to both the injection process as well as a stinging or burning sensation that lasts approximately 10 minutes after the treatment.
At Victorian Cosmetic Institute, we utilise both topical and injectable local anaesthetic injections prior to the administration of the fat dissolving injections which significantly reduces pain during and after the treatment.
What is the price of fat dissolving injections?
For the DC only treatment produced by Allergan, the treatment cost is $870 for the first vial, and $500 for each subsequent vial per session. Most patients will require 2 vials per session, and a much smaller percentage will require 1 or 3 vials. This will depend on the amount and size of the submental fat deposit.
For the combined PC and DC treatment, the treatment is $500 per session, irrespective of the size of the submental fat deposit.
Why choose Victorian Cosmetic Institute as your provider of fat dissolving injections?
At Victorian Cosmetic Institute, we have been using fat dissolving injections for over a decade. When the new DC only version of these injections was released by Allergan in 2017, we utilised our experience with fat dissolving injections to help provide a better experience for patients and to provide better outcomes.
To contact us to make an appointment, please call 1300 863 824.