Injection of an Adipocytolytic Agent for Reduction of Excess Periaxillary Fat

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