Injection lipolysis in aesthetic medicine: mechanisms, clinical safety, and clinical applications.

BACKGROUND

Injection lipolysis is increasingly used as a minimally invasive option for focal fat reduction. However, systematic data on its safety and efficacy remain limited.

OBJECTIVE

This review summarizes the development, mechanism, clinical application, complication management, and future directions of injection lipolysis, grounded in the anatomy of facial and cervical fat.

METHODS

We searched PubMed for literature published between 1943 and 2026 to trace the research history of lipolytic agents. In vitro data were used to compare the differential effects of deoxycholic acid (DCA) on adipocytes versus neural tissue. Clinical indications, injection techniques, and complication strategies were also reviewed.

RESULTS

Deoxycholic acid preferentially disrupts adipocytes and exerts cytolytic effects with relative tissue selectivity. The submental fat pad is the best-documented indication. Poor injection technique can lead to skin necrosis, marginal mandibular nerve palsy, and other complications.

CONCLUSION

Injection lipolysis is an effective tool for spot fat reduction, but its safety depends heavily on anatomical knowledge, patient selection, and strict procedural discipline. Future work should focus on precision fat reduction and further clinical validation.