Plastic Surgery Research Council

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Real-World Experience with 100 Consecutive Patients Undergoing Injection Adipocytolysis for Neck Contouring with ATX-101 (Deoxycholic Acid): An Updated Report with 2-Year Analysis
Sachin M. Shridharani, MD, Grace M. Tisch, BA.
LUXURGERY, New York, NY, USA.

Purpose: In 2015, deoxycholic acid (DCA) injection was approved for treatment of mild-to-moderate convexity associated with submental fat. The efficacy and safety of submental DCA injection have been demonstrated in four phase 3 randomized controlled trials (RCTs), however, critical assessment of DCA injection in conventional clinical practice is lacking. In a previous report, we presented initial findings from our experience with 100 consecutive patients administered submental DCA. This study describes and evaluates real-world experience with submental DCA injection in a clinical practice setting, and provides an update to our previous report, accounting for additional treatment sessions during long-term follow-up.
Methods: This prospective, single-arm, observational study was conducted at a single clinic (private practice) between June 2015 and June 2017. Experience through February 2016 was previously published. The study involved 100 consecutive patients, aged between 18 and 80 years, seeking improvement in convexity/fullness associated with submental fat. Treatment involved DCA injection to the preplatysmal submental fat using an area-adjusted DCA dose of 2 mg/cm2, with up to 75 injections (0.2 mL per injection [maximum, 15 mL]) per treatment session for a maximum of 6 sessions. Treatment response was assessed using the clinician-reported submental fat rating scale CR-SMFRS (0 = absent; 1 = mild; 2 = moderate; 3 = severe; and 4 = extreme) and confirmed by independent physician review of photographs at 1 and 5 to 7 weeks posttreatment. Treatment response was defined as an improvement of ≥1 point. AEs, including injection-site AEs such as local edema, numbness, and tenderness were monitored at each follow-up visit. Patient demographics, response, and safety were compared between patients who underwent single versus multiple treatment sessions.
Results: Since the prior published report, 17 patients have undergone additional treatment sessions. Overall, one hundred patients have had 195 treatment sessions: 41, 36, 14, 6, 2, and 1 patient had 1, 2, 3, 4, 5, and 6 sessions, respectively. In the multiple-treatment-session (MTS) group, most (36/59 [61.0%]) patients had 2 sessions; 14 (23.7%) had 3 sessions, 6 (10.2%) had 4 sessions, 2 (3.4%) had 5 sessions, and 1 (1.7%) had 6 sessions. A mean (SD) of 6.7 (2.3) mL of DCA was administered per treatment session, with significantly more DCA administered to the MTS than single-treatment-session (STS) group (6.8 [2.3] vs 6.1 [2.2] mL/session; p = .049). Overall, 33 of 36 (91.7%) patients in the STS group and all 59 (100.0%) patients in the MTS group had an improved CR-SMFRS score by ≥1 point. Local edema, numbness, and tenderness were reported for a mean (SD) of 7.1 (5.1), 27.9 (11.3), and 3.5 (3.5) days post-treatment, respectively.
Conclusions: Longer-term follow-up of submental DCA injections demonstrated that patients will likely require ≥2 sessions to achieve the desired aesthetic goal in a private practice setting. Both single- and multiple-treatment sessions were generally well tolerated.


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