Fit: The Deal With Dissolve

by Vicky Hallett

ASK PERSONAL TRAINERS how to target that last ounce of jiggle on your waist, and they'll tell you spot reduction is a myth. But that might not be true if you're willing to pony up a couple grand, suffer hundreds of injections and swell up for a few weeks.

Such is the promise of Lipodissolve, a cosmetic procedure that earned raves in Europe before becoming the buzz of Hollywood. (It's rumored to be the force behind Britney's recent svelteness.) And Lipodissolve is heating up in D.C., too, with more spots offering the service, including a new medical chain devoted exclusively to the injectable compound.

But what is it? The combination of phosphatidylcholine (a soy-derived substance that mimics an element of human cell membranes) and deoxycholate (a synthetic bile salt) is said to break down fat deposits and send them out of the body via urine. The side effects — swelling, bruising, burning — might not sound fun, but compared to liposuction, it's a dream: It's thousands of dollars cheaper and requires only a topical anesthetic. Plus, you can go to work the next day, albeit in comfy clothes that'll hide the bulges you'll boast for a few weeks.

"There are no divots, lumps or downtime," explains the Center for Laser Surgery's Dr. Robert Adrian, who three years ago was the first physician in D.C. to offer the service. One of his priorities is making sure patients are suited for the procedure. Because lipodissolve attacks individual pockets of fat, it's meant for healthy people who haven't been able to reduce certain areas through diet and exercise. "If you take someone who's 100 pounds overweight, they'll be disappointed," he says.

Because of the side effects, practitioners (reputable ones, at least) will inject only so much of the compound during a single session, so patients must select one area to focus on at a time. Treatments are usually spaced six to eight weeks apart, and it may take anywhere from two to six weeks to achieve the desired results.

Gabrielle, 48, who lives in Rockville, was willing to be patient (and be a patient) to banish her love handles. "I did 'Slim In 6' videos religiously. I bought the Bean. I did push-ups. I ran. I did ab crunches this way and that way. But the fat wouldn't go away," she says. It didn't matter to her that her husband told her she had a "killer body" — she wanted to wear pants without having a muffin top.

So she turned to MedSculpt, the first in a planned lipodissolve chain that opened in Rockville in January (a second location in the Tysons area is in the works). Its medical board lists two very impressive local names — Dr. Scott Spear, chief of plastic surgery at Georgetown University Hospital, and Dr. Roger Friedman, who is on the faculties of both Georgetown and George Washington universities.

That cred convinced Ellen, 49, of Gaithersburg, who had been a patient of Friedman's. She had been considering a tummy tuck for a stubborn bit of flab on her otherwise tiny frame. "I've had people at gyms say, ‘That's just the way it is,'" she says. But Friedman suggested lipodissolve instead — and after coping with the swollen midsection and black-and-blue skin, she's dropped a pants size. "I can't wait to put on a bathing suit," she gushes.

Patients like her have been spreading the gospel of lipodissolve, leading to increasing demand, says Dr. Shannon Ginnan, medical director of the Reveal MedSpa chain. "We've been watching the market for a while. These procedures have been around long enough and there's a fair amount of data that they work and are safe," he says. So, Reveal added "LipoShape" to its menu in February, advertising it as "lunchtime lipo."

A few weeks ago at the Rockville location, Ginnan was giving 42-year-old Sally, a mother of two, her second belly treatment. She had initially complained of a "pooch," but when she lifted her shirt, her tummy was virtually flat. Ginnan managed to find enough soft fat to delineate the circle he would focus on (he's had to turn away patients for being too thin), and started injecting the compound with a special five-needle syringe. Sally got 190 injections in about 15 minutes, but said it just felt like a light pinching, thanks to the anesthetic she'd rubbed on earlier. And then it was off for some lunch.

After all, starving oneself puts your body in fat storage mode, Ginnan reminds. And habits are important to the long-term results of the procedure. "If you're living a healthy lifestyle, the fat removal is permanent," Friedman says.

But not all doctors are jumping on the bandwagon. Dr. Michael Olding, chief of plastic surgery at George Washington University Hospital and director of the Cosmetic Surgery and Laser Center at GW, refuses to inject patients with the stuff. "This is a technique that hasn't proven safe and effective. To me, it's the sort of thing that reminds me of modern-day snake oil," he says. Lipodissolve isn't approved by the FDA, and phosphatidylcholine is banned in Brazil. And Olding says he knows why: In the past three months, three patients have come to him after botched lipodissolve jobs. "They're lumpy, hard, asymmetric," he says.

For anyone who decides to try it, he suggests asking a few questions: Who's doing the injecting? Is he or she trained? And what's being injected? The Centers for Disease Control and Prevention reported that there was an outbreak of nasty skin reactions in D.C. in 2005 after an unlicensed provider let loose with a syringe filled with artichoke and thuja plant extracts.

"Cheap, easy and non-surgical, that's the name of the game today," Olding says. But realize that nothing is a miracle.

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Photo by Marge Ely/Express
ReadExpress.com, May 29, 2007