Injection of an Adipocytolytic Agent for Reduction of Excess Periaxillary Fat

Abstract

Background The principal current treatment options for reduction of excess anterior periaxillary fat (APAF) are invasive procedures such as excision and liposuction. Objectives The aim of this study was to evaluate the efficacy and safety of ATX-101 (deoxycholic acid injection) as a treatment to reduce APAF. Methods In this retrospective study, 12 women with periaxillary fullness underwent ATX-101 treatment. Patients were examined to confirm that fullness was due to excess APAF and sufficient subcutaneous fat was present to warrant treatment. Before treatment, the lateral and medial borders of the treatment area were identified and marked. A 1-cm grid was placed to guide the placement of the ATX-101 injections. Reduction in APAF was based on visual assessment and palpation by the clinician, and assessment of before/after patient photographs by the patient and 2 blinded plastic surgeons; all had to agree that APAF reduction had occurred. Patient satisfaction was also assessed. Safety was evaluated in terms of adverse events (AEs). Results Patients underwent a mean of 1.8 ATX-101 treatments; 5 patients received 1 treatment, whereas 7 received multiple treatments. Ten patients achieved a reduction in APAF and were satisfied with treatment. One patient was satisfied after 1 treatment but did not return for posttreatment photographs. One patient did not show any noticeable reduction in APAF after 1 treatment; however, this patient was satisfied and additional treatments are planned. Common AEs included injection-site numbness, edema, and tenderness that lasted for a mean of 18.6, 6.0, and 4.5 days, respectively. Conclusions ATX-101 effectively reduced APAF and was generally well tolerated in this small cohort. Larger prospective studies are needed to confirm these findings. Level of Evidence: 4

Chronic Infection and Nodule Formation following Deoxycholate Injection

“…20 However, off-label use of ATX-101 for peri-axillary fat reduction was demonstrated to be safe and effective with no serious complications and high rates of patient satisfaction. 7 Infraorbital fat pad reduction using ATX-101 injection in two patients was found to be safe with minimal edema and bruising, and intralesional use of deoxycholic injection has been shown to reduce xanthelasma around the eyes, with minimal side effects. 10 Common side effects of deoxycholic acid-based injections include swelling, redness, pain, and bruising.…”

“…However, the treatment is most commonly used without ultrasound; the use of DC-based compounds including Aqualyx has been demonstrated to yield effective results. 1,3,5,[7][8][9][10][11] Intralipotherapy involves multiple passes of a sharp 23-gauge needle in a fan-like pattern, with retrograde continuous administration of the solution at varying depths. The solution should not be injected too superficially near the skin, or too deep, that is, into the muscles.…”

Alternative Cosmetic and Medical Applications of Injectable Deoxycholic Acid: A Systematic Review

“…26–28 With the NIH assessment tool, all 5 before–after studies have overall moderate risk of bias with concerns in sample size, follow-up rate, statistical analysis, and multiple outcome measures (See SDCAppendix III—SDCTable S3, Supplemental Digital Content 4 , http://links.lww.com/DSS/A856). 21–25…”

Best Clinical Practices with ATX-101 for Submental Fat Reduction: Patient-related Factors and Physician Considerations

“…Following the approval of ATX-101 for SMF reduction, successful off-label use of ATX-101 has been reported for reduction of excess subcutaneous fat in other areas such as jowl fat 18 , 27 , 28 and bra (peri- and post-axillary) fat. 29 The clinical practices outlined in this article will help physicians improve the treatment experience of patients seeking to address their SMF and rejuvenate their lower face.…”