"A Systematic Review of Injectable Lipolytic agents for Non-Submental Fat Reduction".

Carrion, Kassandra; Salingaros, Sophia; Bernal, Carter; Barger, Branden T; Lipman, Kelsey Jordan; How-Volkman, Christiane; Thawanyarat, Kometh; Nguyen, Dung · Plast Reconstr Surg · 2025

systematic_review · Level I

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Abstract

Injectable lipolytic agents have gained popularity as a non-invasive approach to localized fat reduction. While deoxycholic acid (DCA) remains the only FDA-approved agent for submental fat reduction, its application for non-submental regions is an emerging area of interest. This systematic review evaluates existing literature on injectable lipolytic agents beyond the submental region. A systematic review was conducted using PubMed, MEDLINE, EMBASE, Scopus, and Cochrane Central Register of Controlled Trials. Studies evaluating the use of injectable lipolytic agents for non-submental fat reduction were included. Extracted data included treatment outcomes, patient satisfaction, adverse events, and cost considerations. Bias was assessed using the ROBINS-I and RoB 2 tools. Twenty-five studies met inclusion criteria, encompassing 3,178 patients treated with various agents, including DCA, phosphatidylcholine (PC), and emerging formulations such as CBL-514 and caffeine-hyaluronic acid. Significant reductions in localized adiposity were reported in 93.75% of studies, with 37.5% achieving statistical significance. Adverse events were generally mild and transient. Patient satisfaction varied from 57.1% to 86%. Cost comparisons indicated injectable treatments require multiple sessions, making them costlier than single-session surgical liposuction but competitive with non-invasive modalities like cryolipolysis. Injectable lipolytic agents offer a promising, minimally invasive alternative for fat reduction in non-submental regions. However, further clinical trials are needed to standardize treatment protocols, evaluate long-term efficacy, and assess the cost-effectiveness of combining injectables with other weight management strategies. Expanding FDA approval for additional indications remains a potential future direction.