Lipolysis – non-surgical removal of fat deposits

Lipolysis is a treatment which chemically dissolves fat cells. The main substances in the lipolytic agent are deoxycholic acid and phosphatidylcholine as a carrier. These two substances have the ability to create a strong inflammation in the fat cell membrane, which, over 7 days, leads to the rupture of fat cell membrane and its leakage. This allows the blood and lymph vessels in the adipose tissue to remove fat from that location and eventually expel it from the body.

The use of lipolytic agents dates back many years when they were used to dissolve fat emboli in the lungs and arterial plaque.

In 2001, an association was formed in Germany that dealt with lipolysis and fought for this procedure to be recognized by the World Health Organization. In 2019, lipolysis was approved as a safe and effective method for treatment of submental fat (double chin).

Lipolysis or liposuction?

This should be a procedure that can compete with surgical liposuction, however it should be noted that the results of liposuction and lipolysis cannot be compared. Lipolysis is used exclusively for small amounts of fat deposits and for fine body shaping.
Lipolysis is a method that is also used following liposuction for fine modeling of the treated area.

What does lipolysis treatment look like?

The procedure itself is slightly uncomfortable but not painful. Precisely measured amount of lipolytic agent is injected using very thin needles. This procedure does not require local anesthetic. 15 minutes following the application, the area turns red and the patient starts to feel a tingling sensation which lasts for half an hour, and the treated region begins to swell. While every patient experiences swelling, the size of the swelling is individual. It lasts 3 to 7 days. Bruising at the injection site and tissue inflammation are also possible. After 7 days, the swelling disappears and mild pain in the area persists. The full effect of one procedure is assessed after one month. Usually, 2 to 5 treatments are required for the area being treated. Važno je da se pri svakom tretmanu vidi rezultat. It is important that the result is visible after each treatment. About 5% of the population does not react to lipolytic agents at all.

Allergy to lipolytic agents is possible and more common in individuals who are allergic to soy and peanuts, which is one of the main contraindications for lipolysis.

Redness of the treated area and swelling are considered an integral part of the treatment. It is important to note that redness disappears 7 days following the lipolysis. If redness persists even after 7 days, this could mean the onset of vasculitis or allergy, which is why the subsequent treatments would be contraindicated. Increased levels of cholesterol and triglycerides in the blood do not affect the procedure, since they are not increased as a result of lipolysis either.
Fat is excreted from the body through the liver, so it is desirable that there are no signs of fatty liver on ultrasound.
It is important that the lipolytic agent consists only of deoxycholate and phosphatidylcholine. Mixing it with other lipolytic agents or mesotherapy substances may increase the effect of the lipolytic agent and the possibility of side effects.

If lipolysis is performed properly in sterile conditions, it is a safe and effective method.

The result of lipolysis lasts until weight gain. Once dissolved, fat cells cannot be formed again.
New fat cells cannot develop in adulthood, so fat deposits are created by increasing the fat cells formed in childhood. As lipolysis leads to dissolving of a certain number of fat cells, the result is considered permanent.
If there is a large excess of skin in areas where we wish to dissolve fat, the aesthetic result will not be adequate.

The appearance of cellulite may be improved by lipolysis although it is not primarily a cellulite treatment. Since cellulite is fat which is bound to the surface of the skin, dissolving fat cells will also improve appearance of the skin. Lipolysis needs to be combined with other cellulite treatments. There are numerous studies on the efficacy and safety of this method.

According to a study link conducted in 17 countries on 17,376 patients, an average of 3 treatments are needed to obtain an adequate result.

Side effects are extremely rare:

1. Hyperpigmentation, which can occur mostly due to the deposition of blood pigment hemosiderin and not as a consequence of melanocyte activity.

2. Infections are possible if lipolysis is performed in inadequate conditions, using unregistered substances or on the skin that already has the parameters of infection.

3. The possibility of developing urticaria is reduced to an incidence of 0.003% of treated patients. This is resolved with administration of antihistamines.

4. Pain lasting more than 2 weeks is very rare and is associated with treating very large areas in one treatment and using stronger concentrations of the solution.

5. Dissatisfaction with the outcome is estimated at as many as 20% of treated patients. Objectively, 1 to 5% of treated patients have no therapeutic response to lipolysis. Such a high percentage of dissatisfaction occurs due to unrealistic expectations of patients or inadequately explained results.

6. Uneven areas in the treated region are possible in case of inadequately planned treatment.


1. 1st International Lipolysis Convention in Salzburg – Link

2. Thomas MK, D’Silva JA, Borole AJ. Injection lipolysis with a cocktail of phosphatidylcholine and deoxycholate: an Indian experience. – Link

3. Duncan DI, Chubaty R. Clinical safety data and standards of practice for injection lipolysis: a retrospective study – Link

Lipolysis – Price

Prices for lipolysis treatment are available on our Price list.

Svetlana Đurišić specijalista dermatovenerologije

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