LIPODISSOLVE

Pros

• In a study from 2005 that analyzed 43 patients who had Lipodissolve treatments, 30% saw a dramatic reduction of localized fat; 67% saw mild to moderate improvement. 
• Unlike an invasive plastic surgery procedure, the injectable format of Lipodissolve means you can return to normal activities immediately after treatment.

Cons

• The procedure is illegal in the United States, due to serious safety concerns. The FDA alerted customers in 2010 that it didn’t evaluate or approve products for use in Lipodissolve and it hadn’t received any evidence of its efficacy or safety. Furthermore, the agency noted that it had received reports of unexpected side effects such as permanent scarring; skin deformation; allergic reactions; and deep, painful knots under the skin where Lipodissolve was injected. 
• Fluid retention and bruising in the treated area are common side effects of Lipodissolve. Swelling can last up to 10 days.
• RealSelf members who rated the procedure “Not Worth It” say they had excessive swelling and that the injections were painful. Commonly, they reported no change in their appearance after they healed. 
• Several sessions are recommended, although the number of treatments varies according to the areas of fat being treated. 

It’s highly controversial and connected to the Chapter 11 bankruptcy filing of the specialty spa Fig (formerly called Advanced Lipodissolve).

Lipodissolve is similar to liposuction in that it actually removes fat cells from the areas of fat. (The deoxycholate, or DC, breaks down the fat, whereas phosphatidylcholine, or PC, helps with digestion and removal of the broken-down fat.) So, the fat loss experienced with Lipodissolve is technically permanent. That said, if you gain weight, the fat cells in other areas of your body (and those remaining in the treated area) will expand in size, possibly minimizing your results.

Lipodissolve only has a 94% Worth It rating among RealSelf members, and patients experience mixed results. Those who said it wasn't worth it have reported excessive pain, scarring, and irregularities in the skin for relatively minimal (if any) improvements in the treatment area.

"I have not seen anyone happy with their Lipodissolve results," says New York plastic surgeon Dr. David Shafer, who notes that he often has to fix botched Lipodissolve procedures in his office. "Also, patients describe having to go back for many 'treatments' and having 'lumps.'"

In 2010, the FDA issued warning letters to six U.S. companies as well as one in Brazil, stating that their claims about the efficacy of Lipodissolve were unsubstantiated and that the product might be unsafe. In various reports, the drugs’ quality control has been questioned and concerns have been raised about the poor definition of ingredients, possible complications, and bacterial contamination. 

A 2012 study recommends you avoid a Lipodissolve treatment if:

• You’re pregnant or nursing.
• You have chronic conditions such as heart disease, kidney disease, uncontrolled diabetes, thyroid disorders, or infections.
• You’re currently on aspirin therapy.
• You have a soy allergy (the PCDC mixture is soy-based).

Serious risks and side effects include infection, granulomas (disfigurement at the injection site), and local necrosis (tissue death) as well as possible death from organ failure. Injecting PCDC into breast tissue could result in prolonged inflammation and possible malignant tumors. Injections around or below the knees could lead to skin breakdown. 

Lipodissolve remains unapproved by the FDA.

Most doctors on RealSelf say that liposuction is the most effective procedure for removing stubborn fat. If you’re concerned about a long recovery time, variations such as Smartlipo and VASER liposuction can be easier on the body, with quicker healing.  

These nonsurgical options are also considered safe and effective. 

• SculpSure uses diode-laser energy to heat and kill fat cells. The treatment takes 25 minutes, and multiple areas can be treated at the same time. It has very few side effects and zero downtime. SculpSure’s Worth It Rating is almost as high as that of liposuction, and it’s significantly less expensive. Just keep in mind, you’ll have to wait up to three months to see your full results, and you might need two or more treatments to reach your goals.
• CoolSculpting destroys small pockets of fat by freezing the fat cells. After one treatment session, you’ll gradually lose about 25% of the fat cells in the treatment area. It takes about a month to start seeing results, with improvements for up to 20 weeks. At that point, many RealSelf members opt for a second treatment, to get the results they were after. 
• Vanquish uses radiofrequency energy to melt fat cells, in a painless procedure that lasts about 45 minutes. You’ll have to wait about two weeks to start seeing a difference, with full results in four to eight weeks. Most people need four or more treatments to get the results they want. RealSelf members give it a lower Worth It Rating than either CoolSculpting or WarmSculpting.
• Kybella is an FDA-approved injectable that dissolves fat cells in the chin but also is sometimes used above the knees, at the elbows, or for bra rolls. You’ll need up to six treatments to achieve the desired results.