In the colorful world of Dr Joel Schlessinger [photo], former president of the American Society of Cosmetic Dermatology and Aesthetic Surgery (ASCDAS), Lipodissolve should be banned on all possible levels due to the risks of "bruising, pain, swelling, bloating," and temporary irregular dimples he has observed in six patients.
Could Dr Schlessinger's intense smutt campaigns against Lipodissolve be related to his association with a company competing with Lipodissolve, and planning to introduce a new drug on the market soon, or...? The doctor has spent a lot of time on websites, in interviews and chain-letters to State Medical Boards in efforts to put a ban on Lipodissolve. But, is it right that the voice of a single physician should overrule the opinion of hundreds of licensed physicians who use Lipodissolve in their clinical practice in this country and abroad?

Dr. Joel Schlessinger’s criticism of Lipodissolve - not based on facts but commercially motivated

New York, NY (January 28, 2008) – Dr Joel Schlessinger, former president of the American Society of Cosmetic Dermatology and Aesthetic Surgery (ASCDAS) has actively and aggressively campaigned against the practice of Lipodissolve in media, websites and letters to State Medical Boards. Lipodissolve is known as Injection Lipolysis in Europe.

But is he right; has he been fair? Let us look at the facts.

In a series of newswires and media interviews Dr. Joel Schlessinger has labeled the procedure as “dangerous”. He states, “I’ve seen half a dozen cases of patients who received treatments and then had pain, swelling, bruising, bloating in the treatment areas, irregular dimpling and divots in the skin.”

Fact: You can find half a dozen patients with any surgical procedure [appendectomy, heart surgery, face lift, liposuction, or any other procedure] who have this kind of symptoms after the procedure. With Lipodissolve these symptoms almost always disappear within one to two weeks. What he does not point out is the data on more than 60,000 treatment sessions reported in reputable medical journals, proving beyond doubt that the treatment is safe, and that these symptoms are temporary [Duncan and Chubati, Aesthetic Surgery Journal, September-October 2006; Palmer, et al, Journal of Cosmetic Dermatology, 2006]

We at ASAL have collected data relative to 11,650 Lipodissolve treatments by 74 ASAL trained physicians. Pain or discomfort beyond 2 weeks affected less than 1% of the patients. The most serious complication was skin breakdown requiring skin graft. It happened in 2 cases indicating wrong dosage application to the treatment area. Complications described with liposuction, such as fat embolism, epinephrine and lidocaine toxicity, thrombosis, 3rd space fluid shifts, complications of anesthesia and death [Platt et al. Forensic Science, 2002; Toledo et al. Clinical Plastic Surgery, January 2006], did not happen with Lipodissolve.

Dr. Schlessinger makes a strong point that phosphatidylcholine is not FDA approved for Lipodissolve.

Fact: Phosphatidylcholine has been approved as an active ingredient of several drugs by the FDA [Infasurf, Calsurf, Rapamune, Ablecet] and can thus be used ‘off label’ for other indications under the law. In fact more that 60% of the drugs in this country are used ‘off label’, including Botox, which is used by the doctor in his own daily practice. Furthermore, all phosphatidylcholine used in the U.S. for Lipodissolve is compounded by compounding pharmacists, and cannot be regulated by the FDA as such, as it is covered by different legislation.

• More than 20% of all drugs in the USA are prescribed "Off Label".
• More than 50% of cancer patients receive drugs "Off Label".
• According to some estimates up to 90% of newborns receive off label drugs.
• An estimated 65% of all product use in cosmetic procedures within plastic surgery and/or aesthetic clinics are performed “Off Label”.

Dr Schlessinger cites Fig, a Kansas company with poor medical and business practices, as the reason why this procedure should be banned.

Fact: There are occasional cases where physicians, including plastic surgeons, have poor medical / business practices doing all sorts of procedures. Is that a reason to ban all the procedures?

For further information about Fig, please view the note on the bottom of this page.

Dr Schlessinger criticizes Lipodissove practice by other physicians.

Fact: Perhaps a more accurate reason for the doctors aggressive campaign against Lipodissolve is that Dr Joel Schlessinger is involved in a study doing the same thing with a drug, as a paid consultant of a drug company, and is actively recruiting patients for it. In addition, members of his own organization (eg – Helen Torek, secretary, former member Barry Lycka, former vice president of ASCDAS) are avid enthusiasts. The reader should draw their own conclusions

We, board advisors at the American Society of  Aesthetic Lipodissove, train physicians to perform Lipodissolve correctly and ethically. We are getting tired of such criticism.

With all due respect, we ask Dr. Schlessinger to please stop. It is neither right nor fair!

Khalid Mahmud, MD
Barry Lycka, MD
Thomas Wright, MD
Charles Crutchfield, MD
ASAL Medical Advisory Board

Footnote:

1. Dr Joel Schlessinger is named as one of the sponsored researchers on behalf of Kythera Pharmaceuticals for ATX-101 (Sodium Deoxycholate for Injection) Phase 2 Study for the Treatment of Superficial Lipomas.

2. The company Fig added the name Lipodissolve to their business name under strong opposition from ASAL in 2006. Before the company officially opened their Advanced Lipodissolve clinics in 2006 a legal complaint was filed against Advanced Lipodissolve Center (Fig) by ASAL in objection to the company's use of the name Lipodissolve as a cause of confusion. ASAL felt Fig was undermining patient safety. ASAL claimed that Fig did not offer their patients Lipodissolve but had created new treatment protocols that contained, ex., added deoxycholate and other modified ingredients and dosages, unknown and unverified in Lipodissolve use. Fig advertised these new treatments in their clinics as "Advanced Lipodissolve". ASAL issued a statement to the USPTO that the company's use of the name Lipodissolve in their marketing and advertising would jeopardize patient safety. Fig's procedures did not correlate to Lipodissolve or injection Lipolysis and the company had not been approved to be certified in Lipodissolve. ASAL wanted to issued an early public notice and warning about the company, but was dissuaded by their legal team.