Submental fat reduction by mesotherapy using phosphatidylcholine alone vs. phosphatidylcholine and organic silicium: a pilot study

Summary Background  Excess skin and fatty tissues beneath the jaw lead to a double chin deformity. Localized fat deposits in this area are a cause of discomfort and anguish, leading patients to undergo surgical procedures such as liposuction and dermolipectomy to improve the cosmetic effect. Both procedures require anesthesia and an operating room setting and are quite expensive. Fearful of extensive surgery and its complications, patients and physicians seek less invasive methods. Mesotherapy with phosphatidylcholine and other cocktails have been used to treat localized fat deposits. However, there are few published articles regarding its effectiveness and some are even anecdotal. Objective  This study aims to determine the efficacy of phosphatidylcholine alone vs. phosphatidylcholine and organic silicium in submental fat reduction. Methods  Twelve patients with submental fat deposit with no coexisting morbidity and with informed consent were included in the study. They were submitted to one to five treatment sessions with an average interval of 2 weeks between each session. The medication administered was injected, either pure phosphatidylcholine or a combination of phosphatidylcholine and organic silicium. Baseline measurements of submental fat using vernier caliper and digital photographs of the patients were taken during each treatment session. The occurrence of adverse effects was likewise noted. Results  Among the 12 patients, 11 completed the treatment course, and 1 was excluded from the study because of failure to follow up. Both phosphatidylcholine and a combination of phosphatidylcholine and organic silicium were equally effective in reducing submental fat deposits. There was no significant difference as to the rate and degree of reduction. Significant reduction in the thickness of submental fat was achieved after three treatment sessions. Adverse reactions in both groups were mild and transitory ranging from heavy sensation, localized heat, nodulations, and slight bruising that abated 3 to 5 days after treatment. Limitations  As of this writing, information on the use of both phosphatidylcholine and organic silicium for mesotherapy of localized fat such as the submental area is scarce. The exact mechanisms of action of both treatments are likewise unknown. Ultrasound and histopathological changes were not documented. The study did not involve a double‐blind, placebo‐controlled design, and the sample size was small. Conclusion  Mesotherapy using phosphatidylcholine vs. phosphatidylcholine plus organic silicium was similarly effective in reducing submental fat. There was no significant difference between them in terms of rate and degree of reduction. Optimal reduction of submental fat was achieved after three treatment sessions. Adverse reactions were few, mild, and transitory. Therefore, both regimens are safe, efficacious, cost‐effective, and can be used as alternatives to invasive surgical procedures.