UPDATED How to INSTANTLY Dissolve Stubborn Facial Fat: A Guide to Lipo Vela + INJECTION VIDEO

[Organ]

Dissolve Stubborn Facial Fat
By Organ



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Table of Contents:
Abstract
Introduction
Biochemical Mechanisms and Pharmacological Properties
Facial Anatomy
Treatment Protocols and Technique
Post-Treatment Care and Recovery Management
Complications and Adverse Events
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Abstract

Fat dissolving injections have become an increasingly popular alternative to surgical methods for eliminating unwanted areas of body fat. Lipo Vela is one of the most advanced fat reduction treatments on the market today. Not only does Lipo Vela dissolve the fat cells, but it also contains specific growth factors to promote overall health of the skin. In contrast to previous fat dissolving treatments which could take a month to begin working, Lipo Vela will provide noticeable results within approximately two weeks.

This study provides a comprehensive description of how Lipo Vela functions while acting as a reference guide for the people who wish to administer this treatment. The study will cover all aspects of administration including; the most effective method of administering the Lipo Vela treatment, common potential adverse reactions or side effects to monitor during and after the procedure, and how to address these complications. Additionally, because the injection site may be difficult to navigate due to proximity to nerve branches and blood vessels, the study will identify locations of significant nerves and blood vessels in order to assist with avoidance of injury. The study will combine prior research with FDA approved data for related treatments (i.e., Kybella) and data on anatomical studies of the face to ensure that all necessary information is available to allow people to utilize Lipo Vela effectively and safely.

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Introduction

There are numerous new non-surgical body contouring methods available today; however, among them, fat-dissolving treatments have received a great deal of interest due to their ability to be used safely and without surgical risk to remove excess fat from virtually all parts of the body. Fat-dissolving treatments involve the subcutaneous administration of a mixture of various substances below the surface of the skin. Upon administration, the fat dissolver breaks through the fatty cell membrane allowing the fat to be metabolized and removed by the body.

The early injectable fat dissolvers, such as Aqualyx, and others showed that the use of chemical agents to liquefy fat could successfully treat patients. However, there were many shortcomings associated with these early formulations. Some of the shortcomings include extended periods of edema, prolonged post-procedure healing times and variability in post-procedure physical outcomes. Lipo Vela represents a significant advancement in this area of treatment. Unlike earlier treatments, Lipo Vela contains a fast acting liquid formulation that directly attacks and rapidly removes fat cells. Additionally, Lipo Vela includes peptides, vitamins, and growth factors which help maintain the health and firmness of the surrounding skin during the removal process of fat.

The active pharmaceutical components in Lipo Vela (phosphatidylcholine and sodium deoxycholate) have been extensively evaluated in both laboratory experiments and clinical trials. Phosphatidylcholine is a naturally occurring lipid molecule present within the membranes of fat cells and readily binds to the membranes of fat cells. Sodium deoxycholate functions as a detergent-like compound derived from bile acids which effectively destroys the membranes of fat cells by breaking down their outer wall. Studies conducted identified sodium deoxycholate as the sole ingredient in the mixture capable of inducing lipolysis. While phosphatidylcholine serves primarily as an ingredient for delivering the treatment, research suggests that the combination of both compounds may enhance efficacy.

Due to variations in regulatory policies across countries and regions, laws governing fat dissolving treatments vary widely. In the United States, the FDA approved a deoxycholic acid injection called Kybella in April 2015. Specifically. The approval for Kybella was granted solely for reducing moderate to severe submental fullness (fat under the chin). As part of the application process, the manufacturer completed eighteen separate studies to demonstrate its effectiveness and establish safety protocols. Lipo Vela contains the identical primary active ingredient as Kybella. Although Lipo Vela is categorized as a cosmetic product rather than a pharmaceutical, it is therefore exempted from those FDA regulations.

The purpose of this thread is to provide a comprehensive overview of how Lipo Vela functions in terms of its biochemical mechanisms. The guide will also talk about anatomically-based guidelines for ensuring safe delivery of Lipo Vela into the facial tissues. Furthermore, this thread will synthesize existing evidence regarding clinical efficacy and adverse reactions associated with its administration into the face.

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Biochemical Mechanisms and Pharmacological Properties

2.1 Primary Lipolytic Agents
The fat-dissolving properties of Lipo Vela are due primarily to its two key active ingredients; Phosphatidylcholine and Sodium Deoxycholate. Therefore, understanding the mechanism of action of each individual active ingredient as well as how they interact with one another, is crucial to determining the most likely response of a patient to treatment as well as to identifying any possible adverse reactions that may occur.

Phosphatidylcholine is a form of fat, composed of many naturally occurring chemicals (fatty acids and choline) and is one of the primary components of the membranes protecting all human cells. Upon injection into the subcutaneous fat layer, the phosphatidylcholine molecules become incorporated into the membranes of the adipocytes allowing them to weaken and subsequently release the accumulated fat within the cell. Additionally, the phosphatidylcholine serves as an emulsifying agent to help disperse the fat that has been released so that it can be efficiently metabolized and removed by the body.

As stated above, Sodium Deoxycholate is the primary component in Lipo Vela that causes cellular death. Deoxycholate functions in the gastrointestinal tract to break down and solubilize fats from consumed foods. However, upon delivery via injections into the subcutaneous tissue, deoxycholate acts as a potent surfactant breaking down the lipid bilayer structure of the adipocytes thereby causing complete destruction of the fat cells. Studies demonstrated that deoxycholate was capable of killing cells, lysing cell walls, and destroying adipose tissue in experiments. Moreover, the studies demonstrated that deoxycholate performed equally as effective when administered in combination with phosphatidylcholine versus when it was administered in isolation.

Although the exact concentration of sodium deoxycholate employed in these treatments is critical, there are specific limits on the use of deoxycholic acid. For example, Kybella, a U.S. FDA approved product containing 10 mg/mL of deoxycholic acid, is administered in standardized dosages. Concentration levels of deoxycholate found in custom-made products such as Lipo Vela could differ depending on the manufacturer but are typically recommended dosages equivalent to those used in Kybella. Laboratory studies have shown that deoxycholate formulations containing at least 12.5% of the active ingredient are sufficient to effectively destroy adipocytes yet remain safe for patients provided they are properly administered via injection.

2.2 Ancillary Bioactive Components
Beginning with the fat-reducing properties of Lipo Vela, there are a number of other agents included within the solution. These additional components assist in removing excess fat from the body and supporting the health of the skin through-out the fat loss process. The two vitamins included; riboflavin (B2) and cyanocobalamin (B12) aid in enhancing the functioning of cellular metabolic pathways by acting as co-factors for enzymatic processes. In theory, these vitamins will allow the newly formed fatty acids to be burned at a higher rate than would otherwise occur.

L-Carnitine assists in transporting the fatty acid chains to the mitochondria where they can be used as an energy source. This could potentially shorten the time required for removal of the excess fat from the treated regions.

Peptides and Growth Factors make Lipo-Vela different from most all other chemical fat reducing solutions on the market today. Examples of peptides include Syn-Ake. Syn-Ake is a peptide that has been created to mimic the action of a peptide found in cobra venom. Its intended purpose is to soften and reduce facial expressions, thereby preventing the formation of expression lines and wrinkle patterns in areas that were treated. Epidermal Growth Factor (EGF), Fibroblast Growth Factor-1 (FGF-1), Insulin-Like Growth Factor (IGF) and other similar substances have also been added to promote the healing process by stimulating the body's natural repair mechanisms. These substances should provide a means to contract the tissue layers and prevent excessive sagginess after the fat is lost rapidly.

Although the scientific evidence supporting the use of these additives is less extensive than that related to the primary fat dissolving agents, their inclusion represents an effort to correct many common side effects associated with rapid chemical fat loss. Studies have demonstrated that intradermal injection of these solutions does not induce generalized inflammation in the body or adversely affect either fasting glucose levels or total cholesterol concentrations. Therefore, based upon data available to date, if performed properly, these procedures should not produce systemic adverse reactions.

2.3 Adipocyte Response and Clearance Kinetics
After being injected under the skin, Lipo Vela kills fat cells by breaking apart their outer walls. Tissue studies show that the fat cells start breaking down within just hours of the injection. Under ideal conditions, about 72 percent of the treated fat cells show clear signs of being destroyed within 48 hours. The released fat is then slowly cleared away by the body's natural drainage system and normal metabolism.

The body's healing and swelling response to these fat-dissolving injections follows a predictable timeline. Early swelling and redness show that the body is reacting to the destroyed cell parts. This reaction usually hits its peak between 48 and 72 hours after the treatment, during which patients might experience significant swelling and firmness in the treated areas. The next phase, lasting from the third day through the second week, involves the immune system sending out special helper cells to clean up the dead fat cells while the swelling slowly goes down. Physical results begin to show during this time because the swelling fades, revealing the actual loss of fat volume.

Unlike liposuction, which physically vacuums out fat cells through a tube, these injections rely entirely on the body's own natural cleanup systems. This difference is very important when deciding who is a good candidate for the treatment and how they should take care of themselves afterward. People with poor fluid drainage systems or metabolism issues might take longer to clear the fat and could experience longer-lasting swelling. On the other hand, healthy habits that boost the body's drainage and metabolism (such as drinking plenty of water, staying physically active, and using heat treatments like the sauna) might actually help improve the final results.

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Facial Anatomy

3.1 The Facial Nerve and Motor Branches
The majority of the facial nerve exits the base of the skull, branching off into five major divisions, which all supply the muscles involved with facial expression. It is crucial to understand the locations and depths at which these branches lie, to avoid damaging them during the injection process, since accidental injury may lead to significant cosmetic and functional changes of the face.

The temporal branch serves the muscles of the frontal area (forehead), the eyebrows, and surrounding eye areas. Although generally not in line of sight with cheek injections, excessive superior movement of a treatment towards the temporal area increases the risk of encountering the temporal branch.

The zygomatic branch serves the muscles of the upper lip required for smiling. When injecting the upper lateral cheek or cheek bone area, this branch becomes increasingly relevant to monitor.

The intermediate cheek branch supplies the primary muscle of the cheek and also those of the upper lip, lying directly through the center of the face. Due to its proximity to commonly treated areas for reducing fat in the cheeks, injectors must be extremely aware of both the depth of injections and technique.

However, the marginal mandibular branch (also known as the jawline branch) presents the greatest danger to nerve structures when attempting to dissolve facial fat.

This branch follows the inferior border of the jaw, generally crossing above the primary facial artery approximately one-half inch to one inch anteriorly to the primary masticatory muscle. Human anatomical studies have demonstrated great variability in the course of this nerve among individuals; thus some persons have nerves that extend almost an inch beneath the inferior margin of the jaw. At this point where it crosses the artery, the nerve lies extremely superficially to the skin, creating a high potential for physical contact with a needle or mechanical compression by pressure created by the injected substance.

Damage to this branch creates unique deficits in motor function including inability to depress the lower lip unilaterally. The result is a unilateral asymmetry of smile production, impaired articulation and drooling. Most minor nerve damage resulting from injections will recover spontaneously within weeks to months but permanent nerve damage is always possible.

3.2 Vascular Anatomy and Ophthalmic Complications
There are many other health issues involved with having an injury to one of your facial blood vessels (e.g., temporary or permanent blindness) rather than damage to nerves. One of the largest arteries in your head runs across your lower jaw bone in front of the masseter muscle. As you go up each side of your mouth to the middle of your cheeks, this artery divides into several smaller branches. As it approaches the inner corner of your eye, one of these small branches connects with the major blood vessel coming out of your brain. The major blood vessel comes from your brain’s main blood circulation route and provides blood flow to the center of your retina, as well as the surrounding soft tissue.

Vision loss occurs when some amount of the injected solution is pushed backwards into the bloodstream by the force of the injection. If enough force is used to push the solution into a facial blood vessel, such as those located close to the eye, the solution will be pushed backward in opposition to the natural direction of blood flow, into the larger blood vessel that supplies blood to the back of your eye. Once in this location, it is possible to totally obstruct this blood vessel and result in almost immediately occurring and permanent vision loss. Even if you get immediate emergency medical treatment, nearly all of these types of vision losses are irreversible.

According to various scientific research articles there have been documented over 190 reported cases of blindness associated with cosmetic facial injections.

Veins on your face pose additional concerns due to their ability to rapidly transmit infection from one part of your body to another via a primary blood collection site located at the base of your brain.

Dangerous areas involving the potential for blood vessel complications involve space between your eyebrows, where two large facial blood vessels join together to form part of your eye's circulatory system; the bridge of your nose; which has its own separate blood circulatory system; along your smile lines; where your facial artery also has a circulatory pathway into your eye system; and around your eyes, which creates a single continuous circulatory pathway that allows for rapid spread into your eye. Due to the extremely high risks posed by these areas, you must always proceed with caution.

3.3 Subcutaneous Fat Compartments
When we look at the fat directly under the skin on our faces, it doesn't appear as a single, cohesive layer. Instead, the fat under the skin is separated into discrete, individual compartments or "pockets" of fat that are created and defined by walls made up of connective tissue. There are many different types of these individual compartments; they are found in the cheek's inner wall, in the center of the cheeks, in the areas known as the smile lines, and in the area right under the chin, and so forth. As you can imagine each compartment will age independently of all the other compartments, and will therefore respond uniquely to any type of cosmetic treatment applied to them.

One of the most common locations to treat with fat-dissolving injections is the area where the primary fat compartment is located immediately below the skin in the inner part of the cheek. This particular location has a very strategic advantage. This fat compartment rests over several critical structures including the facial expression muscles and the deep layers of facial tissue. Therefore, there is enough volume loss after treating this compartment to be visually apparent, yet safely removed from both larger nerves and larger blood vessels that are located in the deeper tissue layers. On top, this area is bordered by the suborbital fold (under eye); underneath by the bony edge of the mandible (the lower jaw bone), but an injection must remain far enough above this border to prevent harm; on the inside by the nasolabial folds (smile lines) and on the outside by the masseter muscle (chewing muscle).

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Treatment Protocols and Technique

4.1 Right People for This
The most effective way to get optimal results and minimize risks associated with dissolving facial fat is to understand if you are a right candidate. Adults with small, resistant areas of fat that are unresponsive to dietary changes or increased levels of activity and have good elasticity in the skin that will retract to the new dimensions after the removal of excess fat are considered the perfect candidates. Also, it is crucial for patients to understand that the effects of these procedures occur gradually and may necessitate multiple rounds of treatment to achieve desired results.

Certain medical conditions make the use of this type of treatment unacceptable. Infection in the area being treated; pregnancy or breastfeeding; a known history of anaphylaxis to one or more of the ingredients contained in the injectable material; people with hemophilia; people on anticoagulant therapy; and those with significant metabolic problems such as poorly controlled diabetes or significant impairment to healing potential, should all completely refrain from using this type of treatment.

4.2 Treatment Planning and Mapping
Having a good plan to follow when performing treatments helps provide better consistencies in treatments and safer treatments. When you are treating the cheeks, I suggest creating a grid of anywhere from 9 to 25 areas of injection in each cheek, based on the length of your mandible and what type of results you want to obtain. Then space those areas approximately 1/2 inch (or 1 cm.) apart. The spacing and number of areas create a consistent application of the product throughout the shallow fat pocket in the inner cheek while remaining outside the danger zones.

It is very important to note that when injecting this product, never use more than .2ml. of product in each point. The reason for this is because the product expand significantly after being injected and therefore will spread out over the surface area regardless of how much was initially placed in each site. Therefore, by keeping your injections limited to .2ml., you are able to maintain complete control of how much product has been applied to a given site. This ultimately ensures that the amount of product utilized for a treatment is always going to be safe.

By allowing a minimum of 21 days (three to four weeks), prior to another treatment session, you allow sufficient time for all inflammation associated with the first treatment session to resolve. By waiting long enough to observe how well the treatment responded before proceeding with additional treatments, you will also ensure that you are able to determine how many treatment sessions will be required to produce optimal visual results.

4.3 Injection Technique and Safety Measures
Following proper technique will help minimize the chances of complications occurring. Apply a numbing cream (such as 10-20% Lidocaine Cream) 30-45 minutes prior to treating and remove all of it before cleansing the skin.

Cleansing the skin should be performed using a standard facial cleanser followed by alc wipes. The locations where you plan to administer the product should be marked using a marker. The marker will allow you to place the products in accurate locations and assist in maintaining a well-organized approach.

It is extremely important to use the pinch method when administering injections. Using your non-dominant hand, pinch and elevate the fatty layer between your thumb and index finger. Pinching the fatty layer provides two benefits (one is lifting the fatty layer away from underlying structures such as nerve and vascular bundles; the other is providing tactile feedback regarding the thickness of the tissue). To further reduce the risk of inserting the needle too deeply into the body, insert the needle at a 45 degree angle rather than directly vertically. Additionally, you may choose to simply push the needle directly into the dermal layer until you feel resistance from the dermis, then immediately adjust the needle to a 45 degree angle to continue safely into the subcutaneous fat.

Prior to actually injecting the medication, aspirating or pulling back on the syringe plunger (the aspiration) is another optional safety measure. Aspirating allows you to verify whether or not you have entered a vascular bundle. Prior to releasing the spring-loaded mechanism that injects the medication, pull back on the plunger and hold it in position for 5-10 seconds. If you observe blood entering the syringe during this time, you have inserted the needle into a vascular structure and should withdraw the needle immediately. Please note that aspirating does not always identify every instance when a needle has been placed within a blood vessel. Blood may appear in some instances when there is compression of the blood vessel wall against the inner diameter of the needle tip preventing the blood from flowing into the syringe. Therefore, please do not depend solely upon aspiration as your only safety precaution.

When injecting the medication, release it very slowly. It would be ideal to deliver no greater than .05 to .1 ml/sec. Delivering too much volume rapidly creates increased intravascular pressure, significantly increasing the likelihood of having the medication spread beyond its intended location or being forced into vascular bundles. Injecting small volumes at low pressures greatly reduces these occurrences.

Once injected, apply light pressure with a clean alc wipe to sterilize the skin again. Do not press hard on the treated area nor vigorously massage it. Proceed slowly along your drawn lines and quickly wipe away each line once you have completed an injection at that site. This will prevent you from confusing what you previously treated with what you are currently treating and will assure complete coverage of your intended area without unnecessary repeat treatments of already treated sites.

4.4 My Personal DIY Video

Lipo Vela V: This is what I injected. I ordered 10 vials, but you shouldn't need more than 1 vial per session (if only treating cheeks).
Alcohol wipes: I used this to sterilize my vial as well as my face pre and post injection.
8 mm 27-31 G needles: To extract and inject the solution.
Eyeliner Pen: This was used to draw markings on my face. I suggest getting surgical pens, but I could not be bothered.
Facial Cleanser: This was to make sure my face was clean. I used it pre and post lidocaine.
Topical lidocaine: This was used to numb the areas I was treating. I ordered 10.56% and let it sit on my face for 45 minutes.
Surgical gloves: Used these to make sure everything was sterile.

I sourced my Lipo Vela V (the solution) from here and my topical lidocaine (the numbing cream) from here.

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Post-Treatment Care and Recovery Management

5.1 Right After the Procedure
After the procedure, the site will become swollen and tender for a few days. Swelling is expected as it indicates injury to the fat cells and irritation to the tissue caused by the product.

Most people experience the greatest amount of swelling within 48 – 72 hours post procedure. At this point, the swelling may be quite significant and alter the facial contours temporarily. A cold pack could be applied for 10 – 15 minutes in the first hour of recovery to assist with reducing swelling. The cold pack should never be pressed against the skin.

You should sleep with your head elevated for 2 – 3 days to allow fluids to drain from the treatment area. You should also drink a minimum of 2 – 3 liters of water per day. Drinking large amounts of water will aid in flushing out the fat that has been released from the damaged fat cells.

5.2 The First Week
It is common for the area treated to continue feeling slightly firm and/or tender during the first week post-procedure. These sensations typically indicate continued swelling and/or the beginning stages of tissue repair; which are both normal processes.

You are advised to wash your skin lightly for the first several weeks post-procedure. Harsh cleansers or exfoliating agents should be avoided.

Any high-intensity physical activities or activities that significantly elevate your body temperature should be delayed until at least 7 days post-procedure.

Applying any sort of makeup to areas where treatments have taken place should be avoided for at least 24 hours post-procedure.

Early warning signs include increasing redness, worsening pain, or unusual nerve-related symptoms. If these occur, please be aware.

5.3 Later Results and Keeping Them
Long-term results begin to appear approximately 2-4 weeks post-treatment when swelling subsides. Once fat cells are destroyed via Liposuction, they cannot regenerate. However, existing fat cells can grow larger due to weight gain. Therefore, maintaining a consistent weight is important for optimal results.

As mentioned earlier, Lipo Vela contains various types of growth factors and peptides that can potentially help improve skin elasticity over a period of time (months). Skin tightness achieved via Lipo Vela treatments varies based on many factors including patient’s age, skin type and quality, and overall technique during the procedure.

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Complications and Adverse Events

6.1 Normal Swelling And Pain
Understanding what is "normal" vs. needing medical attention is crucial.
Normal things include:

• Peak swelling at approximately day 3; nearly all swelling resolved by 1 week.
• Firmness for about 1-2 wkees.
• Bruising that will take anywhere from 3-10 days to resolve.
• Mild discomfort/pain for 3-7 days.
• Numbness/tingling which typically resolves spontaneously.

6.2 Infection
Infection occurs rarely with clean technique, however infection can be serious.

Look for these:
• Redness and increased temperature greater than 72 hrs.
• Pus formation.
• Fever.
• Feeling unwell generally.
• Increasing pain over time (after initial resolution).

6.3 Nerve Damage
Facial nerves can become involved in injury to the nerve causing difficulty in moving part of the face. The nerve responsible for pulling the lower lip downward is injured most frequently.

Compression or stretching of the nerve commonly results rather than a full cut. Improvement in movement may require weeks-months.

If you have persistent weakness a nerve conduction study (EMG) may be indicated. Surgical intervention is rarely recommended unless significant improvement does not occur after 3-6 months.

6.4 Blindness
Complete loss of sight, often without prior pain. Blindness can occur instantaneously, during or immediately following injection into the vicinity of the eye (between the eyebrows, or along the bridge of the nose).

Blindness due to arterial occlusion is a potentially life-threatening emergency. Even with prompt emergency treatment, restoration of vision is rare.

Prevention of blindness secondary to arterial occlusion can be achieved through avoidance of injection into high risk locations.

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Spoiler: Sources

https://jcasonline.com/injection-li...rs-in-1269-patients-of-indian-and-south-east/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3667690/
https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.841889/full
https://pubmed.ncbi.nlm.nih.gov/27787266/
https://onlinelibrary.wiley.com/doi/10.1111/j.1524-4725.2004.30305.x
https://academic.oup.com/asj/article-abstract/33/3/400/2801373?redirectedFrom=fulltext
https://pubmed.ncbi.nlm.nih.gov/18612680/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8520020/

@Vrilltrum @Tesarossa @Orka @Sayori @Morgan


​

 

[Organ]

GET IN HERE
@subhuman wasian @Short @sample @Akonic @Lord Vader

 

[Tesarossa]

Good thread you remind me of orka

 

[Organ]

@blinkers @xye @-joe @Icr @hate

 

[Organ]

Dissolve Stubborn Facial Fat
By Organ



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Table of Contents:
Abstract
Introduction
Biochemical Mechanisms and Pharmacological Properties
Facial Anatomy
Treatment Protocols and Technique
Post-Treatment Care and Recovery Management
Complications and Adverse Events
◆━━━━━━━━━━━━━━━━━━━━◆━━━━━━━━━━━━━━━━━━━━◆
Abstract

Fat dissolving injections have become an increasingly popular alternative to surgical methods for eliminating unwanted areas of body fat. Lipo Vela is one of the most advanced fat reduction treatments on the market today. Not only does Lipo Vela dissolve the fat cells, but it also contains specific growth factors to promote overall health of the skin. In contrast to previous fat dissolving treatments which could take a month to begin working, Lipo Vela will provide noticeable results within approximately two weeks.

This study provides a comprehensive description of how Lipo Vela functions while acting as a reference guide for the people who wish to administer this treatment. The study will cover all aspects of administration including; the most effective method of administering the Lipo Vela treatment, common potential adverse reactions or side effects to monitor during and after the procedure, and how to address these complications. Additionally, because the injection site may be difficult to navigate due to proximity to nerve branches and blood vessels, the study will identify locations of significant nerves and blood vessels in order to assist with avoidance of injury. The study will combine prior research with FDA approved data for related treatments (i.e., Kybella) and data on anatomical studies of the face to ensure that all necessary information is available to allow people to utilize Lipo Vela effectively and safely.

◆━━━━━━━━━━━━━━━━━━━━◆━━━━━━━━━━━━━━━━━━━━◆

Introduction

There are numerous new non-surgical body contouring methods available today; however, among them, fat-dissolving treatments have received a great deal of interest due to their ability to be used safely and without surgical risk to remove excess fat from virtually all parts of the body. Fat-dissolving treatments involve the subcutaneous administration of a mixture of various substances below the surface of the skin. Upon administration, the fat dissolver breaks through the fatty cell membrane allowing the fat to be metabolized and removed by the body.

The early injectable fat dissolvers, such as Aqualyx, and others showed that the use of chemical agents to liquefy fat could successfully treat patients. However, there were many shortcomings associated with these early formulations. Some of the shortcomings include extended periods of edema, prolonged post-procedure healing times and variability in post-procedure physical outcomes. Lipo Vela represents a significant advancement in this area of treatment. Unlike earlier treatments, Lipo Vela contains a fast acting liquid formulation that directly attacks and rapidly removes fat cells. Additionally, Lipo Vela includes peptides, vitamins, and growth factors which help maintain the health and firmness of the surrounding skin during the removal process of fat.

The active pharmaceutical components in Lipo Vela (phosphatidylcholine and sodium deoxycholate) have been extensively evaluated in both laboratory experiments and clinical trials. Phosphatidylcholine is a naturally occurring lipid molecule present within the membranes of fat cells and readily binds to the membranes of fat cells. Sodium deoxycholate functions as a detergent-like compound derived from bile acids which effectively destroys the membranes of fat cells by breaking down their outer wall. Studies conducted identified sodium deoxycholate as the sole ingredient in the mixture capable of inducing lipolysis. While phosphatidylcholine serves primarily as an ingredient for delivering the treatment, research suggests that the combination of both compounds may enhance efficacy.

Due to variations in regulatory policies across countries and regions, laws governing fat dissolving treatments vary widely. In the United States, the FDA approved a deoxycholic acid injection called Kybella in April 2015. Specifically. The approval for Kybella was granted solely for reducing moderate to severe submental fullness (fat under the chin). As part of the application process, the manufacturer completed eighteen separate studies to demonstrate its effectiveness and establish safety protocols. Lipo Vela contains the identical primary active ingredient as Kybella. Although Lipo Vela is categorized as a cosmetic product rather than a pharmaceutical, it is therefore exempted from those FDA regulations.

The purpose of this thread is to provide a comprehensive overview of how Lipo Vela functions in terms of its biochemical mechanisms. The guide will also talk about anatomically-based guidelines for ensuring safe delivery of Lipo Vela into the facial tissues. Furthermore, this thread will synthesize existing evidence regarding clinical efficacy and adverse reactions associated with its administration into the face.

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Biochemical Mechanisms and Pharmacological Properties

2.1 Primary Lipolytic Agents
The fat-dissolving properties of Lipo Vela are due primarily to its two key active ingredients; Phosphatidylcholine and Sodium Deoxycholate. Therefore, understanding the mechanism of action of each individual active ingredient as well as how they interact with one another, is crucial to determining the most likely response of a patient to treatment as well as to identifying any possible adverse reactions that may occur.

Phosphatidylcholine is a form of fat, composed of many naturally occurring chemicals (fatty acids and choline) and is one of the primary components of the membranes protecting all human cells. Upon injection into the subcutaneous fat layer, the phosphatidylcholine molecules become incorporated into the membranes of the adipocytes allowing them to weaken and subsequently release the accumulated fat within the cell. Additionally, the phosphatidylcholine serves as an emulsifying agent to help disperse the fat that has been released so that it can be efficiently metabolized and removed by the body.

As stated above, Sodium Deoxycholate is the primary component in Lipo Vela that causes cellular death. Deoxycholate functions in the gastrointestinal tract to break down and solubilize fats from consumed foods. However, upon delivery via injections into the subcutaneous tissue, deoxycholate acts as a potent surfactant breaking down the lipid bilayer structure of the adipocytes thereby causing complete destruction of the fat cells. Studies demonstrated that deoxycholate was capable of killing cells, lysing cell walls, and destroying adipose tissue in experiments. Moreover, the studies demonstrated that deoxycholate performed equally as effective when administered in combination with phosphatidylcholine versus when it was administered in isolation.

Although the exact concentration of sodium deoxycholate employed in these treatments is critical, there are specific limits on the use of deoxycholic acid. For example, Kybella, a U.S. FDA approved product containing 10 mg/mL of deoxycholic acid, is administered in standardized dosages. Concentration levels of deoxycholate found in custom-made products such as Lipo Vela could differ depending on the manufacturer but are typically recommended dosages equivalent to those used in Kybella. Laboratory studies have shown that deoxycholate formulations containing at least 12.5% of the active ingredient are sufficient to effectively destroy adipocytes yet remain safe for patients provided they are properly administered via injection.

2.2 Ancillary Bioactive Components
Beginning with the fat-reducing properties of Lipo Vela, there are a number of other agents included within the solution. These additional components assist in removing excess fat from the body and supporting the health of the skin through-out the fat loss process. The two vitamins included; riboflavin (B2) and cyanocobalamin (B12) aid in enhancing the functioning of cellular metabolic pathways by acting as co-factors for enzymatic processes. In theory, these vitamins will allow the newly formed fatty acids to be burned at a higher rate than would otherwise occur.

L-Carnitine assists in transporting the fatty acid chains to the mitochondria where they can be used as an energy source. This could potentially shorten the time required for removal of the excess fat from the treated regions.

Peptides and Growth Factors make Lipo-Vela different from most all other chemical fat reducing solutions on the market today. Examples of peptides include Syn-Ake. Syn-Ake is a peptide that has been created to mimic the action of a peptide found in cobra venom. Its intended purpose is to soften and reduce facial expressions, thereby preventing the formation of expression lines and wrinkle patterns in areas that were treated. Epidermal Growth Factor (EGF), Fibroblast Growth Factor-1 (FGF-1), Insulin-Like Growth Factor (IGF) and other similar substances have also been added to promote the healing process by stimulating the body's natural repair mechanisms. These substances should provide a means to contract the tissue layers and prevent excessive sagginess after the fat is lost rapidly.

Although the scientific evidence supporting the use of these additives is less extensive than that related to the primary fat dissolving agents, their inclusion represents an effort to correct many common side effects associated with rapid chemical fat loss. Studies have demonstrated that intradermal injection of these solutions does not induce generalized inflammation in the body or adversely affect either fasting glucose levels or total cholesterol concentrations. Therefore, based upon data available to date, if performed properly, these procedures should not produce systemic adverse reactions.

2.3 Adipocyte Response and Clearance Kinetics
After being injected under the skin, Lipo Vela kills fat cells by breaking apart their outer walls. Tissue studies show that the fat cells start breaking down within just hours of the injection. Under ideal conditions, about 72 percent of the treated fat cells show clear signs of being destroyed within 48 hours. The released fat is then slowly cleared away by the body's natural drainage system and normal metabolism.

The body's healing and swelling response to these fat-dissolving injections follows a predictable timeline. Early swelling and redness show that the body is reacting to the destroyed cell parts. This reaction usually hits its peak between 48 and 72 hours after the treatment, during which patients might experience significant swelling and firmness in the treated areas. The next phase, lasting from the third day through the second week, involves the immune system sending out special helper cells to clean up the dead fat cells while the swelling slowly goes down. Physical results begin to show during this time because the swelling fades, revealing the actual loss of fat volume.

Unlike liposuction, which physically vacuums out fat cells through a tube, these injections rely entirely on the body's own natural cleanup systems. This difference is very important when deciding who is a good candidate for the treatment and how they should take care of themselves afterward. People with poor fluid drainage systems or metabolism issues might take longer to clear the fat and could experience longer-lasting swelling. On the other hand, healthy habits that boost the body's drainage and metabolism (such as drinking plenty of water, staying physically active, and using heat treatments like the sauna) might actually help improve the final results.

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Facial Anatomy

3.1 The Facial Nerve and Motor Branches
The majority of the facial nerve exits the base of the skull, branching off into five major divisions, which all supply the muscles involved with facial expression. It is crucial to understand the locations and depths at which these branches lie, to avoid damaging them during the injection process, since accidental injury may lead to significant cosmetic and functional changes of the face.

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The temporal branch serves the muscles of the frontal area (forehead), the eyebrows, and surrounding eye areas. Although generally not in line of sight with cheek injections, excessive superior movement of a treatment towards the temporal area increases the risk of encountering the temporal branch.

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The zygomatic branch serves the muscles of the upper lip required for smiling. When injecting the upper lateral cheek or cheek bone area, this branch becomes increasingly relevant to monitor.

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The intermediate cheek branch supplies the primary muscle of the cheek and also those of the upper lip, lying directly through the center of the face. Due to its proximity to commonly treated areas for reducing fat in the cheeks, injectors must be extremely aware of both the depth of injections and technique.

However, the marginal mandibular branch (also known as the jawline branch) presents the greatest danger to nerve structures when attempting to dissolve facial fat.

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This branch follows the inferior border of the jaw, generally crossing above the primary facial artery approximately one-half inch to one inch anteriorly to the primary masticatory muscle. Human anatomical studies have demonstrated great variability in the course of this nerve among individuals; thus some persons have nerves that extend almost an inch beneath the inferior margin of the jaw. At this point where it crosses the artery, the nerve lies extremely superficially to the skin, creating a high potential for physical contact with a needle or mechanical compression by pressure created by the injected substance.

Damage to this branch creates unique deficits in motor function including inability to depress the lower lip unilaterally. The result is a unilateral asymmetry of smile production, impaired articulation and drooling. Most minor nerve damage resulting from injections will recover spontaneously within weeks to months but permanent nerve damage is always possible.

3.2 Vascular Anatomy and Ophthalmic Complications
There are many other health issues involved with having an injury to one of your facial blood vessels (e.g., temporary or permanent blindness) rather than damage to nerves. One of the largest arteries in your head runs across your lower jaw bone in front of the masseter muscle. As you go up each side of your mouth to the middle of your cheeks, this artery divides into several smaller branches. As it approaches the inner corner of your eye, one of these small branches connects with the major blood vessel coming out of your brain. The major blood vessel comes from your brain’s main blood circulation route and provides blood flow to the center of your retina, as well as the surrounding soft tissue.

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Vision loss occurs when some amount of the injected solution is pushed backwards into the bloodstream by the force of the injection. If enough force is used to push the solution into a facial blood vessel, such as those located close to the eye, the solution will be pushed backward in opposition to the natural direction of blood flow, into the larger blood vessel that supplies blood to the back of your eye. Once in this location, it is possible to totally obstruct this blood vessel and result in almost immediately occurring and permanent vision loss. Even if you get immediate emergency medical treatment, nearly all of these types of vision losses are irreversible.

According to various scientific research articles there have been documented over 190 reported cases of blindness associated with cosmetic facial injections.

Veins on your face pose additional concerns due to their ability to rapidly transmit infection from one part of your body to another via a primary blood collection site located at the base of your brain.

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Dangerous areas involving the potential for blood vessel complications involve space between your eyebrows, where two large facial blood vessels join together to form part of your eye's circulatory system; the bridge of your nose; which has its own separate blood circulatory system; along your smile lines; where your facial artery also has a circulatory pathway into your eye system; and around your eyes, which creates a single continuous circulatory pathway that allows for rapid spread into your eye. Due to the extremely high risks posed by these areas, you must always proceed with caution.

3.3 Subcutaneous Fat Compartments
When we look at the fat directly under the skin on our faces, it doesn't appear as a single, cohesive layer. Instead, the fat under the skin is separated into discrete, individual compartments or "pockets" of fat that are created and defined by walls made up of connective tissue. There are many different types of these individual compartments; they are found in the cheek's inner wall, in the center of the cheeks, in the areas known as the smile lines, and in the area right under the chin, and so forth. As you can imagine each compartment will age independently of all the other compartments, and will therefore respond uniquely to any type of cosmetic treatment applied to them.

One of the most common locations to treat with fat-dissolving injections is the area where the primary fat compartment is located immediately below the skin in the inner part of the cheek. This particular location has a very strategic advantage. This fat compartment rests over several critical structures including the facial expression muscles and the deep layers of facial tissue. Therefore, there is enough volume loss after treating this compartment to be visually apparent, yet safely removed from both larger nerves and larger blood vessels that are located in the deeper tissue layers. On top, this area is bordered by the suborbital fold (under eye); underneath by the bony edge of the mandible (the lower jaw bone), but an injection must remain far enough above this border to prevent harm; on the inside by the nasolabial folds (smile lines) and on the outside by the masseter muscle (chewing muscle).

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Treatment Protocols and Technique

4.1 Right People for This
The most effective way to get optimal results and minimize risks associated with dissolving facial fat is to understand if you are a right candidate. Adults with small, resistant areas of fat that are unresponsive to dietary changes or increased levels of activity and have good elasticity in the skin that will retract to the new dimensions after the removal of excess fat are considered the perfect candidates. Also, it is crucial for patients to understand that the effects of these procedures occur gradually and may necessitate multiple rounds of treatment to achieve desired results.

Certain medical conditions make the use of this type of treatment unacceptable. Infection in the area being treated; pregnancy or breastfeeding; a known history of anaphylaxis to one or more of the ingredients contained in the injectable material; people with hemophilia; people on anticoagulant therapy; and those with significant metabolic problems such as poorly controlled diabetes or significant impairment to healing potential, should all completely refrain from using this type of treatment.

4.2 Treatment Planning and Mapping
Having a good plan to follow when performing treatments helps provide better consistencies in treatments and safer treatments. When you are treating the cheeks, I suggest creating a grid of anywhere from 9 to 25 areas of injection in each cheek, based on the length of your mandible and what type of results you want to obtain. Then space those areas approximately 1/2 inch (or 1 cm.) apart. The spacing and number of areas create a consistent application of the product throughout the shallow fat pocket in the inner cheek while remaining outside the danger zones.

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It is very important to note that when injecting this product, never use more than .2ml. of product in each point. The reason for this is because the product expand significantly after being injected and therefore will spread out over the surface area regardless of how much was initially placed in each site. Therefore, by keeping your injections limited to .2ml., you are able to maintain complete control of how much product has been applied to a given site. This ultimately ensures that the amount of product utilized for a treatment is always going to be safe.

By allowing a minimum of 21 days (three to four weeks), prior to another treatment session, you allow sufficient time for all inflammation associated with the first treatment session to resolve. By waiting long enough to observe how well the treatment responded before proceeding with additional treatments, you will also ensure that you are able to determine how many treatment sessions will be required to produce optimal visual results.

4.3 Injection Technique and Safety Measures
Following proper technique will help minimize the chances of complications occurring. Apply a numbing cream (such as 10-20% Lidocaine Cream) 30-45 minutes prior to treating and remove all of it before cleansing the skin.

Cleansing the skin should be performed using a standard facial cleanser followed by alc wipes. The locations where you plan to administer the product should be marked using a marker. The marker will allow you to place the products in accurate locations and assist in maintaining a well-organized approach.

It is extremely important to use the pinch method when administering injections. Using your non-dominant hand, pinch and elevate the fatty layer between your thumb and index finger. Pinching the fatty layer provides two benefits (one is lifting the fatty layer away from underlying structures such as nerve and vascular bundles; the other is providing tactile feedback regarding the thickness of the tissue). To further reduce the risk of inserting the needle too deeply into the body, insert the needle at a 45 degree angle rather than directly vertically. Additionally, you may choose to simply push the needle directly into the dermal layer until you feel resistance from the dermis, then immediately adjust the needle to a 45 degree angle to continue safely into the subcutaneous fat.

View attachment 5627626

Prior to actually injecting the medication, aspirating or pulling back on the syringe plunger (the aspiration) is another optional safety measure. Aspirating allows you to verify whether or not you have entered a vascular bundle. Prior to releasing the spring-loaded mechanism that injects the medication, pull back on the plunger and hold it in position for 5-10 seconds. If you observe blood entering the syringe during this time, you have inserted the needle into a vascular structure and should withdraw the needle immediately. Please note that aspirating does not always identify every instance when a needle has been placed within a blood vessel. Blood may appear in some instances when there is compression of the blood vessel wall against the inner diameter of the needle tip preventing the blood from flowing into the syringe. Therefore, please do not depend solely upon aspiration as your only safety precaution.

View attachment 5627619

When injecting the medication, release it very slowly. It would be ideal to deliver no greater than .05 to .1 ml/sec. Delivering too much volume rapidly creates increased intravascular pressure, significantly increasing the likelihood of having the medication spread beyond its intended location or being forced into vascular bundles. Injecting small volumes at low pressures greatly reduces these occurrences.

Once injected, apply light pressure with a clean alc wipe to sterilize the skin again. Do not press hard on the treated area nor vigorously massage it. Proceed slowly along your drawn lines and quickly wipe away each line once you have completed an injection at that site. This will prevent you from confusing what you previously treated with what you are currently treating and will assure complete coverage of your intended area without unnecessary repeat treatments of already treated sites.

4.4 My Personal DIY Video

Lipo Vela V: This is what I injected. I ordered 10 vials, but you shouldn't need more than 1 vial per session (if only treating cheeks).
Alcohol wipes: I used this to sterilize my vial as well as my face pre and post injection.
8 mm 27-31 G needles: To extract and inject the solution.
Eyeliner Pen: This was used to draw markings on my face. I suggest getting surgical pens, but I could not be bothered.
Facial Cleanser: This was to make sure my face was clean. I used it pre and post lidocaine.
Topical lidocaine: This was used to numb the areas I was treating. I ordered 10.56% and let it sit on my face for 45 minutes.
Surgical gloves: Used these to make sure everything was sterile.

I sourced my Lipo Vela V (the solution) from here and my topical lidocaine (the numbing cream) from here.

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Post-Treatment Care and Recovery Management

5.1 Right After the Procedure
After the procedure, the site will become swollen and tender for a few days. Swelling is expected as it indicates injury to the fat cells and irritation to the tissue caused by the product.

Most people experience the greatest amount of swelling within 48 – 72 hours post procedure. At this point, the swelling may be quite significant and alter the facial contours temporarily. A cold pack could be applied for 10 – 15 minutes in the first hour of recovery to assist with reducing swelling. The cold pack should never be pressed against the skin.

You should sleep with your head elevated for 2 – 3 days to allow fluids to drain from the treatment area. You should also drink a minimum of 2 – 3 liters of water per day. Drinking large amounts of water will aid in flushing out the fat that has been released from the damaged fat cells.

5.2 The First Week
It is common for the area treated to continue feeling slightly firm and/or tender during the first week post-procedure. These sensations typically indicate continued swelling and/or the beginning stages of tissue repair; which are both normal processes.

You are advised to wash your skin lightly for the first several weeks post-procedure. Harsh cleansers or exfoliating agents should be avoided.

Any high-intensity physical activities or activities that significantly elevate your body temperature should be delayed until at least 7 days post-procedure.

Applying any sort of makeup to areas where treatments have taken place should be avoided for at least 24 hours post-procedure.

Early warning signs include increasing redness, worsening pain, or unusual nerve-related symptoms. If these occur, please be aware.

5.3 Later Results and Keeping Them
Long-term results begin to appear approximately 2-4 weeks post-treatment when swelling subsides. Once fat cells are destroyed via Liposuction, they cannot regenerate. However, existing fat cells can grow larger due to weight gain. Therefore, maintaining a consistent weight is important for optimal results.

As mentioned earlier, Lipo Vela contains various types of growth factors and peptides that can potentially help improve skin elasticity over a period of time (months). Skin tightness achieved via Lipo Vela treatments varies based on many factors including patient’s age, skin type and quality, and overall technique during the procedure.

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Complications and Adverse Events

6.1 Normal Swelling And Pain
Understanding what is "normal" vs. needing medical attention is crucial.
Normal things include:

• Peak swelling at approximately day 3; nearly all swelling resolved by 1 week.
• Firmness for about 1-2 wkees.
• Bruising that will take anywhere from 3-10 days to resolve.
• Mild discomfort/pain for 3-7 days.
• Numbness/tingling which typically resolves spontaneously.

6.2 Infection
Infection occurs rarely with clean technique, however infection can be serious.

Look for these:
• Redness and increased temperature greater than 72 hrs.
• Pus formation.
• Fever.
• Feeling unwell generally.
• Increasing pain over time (after initial resolution).

6.3 Nerve Damage
Facial nerves can become involved in injury to the nerve causing difficulty in moving part of the face. The nerve responsible for pulling the lower lip downward is injured most frequently.

Compression or stretching of the nerve commonly results rather than a full cut. Improvement in movement may require weeks-months.

If you have persistent weakness a nerve conduction study (EMG) may be indicated. Surgical intervention is rarely recommended unless significant improvement does not occur after 3-6 months.

6.4 Blindness
Complete loss of sight, often without prior pain. Blindness can occur instantaneously, during or immediately following injection into the vicinity of the eye (between the eyebrows, or along the bridge of the nose).

Blindness due to arterial occlusion is a potentially life-threatening emergency. Even with prompt emergency treatment, restoration of vision is rare.

Prevention of blindness secondary to arterial occlusion can be achieved through avoidance of injection into high risk locations.

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Spoiler: Sources

https://jcasonline.com/injection-li...rs-in-1269-patients-of-indian-and-south-east/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3667690/
https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.841889/full
https://pubmed.ncbi.nlm.nih.gov/27787266/
https://onlinelibrary.wiley.com/doi/10.1111/j.1524-4725.2004.30305.x
https://academic.oup.com/asj/article-abstract/33/3/400/2801373?redirectedFrom=fulltext
https://pubmed.ncbi.nlm.nih.gov/18612680/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8520020/

@Vrilltrum @Tesarossa @Orka @Sayori @Morgan


​

@xtract @swedchud @trueslavicleo @Paul.jnxy @mistermogsalot

 

[mistermogsalot]

@xtract @swedchud @trueslavicleo @Paul.jnxy @mistermogsalot

sick thread bro thanks for the tag

 

[Organ]

@illusion @pinterest @Sadist @Menas @Gengar’s Ghost

 

[erome]

inb4 botb

 

[Icr]

Dissolve Stubborn Facial Fat
By Organ



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Table of Contents:
Abstract
Introduction
Biochemical Mechanisms and Pharmacological Properties
Facial Anatomy
Treatment Protocols and Technique
Post-Treatment Care and Recovery Management
Complications and Adverse Events
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Abstract

Fat dissolving injections have become an increasingly popular alternative to surgical methods for eliminating unwanted areas of body fat. Lipo Vela is one of the most advanced fat reduction treatments on the market today. Not only does Lipo Vela dissolve the fat cells, but it also contains specific growth factors to promote overall health of the skin. In contrast to previous fat dissolving treatments which could take a month to begin working, Lipo Vela will provide noticeable results within approximately two weeks.

This study provides a comprehensive description of how Lipo Vela functions while acting as a reference guide for the people who wish to administer this treatment. The study will cover all aspects of administration including; the most effective method of administering the Lipo Vela treatment, common potential adverse reactions or side effects to monitor during and after the procedure, and how to address these complications. Additionally, because the injection site may be difficult to navigate due to proximity to nerve branches and blood vessels, the study will identify locations of significant nerves and blood vessels in order to assist with avoidance of injury. The study will combine prior research with FDA approved data for related treatments (i.e., Kybella) and data on anatomical studies of the face to ensure that all necessary information is available to allow people to utilize Lipo Vela effectively and safely.

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Introduction

There are numerous new non-surgical body contouring methods available today; however, among them, fat-dissolving treatments have received a great deal of interest due to their ability to be used safely and without surgical risk to remove excess fat from virtually all parts of the body. Fat-dissolving treatments involve the subcutaneous administration of a mixture of various substances below the surface of the skin. Upon administration, the fat dissolver breaks through the fatty cell membrane allowing the fat to be metabolized and removed by the body.

The early injectable fat dissolvers, such as Aqualyx, and others showed that the use of chemical agents to liquefy fat could successfully treat patients. However, there were many shortcomings associated with these early formulations. Some of the shortcomings include extended periods of edema, prolonged post-procedure healing times and variability in post-procedure physical outcomes. Lipo Vela represents a significant advancement in this area of treatment. Unlike earlier treatments, Lipo Vela contains a fast acting liquid formulation that directly attacks and rapidly removes fat cells. Additionally, Lipo Vela includes peptides, vitamins, and growth factors which help maintain the health and firmness of the surrounding skin during the removal process of fat.

The active pharmaceutical components in Lipo Vela (phosphatidylcholine and sodium deoxycholate) have been extensively evaluated in both laboratory experiments and clinical trials. Phosphatidylcholine is a naturally occurring lipid molecule present within the membranes of fat cells and readily binds to the membranes of fat cells. Sodium deoxycholate functions as a detergent-like compound derived from bile acids which effectively destroys the membranes of fat cells by breaking down their outer wall. Studies conducted identified sodium deoxycholate as the sole ingredient in the mixture capable of inducing lipolysis. While phosphatidylcholine serves primarily as an ingredient for delivering the treatment, research suggests that the combination of both compounds may enhance efficacy.

Due to variations in regulatory policies across countries and regions, laws governing fat dissolving treatments vary widely. In the United States, the FDA approved a deoxycholic acid injection called Kybella in April 2015. Specifically. The approval for Kybella was granted solely for reducing moderate to severe submental fullness (fat under the chin). As part of the application process, the manufacturer completed eighteen separate studies to demonstrate its effectiveness and establish safety protocols. Lipo Vela contains the identical primary active ingredient as Kybella. Although Lipo Vela is categorized as a cosmetic product rather than a pharmaceutical, it is therefore exempted from those FDA regulations.

The purpose of this thread is to provide a comprehensive overview of how Lipo Vela functions in terms of its biochemical mechanisms. The guide will also talk about anatomically-based guidelines for ensuring safe delivery of Lipo Vela into the facial tissues. Furthermore, this thread will synthesize existing evidence regarding clinical efficacy and adverse reactions associated with its administration into the face.

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Biochemical Mechanisms and Pharmacological Properties

2.1 Primary Lipolytic Agents
The fat-dissolving properties of Lipo Vela are due primarily to its two key active ingredients; Phosphatidylcholine and Sodium Deoxycholate. Therefore, understanding the mechanism of action of each individual active ingredient as well as how they interact with one another, is crucial to determining the most likely response of a patient to treatment as well as to identifying any possible adverse reactions that may occur.

Phosphatidylcholine is a form of fat, composed of many naturally occurring chemicals (fatty acids and choline) and is one of the primary components of the membranes protecting all human cells. Upon injection into the subcutaneous fat layer, the phosphatidylcholine molecules become incorporated into the membranes of the adipocytes allowing them to weaken and subsequently release the accumulated fat within the cell. Additionally, the phosphatidylcholine serves as an emulsifying agent to help disperse the fat that has been released so that it can be efficiently metabolized and removed by the body.

As stated above, Sodium Deoxycholate is the primary component in Lipo Vela that causes cellular death. Deoxycholate functions in the gastrointestinal tract to break down and solubilize fats from consumed foods. However, upon delivery via injections into the subcutaneous tissue, deoxycholate acts as a potent surfactant breaking down the lipid bilayer structure of the adipocytes thereby causing complete destruction of the fat cells. Studies demonstrated that deoxycholate was capable of killing cells, lysing cell walls, and destroying adipose tissue in experiments. Moreover, the studies demonstrated that deoxycholate performed equally as effective when administered in combination with phosphatidylcholine versus when it was administered in isolation.

Although the exact concentration of sodium deoxycholate employed in these treatments is critical, there are specific limits on the use of deoxycholic acid. For example, Kybella, a U.S. FDA approved product containing 10 mg/mL of deoxycholic acid, is administered in standardized dosages. Concentration levels of deoxycholate found in custom-made products such as Lipo Vela could differ depending on the manufacturer but are typically recommended dosages equivalent to those used in Kybella. Laboratory studies have shown that deoxycholate formulations containing at least 12.5% of the active ingredient are sufficient to effectively destroy adipocytes yet remain safe for patients provided they are properly administered via injection.

2.2 Ancillary Bioactive Components
Beginning with the fat-reducing properties of Lipo Vela, there are a number of other agents included within the solution. These additional components assist in removing excess fat from the body and supporting the health of the skin through-out the fat loss process. The two vitamins included; riboflavin (B2) and cyanocobalamin (B12) aid in enhancing the functioning of cellular metabolic pathways by acting as co-factors for enzymatic processes. In theory, these vitamins will allow the newly formed fatty acids to be burned at a higher rate than would otherwise occur.

L-Carnitine assists in transporting the fatty acid chains to the mitochondria where they can be used as an energy source. This could potentially shorten the time required for removal of the excess fat from the treated regions.

Peptides and Growth Factors make Lipo-Vela different from most all other chemical fat reducing solutions on the market today. Examples of peptides include Syn-Ake. Syn-Ake is a peptide that has been created to mimic the action of a peptide found in cobra venom. Its intended purpose is to soften and reduce facial expressions, thereby preventing the formation of expression lines and wrinkle patterns in areas that were treated. Epidermal Growth Factor (EGF), Fibroblast Growth Factor-1 (FGF-1), Insulin-Like Growth Factor (IGF) and other similar substances have also been added to promote the healing process by stimulating the body's natural repair mechanisms. These substances should provide a means to contract the tissue layers and prevent excessive sagginess after the fat is lost rapidly.

Although the scientific evidence supporting the use of these additives is less extensive than that related to the primary fat dissolving agents, their inclusion represents an effort to correct many common side effects associated with rapid chemical fat loss. Studies have demonstrated that intradermal injection of these solutions does not induce generalized inflammation in the body or adversely affect either fasting glucose levels or total cholesterol concentrations. Therefore, based upon data available to date, if performed properly, these procedures should not produce systemic adverse reactions.

2.3 Adipocyte Response and Clearance Kinetics
After being injected under the skin, Lipo Vela kills fat cells by breaking apart their outer walls. Tissue studies show that the fat cells start breaking down within just hours of the injection. Under ideal conditions, about 72 percent of the treated fat cells show clear signs of being destroyed within 48 hours. The released fat is then slowly cleared away by the body's natural drainage system and normal metabolism.

The body's healing and swelling response to these fat-dissolving injections follows a predictable timeline. Early swelling and redness show that the body is reacting to the destroyed cell parts. This reaction usually hits its peak between 48 and 72 hours after the treatment, during which patients might experience significant swelling and firmness in the treated areas. The next phase, lasting from the third day through the second week, involves the immune system sending out special helper cells to clean up the dead fat cells while the swelling slowly goes down. Physical results begin to show during this time because the swelling fades, revealing the actual loss of fat volume.

Unlike liposuction, which physically vacuums out fat cells through a tube, these injections rely entirely on the body's own natural cleanup systems. This difference is very important when deciding who is a good candidate for the treatment and how they should take care of themselves afterward. People with poor fluid drainage systems or metabolism issues might take longer to clear the fat and could experience longer-lasting swelling. On the other hand, healthy habits that boost the body's drainage and metabolism (such as drinking plenty of water, staying physically active, and using heat treatments like the sauna) might actually help improve the final results.

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Facial Anatomy

3.1 The Facial Nerve and Motor Branches
The majority of the facial nerve exits the base of the skull, branching off into five major divisions, which all supply the muscles involved with facial expression. It is crucial to understand the locations and depths at which these branches lie, to avoid damaging them during the injection process, since accidental injury may lead to significant cosmetic and functional changes of the face.

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The temporal branch serves the muscles of the frontal area (forehead), the eyebrows, and surrounding eye areas. Although generally not in line of sight with cheek injections, excessive superior movement of a treatment towards the temporal area increases the risk of encountering the temporal branch.

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The zygomatic branch serves the muscles of the upper lip required for smiling. When injecting the upper lateral cheek or cheek bone area, this branch becomes increasingly relevant to monitor.

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The intermediate cheek branch supplies the primary muscle of the cheek and also those of the upper lip, lying directly through the center of the face. Due to its proximity to commonly treated areas for reducing fat in the cheeks, injectors must be extremely aware of both the depth of injections and technique.

However, the marginal mandibular branch (also known as the jawline branch) presents the greatest danger to nerve structures when attempting to dissolve facial fat.

View attachment 5623522

This branch follows the inferior border of the jaw, generally crossing above the primary facial artery approximately one-half inch to one inch anteriorly to the primary masticatory muscle. Human anatomical studies have demonstrated great variability in the course of this nerve among individuals; thus some persons have nerves that extend almost an inch beneath the inferior margin of the jaw. At this point where it crosses the artery, the nerve lies extremely superficially to the skin, creating a high potential for physical contact with a needle or mechanical compression by pressure created by the injected substance.

Damage to this branch creates unique deficits in motor function including inability to depress the lower lip unilaterally. The result is a unilateral asymmetry of smile production, impaired articulation and drooling. Most minor nerve damage resulting from injections will recover spontaneously within weeks to months but permanent nerve damage is always possible.

3.2 Vascular Anatomy and Ophthalmic Complications
There are many other health issues involved with having an injury to one of your facial blood vessels (e.g., temporary or permanent blindness) rather than damage to nerves. One of the largest arteries in your head runs across your lower jaw bone in front of the masseter muscle. As you go up each side of your mouth to the middle of your cheeks, this artery divides into several smaller branches. As it approaches the inner corner of your eye, one of these small branches connects with the major blood vessel coming out of your brain. The major blood vessel comes from your brain’s main blood circulation route and provides blood flow to the center of your retina, as well as the surrounding soft tissue.

View attachment 5623563

Vision loss occurs when some amount of the injected solution is pushed backwards into the bloodstream by the force of the injection. If enough force is used to push the solution into a facial blood vessel, such as those located close to the eye, the solution will be pushed backward in opposition to the natural direction of blood flow, into the larger blood vessel that supplies blood to the back of your eye. Once in this location, it is possible to totally obstruct this blood vessel and result in almost immediately occurring and permanent vision loss. Even if you get immediate emergency medical treatment, nearly all of these types of vision losses are irreversible.

According to various scientific research articles there have been documented over 190 reported cases of blindness associated with cosmetic facial injections.

Veins on your face pose additional concerns due to their ability to rapidly transmit infection from one part of your body to another via a primary blood collection site located at the base of your brain.

View attachment 5623569

Dangerous areas involving the potential for blood vessel complications involve space between your eyebrows, where two large facial blood vessels join together to form part of your eye's circulatory system; the bridge of your nose; which has its own separate blood circulatory system; along your smile lines; where your facial artery also has a circulatory pathway into your eye system; and around your eyes, which creates a single continuous circulatory pathway that allows for rapid spread into your eye. Due to the extremely high risks posed by these areas, you must always proceed with caution.

3.3 Subcutaneous Fat Compartments
When we look at the fat directly under the skin on our faces, it doesn't appear as a single, cohesive layer. Instead, the fat under the skin is separated into discrete, individual compartments or "pockets" of fat that are created and defined by walls made up of connective tissue. There are many different types of these individual compartments; they are found in the cheek's inner wall, in the center of the cheeks, in the areas known as the smile lines, and in the area right under the chin, and so forth. As you can imagine each compartment will age independently of all the other compartments, and will therefore respond uniquely to any type of cosmetic treatment applied to them.

One of the most common locations to treat with fat-dissolving injections is the area where the primary fat compartment is located immediately below the skin in the inner part of the cheek. This particular location has a very strategic advantage. This fat compartment rests over several critical structures including the facial expression muscles and the deep layers of facial tissue. Therefore, there is enough volume loss after treating this compartment to be visually apparent, yet safely removed from both larger nerves and larger blood vessels that are located in the deeper tissue layers. On top, this area is bordered by the suborbital fold (under eye); underneath by the bony edge of the mandible (the lower jaw bone), but an injection must remain far enough above this border to prevent harm; on the inside by the nasolabial folds (smile lines) and on the outside by the masseter muscle (chewing muscle).

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Treatment Protocols and Technique

4.1 Right People for This
The most effective way to get optimal results and minimize risks associated with dissolving facial fat is to understand if you are a right candidate. Adults with small, resistant areas of fat that are unresponsive to dietary changes or increased levels of activity and have good elasticity in the skin that will retract to the new dimensions after the removal of excess fat are considered the perfect candidates. Also, it is crucial for patients to understand that the effects of these procedures occur gradually and may necessitate multiple rounds of treatment to achieve desired results.

Certain medical conditions make the use of this type of treatment unacceptable. Infection in the area being treated; pregnancy or breastfeeding; a known history of anaphylaxis to one or more of the ingredients contained in the injectable material; people with hemophilia; people on anticoagulant therapy; and those with significant metabolic problems such as poorly controlled diabetes or significant impairment to healing potential, should all completely refrain from using this type of treatment.

4.2 Treatment Planning and Mapping
Having a good plan to follow when performing treatments helps provide better consistencies in treatments and safer treatments. When you are treating the cheeks, I suggest creating a grid of anywhere from 9 to 25 areas of injection in each cheek, based on the length of your mandible and what type of results you want to obtain. Then space those areas approximately 1/2 inch (or 1 cm.) apart. The spacing and number of areas create a consistent application of the product throughout the shallow fat pocket in the inner cheek while remaining outside the danger zones.

View attachment 5633813

It is very important to note that when injecting this product, never use more than .2ml. of product in each point. The reason for this is because the product expand significantly after being injected and therefore will spread out over the surface area regardless of how much was initially placed in each site. Therefore, by keeping your injections limited to .2ml., you are able to maintain complete control of how much product has been applied to a given site. This ultimately ensures that the amount of product utilized for a treatment is always going to be safe.

By allowing a minimum of 21 days (three to four weeks), prior to another treatment session, you allow sufficient time for all inflammation associated with the first treatment session to resolve. By waiting long enough to observe how well the treatment responded before proceeding with additional treatments, you will also ensure that you are able to determine how many treatment sessions will be required to produce optimal visual results.

4.3 Injection Technique and Safety Measures
Following proper technique will help minimize the chances of complications occurring. Apply a numbing cream (such as 10-20% Lidocaine Cream) 30-45 minutes prior to treating and remove all of it before cleansing the skin.

Cleansing the skin should be performed using a standard facial cleanser followed by alc wipes. The locations where you plan to administer the product should be marked using a marker. The marker will allow you to place the products in accurate locations and assist in maintaining a well-organized approach.

It is extremely important to use the pinch method when administering injections. Using your non-dominant hand, pinch and elevate the fatty layer between your thumb and index finger. Pinching the fatty layer provides two benefits (one is lifting the fatty layer away from underlying structures such as nerve and vascular bundles; the other is providing tactile feedback regarding the thickness of the tissue). To further reduce the risk of inserting the needle too deeply into the body, insert the needle at a 45 degree angle rather than directly vertically. Additionally, you may choose to simply push the needle directly into the dermal layer until you feel resistance from the dermis, then immediately adjust the needle to a 45 degree angle to continue safely into the subcutaneous fat.

View attachment 5627626

Prior to actually injecting the medication, aspirating or pulling back on the syringe plunger (the aspiration) is another optional safety measure. Aspirating allows you to verify whether or not you have entered a vascular bundle. Prior to releasing the spring-loaded mechanism that injects the medication, pull back on the plunger and hold it in position for 5-10 seconds. If you observe blood entering the syringe during this time, you have inserted the needle into a vascular structure and should withdraw the needle immediately. Please note that aspirating does not always identify every instance when a needle has been placed within a blood vessel. Blood may appear in some instances when there is compression of the blood vessel wall against the inner diameter of the needle tip preventing the blood from flowing into the syringe. Therefore, please do not depend solely upon aspiration as your only safety precaution.

View attachment 5627619

When injecting the medication, release it very slowly. It would be ideal to deliver no greater than .05 to .1 ml/sec. Delivering too much volume rapidly creates increased intravascular pressure, significantly increasing the likelihood of having the medication spread beyond its intended location or being forced into vascular bundles. Injecting small volumes at low pressures greatly reduces these occurrences.

Once injected, apply light pressure with a clean alc wipe to sterilize the skin again. Do not press hard on the treated area nor vigorously massage it. Proceed slowly along your drawn lines and quickly wipe away each line once you have completed an injection at that site. This will prevent you from confusing what you previously treated with what you are currently treating and will assure complete coverage of your intended area without unnecessary repeat treatments of already treated sites.

4.4 My Personal DIY Video

Lipo Vela V: This is what I injected. I ordered 10 vials, but you shouldn't need more than 1 vial per session (if only treating cheeks).
Alcohol wipes: I used this to sterilize my vial as well as my face pre and post injection.
8 mm 27-31 G needles: To extract and inject the solution.
Eyeliner Pen: This was used to draw markings on my face. I suggest getting surgical pens, but I could not be bothered.
Facial Cleanser: This was to make sure my face was clean. I used it pre and post lidocaine.
Topical lidocaine: This was used to numb the areas I was treating. I ordered 10.56% and let it sit on my face for 45 minutes.
Surgical gloves: Used these to make sure everything was sterile.

I sourced my Lipo Vela V (the solution) from here and my topical lidocaine (the numbing cream) from here.

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Post-Treatment Care and Recovery Management

5.1 Right After the Procedure
After the procedure, the site will become swollen and tender for a few days. Swelling is expected as it indicates injury to the fat cells and irritation to the tissue caused by the product.

Most people experience the greatest amount of swelling within 48 – 72 hours post procedure. At this point, the swelling may be quite significant and alter the facial contours temporarily. A cold pack could be applied for 10 – 15 minutes in the first hour of recovery to assist with reducing swelling. The cold pack should never be pressed against the skin.

You should sleep with your head elevated for 2 – 3 days to allow fluids to drain from the treatment area. You should also drink a minimum of 2 – 3 liters of water per day. Drinking large amounts of water will aid in flushing out the fat that has been released from the damaged fat cells.

5.2 The First Week
It is common for the area treated to continue feeling slightly firm and/or tender during the first week post-procedure. These sensations typically indicate continued swelling and/or the beginning stages of tissue repair; which are both normal processes.

You are advised to wash your skin lightly for the first several weeks post-procedure. Harsh cleansers or exfoliating agents should be avoided.

Any high-intensity physical activities or activities that significantly elevate your body temperature should be delayed until at least 7 days post-procedure.

Applying any sort of makeup to areas where treatments have taken place should be avoided for at least 24 hours post-procedure.

Early warning signs include increasing redness, worsening pain, or unusual nerve-related symptoms. If these occur, please be aware.

5.3 Later Results and Keeping Them
Long-term results begin to appear approximately 2-4 weeks post-treatment when swelling subsides. Once fat cells are destroyed via Liposuction, they cannot regenerate. However, existing fat cells can grow larger due to weight gain. Therefore, maintaining a consistent weight is important for optimal results.

As mentioned earlier, Lipo Vela contains various types of growth factors and peptides that can potentially help improve skin elasticity over a period of time (months). Skin tightness achieved via Lipo Vela treatments varies based on many factors including patient’s age, skin type and quality, and overall technique during the procedure.

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Complications and Adverse Events

6.1 Normal Swelling And Pain
Understanding what is "normal" vs. needing medical attention is crucial.
Normal things include:

• Peak swelling at approximately day 3; nearly all swelling resolved by 1 week.
• Firmness for about 1-2 wkees.
• Bruising that will take anywhere from 3-10 days to resolve.
• Mild discomfort/pain for 3-7 days.
• Numbness/tingling which typically resolves spontaneously.

6.2 Infection
Infection occurs rarely with clean technique, however infection can be serious.

Look for these:
• Redness and increased temperature greater than 72 hrs.
• Pus formation.
• Fever.
• Feeling unwell generally.
• Increasing pain over time (after initial resolution).

6.3 Nerve Damage
Facial nerves can become involved in injury to the nerve causing difficulty in moving part of the face. The nerve responsible for pulling the lower lip downward is injured most frequently.

Compression or stretching of the nerve commonly results rather than a full cut. Improvement in movement may require weeks-months.

If you have persistent weakness a nerve conduction study (EMG) may be indicated. Surgical intervention is rarely recommended unless significant improvement does not occur after 3-6 months.

6.4 Blindness
Complete loss of sight, often without prior pain. Blindness can occur instantaneously, during or immediately following injection into the vicinity of the eye (between the eyebrows, or along the bridge of the nose).

Blindness due to arterial occlusion is a potentially life-threatening emergency. Even with prompt emergency treatment, restoration of vision is rare.

Prevention of blindness secondary to arterial occlusion can be achieved through avoidance of injection into high risk locations.

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Spoiler: Sources

https://jcasonline.com/injection-li...rs-in-1269-patients-of-indian-and-south-east/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3667690/
https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.841889/full
https://pubmed.ncbi.nlm.nih.gov/27787266/
https://onlinelibrary.wiley.com/doi/10.1111/j.1524-4725.2004.30305.x
https://academic.oup.com/asj/article-abstract/33/3/400/2801373?redirectedFrom=fulltext
https://pubmed.ncbi.nlm.nih.gov/18612680/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8520020/

@Vrilltrum @Tesarossa @Orka @Sayori @Morgan


​

Mirin thread Bhai better than my shit formating
But how could u forget
Sodium Deoxycholate
Phosphatidylcholine
CBL-514

 

[Icr]

Mirin thread Bhai better than my shit formating
But how could u forget
Sodium Deoxycholate
Phosphatidylcholine
CBL-514

Btw i completely forgot who are u lol
And how do i follow u
Anyways mirin thread Bhai

 

[-joe]

Mirin mirin mirin bra, might as well @ the mods also

@Mods @Master yall fuck with his guide ?

Ma nga was taggin everyone js wanted to include you guys

 

[Icr]

Mirin mirin mirin bra, might as well @ the mods also

@Mods @Master yall fuck with his guide ?

Ma nga was taggin everyone js wanted to include you guys

I can't the mods tag

 

[Orka]

Dissolve Stubborn Facial Fat
By Organ



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Table of Contents:
Abstract
Introduction
Biochemical Mechanisms and Pharmacological Properties
Facial Anatomy
Treatment Protocols and Technique
Post-Treatment Care and Recovery Management
Complications and Adverse Events
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Abstract

Fat dissolving injections have become an increasingly popular alternative to surgical methods for eliminating unwanted areas of body fat. Lipo Vela is one of the most advanced fat reduction treatments on the market today. Not only does Lipo Vela dissolve the fat cells, but it also contains specific growth factors to promote overall health of the skin. In contrast to previous fat dissolving treatments which could take a month to begin working, Lipo Vela will provide noticeable results within approximately two weeks.

This study provides a comprehensive description of how Lipo Vela functions while acting as a reference guide for the people who wish to administer this treatment. The study will cover all aspects of administration including; the most effective method of administering the Lipo Vela treatment, common potential adverse reactions or side effects to monitor during and after the procedure, and how to address these complications. Additionally, because the injection site may be difficult to navigate due to proximity to nerve branches and blood vessels, the study will identify locations of significant nerves and blood vessels in order to assist with avoidance of injury. The study will combine prior research with FDA approved data for related treatments (i.e., Kybella) and data on anatomical studies of the face to ensure that all necessary information is available to allow people to utilize Lipo Vela effectively and safely.

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Introduction

There are numerous new non-surgical body contouring methods available today; however, among them, fat-dissolving treatments have received a great deal of interest due to their ability to be used safely and without surgical risk to remove excess fat from virtually all parts of the body. Fat-dissolving treatments involve the subcutaneous administration of a mixture of various substances below the surface of the skin. Upon administration, the fat dissolver breaks through the fatty cell membrane allowing the fat to be metabolized and removed by the body.

The early injectable fat dissolvers, such as Aqualyx, and others showed that the use of chemical agents to liquefy fat could successfully treat patients. However, there were many shortcomings associated with these early formulations. Some of the shortcomings include extended periods of edema, prolonged post-procedure healing times and variability in post-procedure physical outcomes. Lipo Vela represents a significant advancement in this area of treatment. Unlike earlier treatments, Lipo Vela contains a fast acting liquid formulation that directly attacks and rapidly removes fat cells. Additionally, Lipo Vela includes peptides, vitamins, and growth factors which help maintain the health and firmness of the surrounding skin during the removal process of fat.

The active pharmaceutical components in Lipo Vela (phosphatidylcholine and sodium deoxycholate) have been extensively evaluated in both laboratory experiments and clinical trials. Phosphatidylcholine is a naturally occurring lipid molecule present within the membranes of fat cells and readily binds to the membranes of fat cells. Sodium deoxycholate functions as a detergent-like compound derived from bile acids which effectively destroys the membranes of fat cells by breaking down their outer wall. Studies conducted identified sodium deoxycholate as the sole ingredient in the mixture capable of inducing lipolysis. While phosphatidylcholine serves primarily as an ingredient for delivering the treatment, research suggests that the combination of both compounds may enhance efficacy.

Due to variations in regulatory policies across countries and regions, laws governing fat dissolving treatments vary widely. In the United States, the FDA approved a deoxycholic acid injection called Kybella in April 2015. Specifically. The approval for Kybella was granted solely for reducing moderate to severe submental fullness (fat under the chin). As part of the application process, the manufacturer completed eighteen separate studies to demonstrate its effectiveness and establish safety protocols. Lipo Vela contains the identical primary active ingredient as Kybella. Although Lipo Vela is categorized as a cosmetic product rather than a pharmaceutical, it is therefore exempted from those FDA regulations.

The purpose of this thread is to provide a comprehensive overview of how Lipo Vela functions in terms of its biochemical mechanisms. The guide will also talk about anatomically-based guidelines for ensuring safe delivery of Lipo Vela into the facial tissues. Furthermore, this thread will synthesize existing evidence regarding clinical efficacy and adverse reactions associated with its administration into the face.

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Biochemical Mechanisms and Pharmacological Properties

2.1 Primary Lipolytic Agents
The fat-dissolving properties of Lipo Vela are due primarily to its two key active ingredients; Phosphatidylcholine and Sodium Deoxycholate. Therefore, understanding the mechanism of action of each individual active ingredient as well as how they interact with one another, is crucial to determining the most likely response of a patient to treatment as well as to identifying any possible adverse reactions that may occur.

Phosphatidylcholine is a form of fat, composed of many naturally occurring chemicals (fatty acids and choline) and is one of the primary components of the membranes protecting all human cells. Upon injection into the subcutaneous fat layer, the phosphatidylcholine molecules become incorporated into the membranes of the adipocytes allowing them to weaken and subsequently release the accumulated fat within the cell. Additionally, the phosphatidylcholine serves as an emulsifying agent to help disperse the fat that has been released so that it can be efficiently metabolized and removed by the body.

As stated above, Sodium Deoxycholate is the primary component in Lipo Vela that causes cellular death. Deoxycholate functions in the gastrointestinal tract to break down and solubilize fats from consumed foods. However, upon delivery via injections into the subcutaneous tissue, deoxycholate acts as a potent surfactant breaking down the lipid bilayer structure of the adipocytes thereby causing complete destruction of the fat cells. Studies demonstrated that deoxycholate was capable of killing cells, lysing cell walls, and destroying adipose tissue in experiments. Moreover, the studies demonstrated that deoxycholate performed equally as effective when administered in combination with phosphatidylcholine versus when it was administered in isolation.

Although the exact concentration of sodium deoxycholate employed in these treatments is critical, there are specific limits on the use of deoxycholic acid. For example, Kybella, a U.S. FDA approved product containing 10 mg/mL of deoxycholic acid, is administered in standardized dosages. Concentration levels of deoxycholate found in custom-made products such as Lipo Vela could differ depending on the manufacturer but are typically recommended dosages equivalent to those used in Kybella. Laboratory studies have shown that deoxycholate formulations containing at least 12.5% of the active ingredient are sufficient to effectively destroy adipocytes yet remain safe for patients provided they are properly administered via injection.

2.2 Ancillary Bioactive Components
Beginning with the fat-reducing properties of Lipo Vela, there are a number of other agents included within the solution. These additional components assist in removing excess fat from the body and supporting the health of the skin through-out the fat loss process. The two vitamins included; riboflavin (B2) and cyanocobalamin (B12) aid in enhancing the functioning of cellular metabolic pathways by acting as co-factors for enzymatic processes. In theory, these vitamins will allow the newly formed fatty acids to be burned at a higher rate than would otherwise occur.

L-Carnitine assists in transporting the fatty acid chains to the mitochondria where they can be used as an energy source. This could potentially shorten the time required for removal of the excess fat from the treated regions.

Peptides and Growth Factors make Lipo-Vela different from most all other chemical fat reducing solutions on the market today. Examples of peptides include Syn-Ake. Syn-Ake is a peptide that has been created to mimic the action of a peptide found in cobra venom. Its intended purpose is to soften and reduce facial expressions, thereby preventing the formation of expression lines and wrinkle patterns in areas that were treated. Epidermal Growth Factor (EGF), Fibroblast Growth Factor-1 (FGF-1), Insulin-Like Growth Factor (IGF) and other similar substances have also been added to promote the healing process by stimulating the body's natural repair mechanisms. These substances should provide a means to contract the tissue layers and prevent excessive sagginess after the fat is lost rapidly.

Although the scientific evidence supporting the use of these additives is less extensive than that related to the primary fat dissolving agents, their inclusion represents an effort to correct many common side effects associated with rapid chemical fat loss. Studies have demonstrated that intradermal injection of these solutions does not induce generalized inflammation in the body or adversely affect either fasting glucose levels or total cholesterol concentrations. Therefore, based upon data available to date, if performed properly, these procedures should not produce systemic adverse reactions.

2.3 Adipocyte Response and Clearance Kinetics
After being injected under the skin, Lipo Vela kills fat cells by breaking apart their outer walls. Tissue studies show that the fat cells start breaking down within just hours of the injection. Under ideal conditions, about 72 percent of the treated fat cells show clear signs of being destroyed within 48 hours. The released fat is then slowly cleared away by the body's natural drainage system and normal metabolism.

The body's healing and swelling response to these fat-dissolving injections follows a predictable timeline. Early swelling and redness show that the body is reacting to the destroyed cell parts. This reaction usually hits its peak between 48 and 72 hours after the treatment, during which patients might experience significant swelling and firmness in the treated areas. The next phase, lasting from the third day through the second week, involves the immune system sending out special helper cells to clean up the dead fat cells while the swelling slowly goes down. Physical results begin to show during this time because the swelling fades, revealing the actual loss of fat volume.

Unlike liposuction, which physically vacuums out fat cells through a tube, these injections rely entirely on the body's own natural cleanup systems. This difference is very important when deciding who is a good candidate for the treatment and how they should take care of themselves afterward. People with poor fluid drainage systems or metabolism issues might take longer to clear the fat and could experience longer-lasting swelling. On the other hand, healthy habits that boost the body's drainage and metabolism (such as drinking plenty of water, staying physically active, and using heat treatments like the sauna) might actually help improve the final results.

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Facial Anatomy

3.1 The Facial Nerve and Motor Branches
The majority of the facial nerve exits the base of the skull, branching off into five major divisions, which all supply the muscles involved with facial expression. It is crucial to understand the locations and depths at which these branches lie, to avoid damaging them during the injection process, since accidental injury may lead to significant cosmetic and functional changes of the face.

View attachment 5623275

The temporal branch serves the muscles of the frontal area (forehead), the eyebrows, and surrounding eye areas. Although generally not in line of sight with cheek injections, excessive superior movement of a treatment towards the temporal area increases the risk of encountering the temporal branch.

View attachment 5623277

The zygomatic branch serves the muscles of the upper lip required for smiling. When injecting the upper lateral cheek or cheek bone area, this branch becomes increasingly relevant to monitor.

View attachment 5623509

The intermediate cheek branch supplies the primary muscle of the cheek and also those of the upper lip, lying directly through the center of the face. Due to its proximity to commonly treated areas for reducing fat in the cheeks, injectors must be extremely aware of both the depth of injections and technique.

However, the marginal mandibular branch (also known as the jawline branch) presents the greatest danger to nerve structures when attempting to dissolve facial fat.

View attachment 5623522

This branch follows the inferior border of the jaw, generally crossing above the primary facial artery approximately one-half inch to one inch anteriorly to the primary masticatory muscle. Human anatomical studies have demonstrated great variability in the course of this nerve among individuals; thus some persons have nerves that extend almost an inch beneath the inferior margin of the jaw. At this point where it crosses the artery, the nerve lies extremely superficially to the skin, creating a high potential for physical contact with a needle or mechanical compression by pressure created by the injected substance.

Damage to this branch creates unique deficits in motor function including inability to depress the lower lip unilaterally. The result is a unilateral asymmetry of smile production, impaired articulation and drooling. Most minor nerve damage resulting from injections will recover spontaneously within weeks to months but permanent nerve damage is always possible.

3.2 Vascular Anatomy and Ophthalmic Complications
There are many other health issues involved with having an injury to one of your facial blood vessels (e.g., temporary or permanent blindness) rather than damage to nerves. One of the largest arteries in your head runs across your lower jaw bone in front of the masseter muscle. As you go up each side of your mouth to the middle of your cheeks, this artery divides into several smaller branches. As it approaches the inner corner of your eye, one of these small branches connects with the major blood vessel coming out of your brain. The major blood vessel comes from your brain’s main blood circulation route and provides blood flow to the center of your retina, as well as the surrounding soft tissue.

View attachment 5623563

Vision loss occurs when some amount of the injected solution is pushed backwards into the bloodstream by the force of the injection. If enough force is used to push the solution into a facial blood vessel, such as those located close to the eye, the solution will be pushed backward in opposition to the natural direction of blood flow, into the larger blood vessel that supplies blood to the back of your eye. Once in this location, it is possible to totally obstruct this blood vessel and result in almost immediately occurring and permanent vision loss. Even if you get immediate emergency medical treatment, nearly all of these types of vision losses are irreversible.

According to various scientific research articles there have been documented over 190 reported cases of blindness associated with cosmetic facial injections.

Veins on your face pose additional concerns due to their ability to rapidly transmit infection from one part of your body to another via a primary blood collection site located at the base of your brain.

View attachment 5623569

Dangerous areas involving the potential for blood vessel complications involve space between your eyebrows, where two large facial blood vessels join together to form part of your eye's circulatory system; the bridge of your nose; which has its own separate blood circulatory system; along your smile lines; where your facial artery also has a circulatory pathway into your eye system; and around your eyes, which creates a single continuous circulatory pathway that allows for rapid spread into your eye. Due to the extremely high risks posed by these areas, you must always proceed with caution.

3.3 Subcutaneous Fat Compartments
When we look at the fat directly under the skin on our faces, it doesn't appear as a single, cohesive layer. Instead, the fat under the skin is separated into discrete, individual compartments or "pockets" of fat that are created and defined by walls made up of connective tissue. There are many different types of these individual compartments; they are found in the cheek's inner wall, in the center of the cheeks, in the areas known as the smile lines, and in the area right under the chin, and so forth. As you can imagine each compartment will age independently of all the other compartments, and will therefore respond uniquely to any type of cosmetic treatment applied to them.

One of the most common locations to treat with fat-dissolving injections is the area where the primary fat compartment is located immediately below the skin in the inner part of the cheek. This particular location has a very strategic advantage. This fat compartment rests over several critical structures including the facial expression muscles and the deep layers of facial tissue. Therefore, there is enough volume loss after treating this compartment to be visually apparent, yet safely removed from both larger nerves and larger blood vessels that are located in the deeper tissue layers. On top, this area is bordered by the suborbital fold (under eye); underneath by the bony edge of the mandible (the lower jaw bone), but an injection must remain far enough above this border to prevent harm; on the inside by the nasolabial folds (smile lines) and on the outside by the masseter muscle (chewing muscle).

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Treatment Protocols and Technique

4.1 Right People for This
The most effective way to get optimal results and minimize risks associated with dissolving facial fat is to understand if you are a right candidate. Adults with small, resistant areas of fat that are unresponsive to dietary changes or increased levels of activity and have good elasticity in the skin that will retract to the new dimensions after the removal of excess fat are considered the perfect candidates. Also, it is crucial for patients to understand that the effects of these procedures occur gradually and may necessitate multiple rounds of treatment to achieve desired results.

Certain medical conditions make the use of this type of treatment unacceptable. Infection in the area being treated; pregnancy or breastfeeding; a known history of anaphylaxis to one or more of the ingredients contained in the injectable material; people with hemophilia; people on anticoagulant therapy; and those with significant metabolic problems such as poorly controlled diabetes or significant impairment to healing potential, should all completely refrain from using this type of treatment.

4.2 Treatment Planning and Mapping
Having a good plan to follow when performing treatments helps provide better consistencies in treatments and safer treatments. When you are treating the cheeks, I suggest creating a grid of anywhere from 9 to 25 areas of injection in each cheek, based on the length of your mandible and what type of results you want to obtain. Then space those areas approximately 1/2 inch (or 1 cm.) apart. The spacing and number of areas create a consistent application of the product throughout the shallow fat pocket in the inner cheek while remaining outside the danger zones.

View attachment 5633813

It is very important to note that when injecting this product, never use more than .2ml. of product in each point. The reason for this is because the product expand significantly after being injected and therefore will spread out over the surface area regardless of how much was initially placed in each site. Therefore, by keeping your injections limited to .2ml., you are able to maintain complete control of how much product has been applied to a given site. This ultimately ensures that the amount of product utilized for a treatment is always going to be safe.

By allowing a minimum of 21 days (three to four weeks), prior to another treatment session, you allow sufficient time for all inflammation associated with the first treatment session to resolve. By waiting long enough to observe how well the treatment responded before proceeding with additional treatments, you will also ensure that you are able to determine how many treatment sessions will be required to produce optimal visual results.

4.3 Injection Technique and Safety Measures
Following proper technique will help minimize the chances of complications occurring. Apply a numbing cream (such as 10-20% Lidocaine Cream) 30-45 minutes prior to treating and remove all of it before cleansing the skin.

Cleansing the skin should be performed using a standard facial cleanser followed by alc wipes. The locations where you plan to administer the product should be marked using a marker. The marker will allow you to place the products in accurate locations and assist in maintaining a well-organized approach.

It is extremely important to use the pinch method when administering injections. Using your non-dominant hand, pinch and elevate the fatty layer between your thumb and index finger. Pinching the fatty layer provides two benefits (one is lifting the fatty layer away from underlying structures such as nerve and vascular bundles; the other is providing tactile feedback regarding the thickness of the tissue). To further reduce the risk of inserting the needle too deeply into the body, insert the needle at a 45 degree angle rather than directly vertically. Additionally, you may choose to simply push the needle directly into the dermal layer until you feel resistance from the dermis, then immediately adjust the needle to a 45 degree angle to continue safely into the subcutaneous fat.

View attachment 5627626

Prior to actually injecting the medication, aspirating or pulling back on the syringe plunger (the aspiration) is another optional safety measure. Aspirating allows you to verify whether or not you have entered a vascular bundle. Prior to releasing the spring-loaded mechanism that injects the medication, pull back on the plunger and hold it in position for 5-10 seconds. If you observe blood entering the syringe during this time, you have inserted the needle into a vascular structure and should withdraw the needle immediately. Please note that aspirating does not always identify every instance when a needle has been placed within a blood vessel. Blood may appear in some instances when there is compression of the blood vessel wall against the inner diameter of the needle tip preventing the blood from flowing into the syringe. Therefore, please do not depend solely upon aspiration as your only safety precaution.

View attachment 5627619

When injecting the medication, release it very slowly. It would be ideal to deliver no greater than .05 to .1 ml/sec. Delivering too much volume rapidly creates increased intravascular pressure, significantly increasing the likelihood of having the medication spread beyond its intended location or being forced into vascular bundles. Injecting small volumes at low pressures greatly reduces these occurrences.

Once injected, apply light pressure with a clean alc wipe to sterilize the skin again. Do not press hard on the treated area nor vigorously massage it. Proceed slowly along your drawn lines and quickly wipe away each line once you have completed an injection at that site. This will prevent you from confusing what you previously treated with what you are currently treating and will assure complete coverage of your intended area without unnecessary repeat treatments of already treated sites.

4.4 My Personal DIY Video

Lipo Vela V: This is what I injected. I ordered 10 vials, but you shouldn't need more than 1 vial per session (if only treating cheeks).
Alcohol wipes: I used this to sterilize my vial as well as my face pre and post injection.
8 mm 27-31 G needles: To extract and inject the solution.
Eyeliner Pen: This was used to draw markings on my face. I suggest getting surgical pens, but I could not be bothered.
Facial Cleanser: This was to make sure my face was clean. I used it pre and post lidocaine.
Topical lidocaine: This was used to numb the areas I was treating. I ordered 10.56% and let it sit on my face for 45 minutes.
Surgical gloves: Used these to make sure everything was sterile.

I sourced my Lipo Vela V (the solution) from here and my topical lidocaine (the numbing cream) from here.

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Post-Treatment Care and Recovery Management

5.1 Right After the Procedure
After the procedure, the site will become swollen and tender for a few days. Swelling is expected as it indicates injury to the fat cells and irritation to the tissue caused by the product.

Most people experience the greatest amount of swelling within 48 – 72 hours post procedure. At this point, the swelling may be quite significant and alter the facial contours temporarily. A cold pack could be applied for 10 – 15 minutes in the first hour of recovery to assist with reducing swelling. The cold pack should never be pressed against the skin.

You should sleep with your head elevated for 2 – 3 days to allow fluids to drain from the treatment area. You should also drink a minimum of 2 – 3 liters of water per day. Drinking large amounts of water will aid in flushing out the fat that has been released from the damaged fat cells.

5.2 The First Week
It is common for the area treated to continue feeling slightly firm and/or tender during the first week post-procedure. These sensations typically indicate continued swelling and/or the beginning stages of tissue repair; which are both normal processes.

You are advised to wash your skin lightly for the first several weeks post-procedure. Harsh cleansers or exfoliating agents should be avoided.

Any high-intensity physical activities or activities that significantly elevate your body temperature should be delayed until at least 7 days post-procedure.

Applying any sort of makeup to areas where treatments have taken place should be avoided for at least 24 hours post-procedure.

Early warning signs include increasing redness, worsening pain, or unusual nerve-related symptoms. If these occur, please be aware.

5.3 Later Results and Keeping Them
Long-term results begin to appear approximately 2-4 weeks post-treatment when swelling subsides. Once fat cells are destroyed via Liposuction, they cannot regenerate. However, existing fat cells can grow larger due to weight gain. Therefore, maintaining a consistent weight is important for optimal results.

As mentioned earlier, Lipo Vela contains various types of growth factors and peptides that can potentially help improve skin elasticity over a period of time (months). Skin tightness achieved via Lipo Vela treatments varies based on many factors including patient’s age, skin type and quality, and overall technique during the procedure.

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Complications and Adverse Events

6.1 Normal Swelling And Pain
Understanding what is "normal" vs. needing medical attention is crucial.
Normal things include:

• Peak swelling at approximately day 3; nearly all swelling resolved by 1 week.
• Firmness for about 1-2 wkees.
• Bruising that will take anywhere from 3-10 days to resolve.
• Mild discomfort/pain for 3-7 days.
• Numbness/tingling which typically resolves spontaneously.

6.2 Infection
Infection occurs rarely with clean technique, however infection can be serious.

Look for these:
• Redness and increased temperature greater than 72 hrs.
• Pus formation.
• Fever.
• Feeling unwell generally.
• Increasing pain over time (after initial resolution).

6.3 Nerve Damage
Facial nerves can become involved in injury to the nerve causing difficulty in moving part of the face. The nerve responsible for pulling the lower lip downward is injured most frequently.

Compression or stretching of the nerve commonly results rather than a full cut. Improvement in movement may require weeks-months.

If you have persistent weakness a nerve conduction study (EMG) may be indicated. Surgical intervention is rarely recommended unless significant improvement does not occur after 3-6 months.

6.4 Blindness
Complete loss of sight, often without prior pain. Blindness can occur instantaneously, during or immediately following injection into the vicinity of the eye (between the eyebrows, or along the bridge of the nose).

Blindness due to arterial occlusion is a potentially life-threatening emergency. Even with prompt emergency treatment, restoration of vision is rare.

Prevention of blindness secondary to arterial occlusion can be achieved through avoidance of injection into high risk locations.

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Spoiler: Sources

https://jcasonline.com/injection-li...rs-in-1269-patients-of-indian-and-south-east/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3667690/
https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.841889/full
https://pubmed.ncbi.nlm.nih.gov/27787266/
https://onlinelibrary.wiley.com/doi/10.1111/j.1524-4725.2004.30305.x
https://academic.oup.com/asj/article-abstract/33/3/400/2801373?redirectedFrom=fulltext
https://pubmed.ncbi.nlm.nih.gov/18612680/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8520020/

@Vrilltrum @Tesarossa @Orka @Sayori @Morgan


​

Used the Orka Trademark title, I've copyrighted "INSTANTLY" in all caps

 

[-joe]

Jokes aside OP is Low inhib asf

 

[blinkers]

GET IN HERE
@subhuman wasian @Short @sample @Akonic @Lord Vader

Great thread as always g

 

[Paul.jnxy]

Dissolve Stubborn Facial Fat
By Organ



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Table of Contents:
Abstract
Introduction
Biochemical Mechanisms and Pharmacological Properties
Facial Anatomy
Treatment Protocols and Technique
Post-Treatment Care and Recovery Management
Complications and Adverse Events
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Abstract

Fat dissolving injections have become an increasingly popular alternative to surgical methods for eliminating unwanted areas of body fat. Lipo Vela is one of the most advanced fat reduction treatments on the market today. Not only does Lipo Vela dissolve the fat cells, but it also contains specific growth factors to promote overall health of the skin. In contrast to previous fat dissolving treatments which could take a month to begin working, Lipo Vela will provide noticeable results within approximately two weeks.

This study provides a comprehensive description of how Lipo Vela functions while acting as a reference guide for the people who wish to administer this treatment. The study will cover all aspects of administration including; the most effective method of administering the Lipo Vela treatment, common potential adverse reactions or side effects to monitor during and after the procedure, and how to address these complications. Additionally, because the injection site may be difficult to navigate due to proximity to nerve branches and blood vessels, the study will identify locations of significant nerves and blood vessels in order to assist with avoidance of injury. The study will combine prior research with FDA approved data for related treatments (i.e., Kybella) and data on anatomical studies of the face to ensure that all necessary information is available to allow people to utilize Lipo Vela effectively and safely.

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Introduction

There are numerous new non-surgical body contouring methods available today; however, among them, fat-dissolving treatments have received a great deal of interest due to their ability to be used safely and without surgical risk to remove excess fat from virtually all parts of the body. Fat-dissolving treatments involve the subcutaneous administration of a mixture of various substances below the surface of the skin. Upon administration, the fat dissolver breaks through the fatty cell membrane allowing the fat to be metabolized and removed by the body.

The early injectable fat dissolvers, such as Aqualyx, and others showed that the use of chemical agents to liquefy fat could successfully treat patients. However, there were many shortcomings associated with these early formulations. Some of the shortcomings include extended periods of edema, prolonged post-procedure healing times and variability in post-procedure physical outcomes. Lipo Vela represents a significant advancement in this area of treatment. Unlike earlier treatments, Lipo Vela contains a fast acting liquid formulation that directly attacks and rapidly removes fat cells. Additionally, Lipo Vela includes peptides, vitamins, and growth factors which help maintain the health and firmness of the surrounding skin during the removal process of fat.

The active pharmaceutical components in Lipo Vela (phosphatidylcholine and sodium deoxycholate) have been extensively evaluated in both laboratory experiments and clinical trials. Phosphatidylcholine is a naturally occurring lipid molecule present within the membranes of fat cells and readily binds to the membranes of fat cells. Sodium deoxycholate functions as a detergent-like compound derived from bile acids which effectively destroys the membranes of fat cells by breaking down their outer wall. Studies conducted identified sodium deoxycholate as the sole ingredient in the mixture capable of inducing lipolysis. While phosphatidylcholine serves primarily as an ingredient for delivering the treatment, research suggests that the combination of both compounds may enhance efficacy.

Due to variations in regulatory policies across countries and regions, laws governing fat dissolving treatments vary widely. In the United States, the FDA approved a deoxycholic acid injection called Kybella in April 2015. Specifically. The approval for Kybella was granted solely for reducing moderate to severe submental fullness (fat under the chin). As part of the application process, the manufacturer completed eighteen separate studies to demonstrate its effectiveness and establish safety protocols. Lipo Vela contains the identical primary active ingredient as Kybella. Although Lipo Vela is categorized as a cosmetic product rather than a pharmaceutical, it is therefore exempted from those FDA regulations.

The purpose of this thread is to provide a comprehensive overview of how Lipo Vela functions in terms of its biochemical mechanisms. The guide will also talk about anatomically-based guidelines for ensuring safe delivery of Lipo Vela into the facial tissues. Furthermore, this thread will synthesize existing evidence regarding clinical efficacy and adverse reactions associated with its administration into the face.

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Biochemical Mechanisms and Pharmacological Properties

2.1 Primary Lipolytic Agents
The fat-dissolving properties of Lipo Vela are due primarily to its two key active ingredients; Phosphatidylcholine and Sodium Deoxycholate. Therefore, understanding the mechanism of action of each individual active ingredient as well as how they interact with one another, is crucial to determining the most likely response of a patient to treatment as well as to identifying any possible adverse reactions that may occur.

Phosphatidylcholine is a form of fat, composed of many naturally occurring chemicals (fatty acids and choline) and is one of the primary components of the membranes protecting all human cells. Upon injection into the subcutaneous fat layer, the phosphatidylcholine molecules become incorporated into the membranes of the adipocytes allowing them to weaken and subsequently release the accumulated fat within the cell. Additionally, the phosphatidylcholine serves as an emulsifying agent to help disperse the fat that has been released so that it can be efficiently metabolized and removed by the body.

As stated above, Sodium Deoxycholate is the primary component in Lipo Vela that causes cellular death. Deoxycholate functions in the gastrointestinal tract to break down and solubilize fats from consumed foods. However, upon delivery via injections into the subcutaneous tissue, deoxycholate acts as a potent surfactant breaking down the lipid bilayer structure of the adipocytes thereby causing complete destruction of the fat cells. Studies demonstrated that deoxycholate was capable of killing cells, lysing cell walls, and destroying adipose tissue in experiments. Moreover, the studies demonstrated that deoxycholate performed equally as effective when administered in combination with phosphatidylcholine versus when it was administered in isolation.

Although the exact concentration of sodium deoxycholate employed in these treatments is critical, there are specific limits on the use of deoxycholic acid. For example, Kybella, a U.S. FDA approved product containing 10 mg/mL of deoxycholic acid, is administered in standardized dosages. Concentration levels of deoxycholate found in custom-made products such as Lipo Vela could differ depending on the manufacturer but are typically recommended dosages equivalent to those used in Kybella. Laboratory studies have shown that deoxycholate formulations containing at least 12.5% of the active ingredient are sufficient to effectively destroy adipocytes yet remain safe for patients provided they are properly administered via injection.

2.2 Ancillary Bioactive Components
Beginning with the fat-reducing properties of Lipo Vela, there are a number of other agents included within the solution. These additional components assist in removing excess fat from the body and supporting the health of the skin through-out the fat loss process. The two vitamins included; riboflavin (B2) and cyanocobalamin (B12) aid in enhancing the functioning of cellular metabolic pathways by acting as co-factors for enzymatic processes. In theory, these vitamins will allow the newly formed fatty acids to be burned at a higher rate than would otherwise occur.

L-Carnitine assists in transporting the fatty acid chains to the mitochondria where they can be used as an energy source. This could potentially shorten the time required for removal of the excess fat from the treated regions.

Peptides and Growth Factors make Lipo-Vela different from most all other chemical fat reducing solutions on the market today. Examples of peptides include Syn-Ake. Syn-Ake is a peptide that has been created to mimic the action of a peptide found in cobra venom. Its intended purpose is to soften and reduce facial expressions, thereby preventing the formation of expression lines and wrinkle patterns in areas that were treated. Epidermal Growth Factor (EGF), Fibroblast Growth Factor-1 (FGF-1), Insulin-Like Growth Factor (IGF) and other similar substances have also been added to promote the healing process by stimulating the body's natural repair mechanisms. These substances should provide a means to contract the tissue layers and prevent excessive sagginess after the fat is lost rapidly.

Although the scientific evidence supporting the use of these additives is less extensive than that related to the primary fat dissolving agents, their inclusion represents an effort to correct many common side effects associated with rapid chemical fat loss. Studies have demonstrated that intradermal injection of these solutions does not induce generalized inflammation in the body or adversely affect either fasting glucose levels or total cholesterol concentrations. Therefore, based upon data available to date, if performed properly, these procedures should not produce systemic adverse reactions.

2.3 Adipocyte Response and Clearance Kinetics
After being injected under the skin, Lipo Vela kills fat cells by breaking apart their outer walls. Tissue studies show that the fat cells start breaking down within just hours of the injection. Under ideal conditions, about 72 percent of the treated fat cells show clear signs of being destroyed within 48 hours. The released fat is then slowly cleared away by the body's natural drainage system and normal metabolism.

The body's healing and swelling response to these fat-dissolving injections follows a predictable timeline. Early swelling and redness show that the body is reacting to the destroyed cell parts. This reaction usually hits its peak between 48 and 72 hours after the treatment, during which patients might experience significant swelling and firmness in the treated areas. The next phase, lasting from the third day through the second week, involves the immune system sending out special helper cells to clean up the dead fat cells while the swelling slowly goes down. Physical results begin to show during this time because the swelling fades, revealing the actual loss of fat volume.

Unlike liposuction, which physically vacuums out fat cells through a tube, these injections rely entirely on the body's own natural cleanup systems. This difference is very important when deciding who is a good candidate for the treatment and how they should take care of themselves afterward. People with poor fluid drainage systems or metabolism issues might take longer to clear the fat and could experience longer-lasting swelling. On the other hand, healthy habits that boost the body's drainage and metabolism (such as drinking plenty of water, staying physically active, and using heat treatments like the sauna) might actually help improve the final results.

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Facial Anatomy

3.1 The Facial Nerve and Motor Branches
The majority of the facial nerve exits the base of the skull, branching off into five major divisions, which all supply the muscles involved with facial expression. It is crucial to understand the locations and depths at which these branches lie, to avoid damaging them during the injection process, since accidental injury may lead to significant cosmetic and functional changes of the face.

View attachment 5623275

The temporal branch serves the muscles of the frontal area (forehead), the eyebrows, and surrounding eye areas. Although generally not in line of sight with cheek injections, excessive superior movement of a treatment towards the temporal area increases the risk of encountering the temporal branch.

View attachment 5623277

The zygomatic branch serves the muscles of the upper lip required for smiling. When injecting the upper lateral cheek or cheek bone area, this branch becomes increasingly relevant to monitor.

View attachment 5623509

The intermediate cheek branch supplies the primary muscle of the cheek and also those of the upper lip, lying directly through the center of the face. Due to its proximity to commonly treated areas for reducing fat in the cheeks, injectors must be extremely aware of both the depth of injections and technique.

However, the marginal mandibular branch (also known as the jawline branch) presents the greatest danger to nerve structures when attempting to dissolve facial fat.

View attachment 5623522

This branch follows the inferior border of the jaw, generally crossing above the primary facial artery approximately one-half inch to one inch anteriorly to the primary masticatory muscle. Human anatomical studies have demonstrated great variability in the course of this nerve among individuals; thus some persons have nerves that extend almost an inch beneath the inferior margin of the jaw. At this point where it crosses the artery, the nerve lies extremely superficially to the skin, creating a high potential for physical contact with a needle or mechanical compression by pressure created by the injected substance.

Damage to this branch creates unique deficits in motor function including inability to depress the lower lip unilaterally. The result is a unilateral asymmetry of smile production, impaired articulation and drooling. Most minor nerve damage resulting from injections will recover spontaneously within weeks to months but permanent nerve damage is always possible.

3.2 Vascular Anatomy and Ophthalmic Complications
There are many other health issues involved with having an injury to one of your facial blood vessels (e.g., temporary or permanent blindness) rather than damage to nerves. One of the largest arteries in your head runs across your lower jaw bone in front of the masseter muscle. As you go up each side of your mouth to the middle of your cheeks, this artery divides into several smaller branches. As it approaches the inner corner of your eye, one of these small branches connects with the major blood vessel coming out of your brain. The major blood vessel comes from your brain’s main blood circulation route and provides blood flow to the center of your retina, as well as the surrounding soft tissue.

View attachment 5623563

Vision loss occurs when some amount of the injected solution is pushed backwards into the bloodstream by the force of the injection. If enough force is used to push the solution into a facial blood vessel, such as those located close to the eye, the solution will be pushed backward in opposition to the natural direction of blood flow, into the larger blood vessel that supplies blood to the back of your eye. Once in this location, it is possible to totally obstruct this blood vessel and result in almost immediately occurring and permanent vision loss. Even if you get immediate emergency medical treatment, nearly all of these types of vision losses are irreversible.

According to various scientific research articles there have been documented over 190 reported cases of blindness associated with cosmetic facial injections.

Veins on your face pose additional concerns due to their ability to rapidly transmit infection from one part of your body to another via a primary blood collection site located at the base of your brain.

View attachment 5623569

Dangerous areas involving the potential for blood vessel complications involve space between your eyebrows, where two large facial blood vessels join together to form part of your eye's circulatory system; the bridge of your nose; which has its own separate blood circulatory system; along your smile lines; where your facial artery also has a circulatory pathway into your eye system; and around your eyes, which creates a single continuous circulatory pathway that allows for rapid spread into your eye. Due to the extremely high risks posed by these areas, you must always proceed with caution.

3.3 Subcutaneous Fat Compartments
When we look at the fat directly under the skin on our faces, it doesn't appear as a single, cohesive layer. Instead, the fat under the skin is separated into discrete, individual compartments or "pockets" of fat that are created and defined by walls made up of connective tissue. There are many different types of these individual compartments; they are found in the cheek's inner wall, in the center of the cheeks, in the areas known as the smile lines, and in the area right under the chin, and so forth. As you can imagine each compartment will age independently of all the other compartments, and will therefore respond uniquely to any type of cosmetic treatment applied to them.

One of the most common locations to treat with fat-dissolving injections is the area where the primary fat compartment is located immediately below the skin in the inner part of the cheek. This particular location has a very strategic advantage. This fat compartment rests over several critical structures including the facial expression muscles and the deep layers of facial tissue. Therefore, there is enough volume loss after treating this compartment to be visually apparent, yet safely removed from both larger nerves and larger blood vessels that are located in the deeper tissue layers. On top, this area is bordered by the suborbital fold (under eye); underneath by the bony edge of the mandible (the lower jaw bone), but an injection must remain far enough above this border to prevent harm; on the inside by the nasolabial folds (smile lines) and on the outside by the masseter muscle (chewing muscle).

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Treatment Protocols and Technique

4.1 Right People for This
The most effective way to get optimal results and minimize risks associated with dissolving facial fat is to understand if you are a right candidate. Adults with small, resistant areas of fat that are unresponsive to dietary changes or increased levels of activity and have good elasticity in the skin that will retract to the new dimensions after the removal of excess fat are considered the perfect candidates. Also, it is crucial for patients to understand that the effects of these procedures occur gradually and may necessitate multiple rounds of treatment to achieve desired results.

Certain medical conditions make the use of this type of treatment unacceptable. Infection in the area being treated; pregnancy or breastfeeding; a known history of anaphylaxis to one or more of the ingredients contained in the injectable material; people with hemophilia; people on anticoagulant therapy; and those with significant metabolic problems such as poorly controlled diabetes or significant impairment to healing potential, should all completely refrain from using this type of treatment.

4.2 Treatment Planning and Mapping
Having a good plan to follow when performing treatments helps provide better consistencies in treatments and safer treatments. When you are treating the cheeks, I suggest creating a grid of anywhere from 9 to 25 areas of injection in each cheek, based on the length of your mandible and what type of results you want to obtain. Then space those areas approximately 1/2 inch (or 1 cm.) apart. The spacing and number of areas create a consistent application of the product throughout the shallow fat pocket in the inner cheek while remaining outside the danger zones.

View attachment 5633813

It is very important to note that when injecting this product, never use more than .2ml. of product in each point. The reason for this is because the product expand significantly after being injected and therefore will spread out over the surface area regardless of how much was initially placed in each site. Therefore, by keeping your injections limited to .2ml., you are able to maintain complete control of how much product has been applied to a given site. This ultimately ensures that the amount of product utilized for a treatment is always going to be safe.

By allowing a minimum of 21 days (three to four weeks), prior to another treatment session, you allow sufficient time for all inflammation associated with the first treatment session to resolve. By waiting long enough to observe how well the treatment responded before proceeding with additional treatments, you will also ensure that you are able to determine how many treatment sessions will be required to produce optimal visual results.

4.3 Injection Technique and Safety Measures
Following proper technique will help minimize the chances of complications occurring. Apply a numbing cream (such as 10-20% Lidocaine Cream) 30-45 minutes prior to treating and remove all of it before cleansing the skin.

Cleansing the skin should be performed using a standard facial cleanser followed by alc wipes. The locations where you plan to administer the product should be marked using a marker. The marker will allow you to place the products in accurate locations and assist in maintaining a well-organized approach.

It is extremely important to use the pinch method when administering injections. Using your non-dominant hand, pinch and elevate the fatty layer between your thumb and index finger. Pinching the fatty layer provides two benefits (one is lifting the fatty layer away from underlying structures such as nerve and vascular bundles; the other is providing tactile feedback regarding the thickness of the tissue). To further reduce the risk of inserting the needle too deeply into the body, insert the needle at a 45 degree angle rather than directly vertically. Additionally, you may choose to simply push the needle directly into the dermal layer until you feel resistance from the dermis, then immediately adjust the needle to a 45 degree angle to continue safely into the subcutaneous fat.

View attachment 5627626

Prior to actually injecting the medication, aspirating or pulling back on the syringe plunger (the aspiration) is another optional safety measure. Aspirating allows you to verify whether or not you have entered a vascular bundle. Prior to releasing the spring-loaded mechanism that injects the medication, pull back on the plunger and hold it in position for 5-10 seconds. If you observe blood entering the syringe during this time, you have inserted the needle into a vascular structure and should withdraw the needle immediately. Please note that aspirating does not always identify every instance when a needle has been placed within a blood vessel. Blood may appear in some instances when there is compression of the blood vessel wall against the inner diameter of the needle tip preventing the blood from flowing into the syringe. Therefore, please do not depend solely upon aspiration as your only safety precaution.

View attachment 5627619

When injecting the medication, release it very slowly. It would be ideal to deliver no greater than .05 to .1 ml/sec. Delivering too much volume rapidly creates increased intravascular pressure, significantly increasing the likelihood of having the medication spread beyond its intended location or being forced into vascular bundles. Injecting small volumes at low pressures greatly reduces these occurrences.

Once injected, apply light pressure with a clean alc wipe to sterilize the skin again. Do not press hard on the treated area nor vigorously massage it. Proceed slowly along your drawn lines and quickly wipe away each line once you have completed an injection at that site. This will prevent you from confusing what you previously treated with what you are currently treating and will assure complete coverage of your intended area without unnecessary repeat treatments of already treated sites.

4.4 My Personal DIY Video

Lipo Vela V: This is what I injected. I ordered 10 vials, but you shouldn't need more than 1 vial per session (if only treating cheeks).
Alcohol wipes: I used this to sterilize my vial as well as my face pre and post injection.
8 mm 27-31 G needles: To extract and inject the solution.
Eyeliner Pen: This was used to draw markings on my face. I suggest getting surgical pens, but I could not be bothered.
Facial Cleanser: This was to make sure my face was clean. I used it pre and post lidocaine.
Topical lidocaine: This was used to numb the areas I was treating. I ordered 10.56% and let it sit on my face for 45 minutes.
Surgical gloves: Used these to make sure everything was sterile.

I sourced my Lipo Vela V (the solution) from here and my topical lidocaine (the numbing cream) from here.

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Post-Treatment Care and Recovery Management

5.1 Right After the Procedure
After the procedure, the site will become swollen and tender for a few days. Swelling is expected as it indicates injury to the fat cells and irritation to the tissue caused by the product.

Most people experience the greatest amount of swelling within 48 – 72 hours post procedure. At this point, the swelling may be quite significant and alter the facial contours temporarily. A cold pack could be applied for 10 – 15 minutes in the first hour of recovery to assist with reducing swelling. The cold pack should never be pressed against the skin.

You should sleep with your head elevated for 2 – 3 days to allow fluids to drain from the treatment area. You should also drink a minimum of 2 – 3 liters of water per day. Drinking large amounts of water will aid in flushing out the fat that has been released from the damaged fat cells.

5.2 The First Week
It is common for the area treated to continue feeling slightly firm and/or tender during the first week post-procedure. These sensations typically indicate continued swelling and/or the beginning stages of tissue repair; which are both normal processes.

You are advised to wash your skin lightly for the first several weeks post-procedure. Harsh cleansers or exfoliating agents should be avoided.

Any high-intensity physical activities or activities that significantly elevate your body temperature should be delayed until at least 7 days post-procedure.

Applying any sort of makeup to areas where treatments have taken place should be avoided for at least 24 hours post-procedure.

Early warning signs include increasing redness, worsening pain, or unusual nerve-related symptoms. If these occur, please be aware.

5.3 Later Results and Keeping Them
Long-term results begin to appear approximately 2-4 weeks post-treatment when swelling subsides. Once fat cells are destroyed via Liposuction, they cannot regenerate. However, existing fat cells can grow larger due to weight gain. Therefore, maintaining a consistent weight is important for optimal results.

As mentioned earlier, Lipo Vela contains various types of growth factors and peptides that can potentially help improve skin elasticity over a period of time (months). Skin tightness achieved via Lipo Vela treatments varies based on many factors including patient’s age, skin type and quality, and overall technique during the procedure.

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Complications and Adverse Events

6.1 Normal Swelling And Pain
Understanding what is "normal" vs. needing medical attention is crucial.
Normal things include:

• Peak swelling at approximately day 3; nearly all swelling resolved by 1 week.
• Firmness for about 1-2 wkees.
• Bruising that will take anywhere from 3-10 days to resolve.
• Mild discomfort/pain for 3-7 days.
• Numbness/tingling which typically resolves spontaneously.

6.2 Infection
Infection occurs rarely with clean technique, however infection can be serious.

Look for these:
• Redness and increased temperature greater than 72 hrs.
• Pus formation.
• Fever.
• Feeling unwell generally.
• Increasing pain over time (after initial resolution).

6.3 Nerve Damage
Facial nerves can become involved in injury to the nerve causing difficulty in moving part of the face. The nerve responsible for pulling the lower lip downward is injured most frequently.

Compression or stretching of the nerve commonly results rather than a full cut. Improvement in movement may require weeks-months.

If you have persistent weakness a nerve conduction study (EMG) may be indicated. Surgical intervention is rarely recommended unless significant improvement does not occur after 3-6 months.

6.4 Blindness
Complete loss of sight, often without prior pain. Blindness can occur instantaneously, during or immediately following injection into the vicinity of the eye (between the eyebrows, or along the bridge of the nose).

Blindness due to arterial occlusion is a potentially life-threatening emergency. Even with prompt emergency treatment, restoration of vision is rare.

Prevention of blindness secondary to arterial occlusion can be achieved through avoidance of injection into high risk locations.

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Spoiler: Sources

https://jcasonline.com/injection-li...rs-in-1269-patients-of-indian-and-south-east/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3667690/
https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.841889/full
https://pubmed.ncbi.nlm.nih.gov/27787266/
https://onlinelibrary.wiley.com/doi/10.1111/j.1524-4725.2004.30305.x
https://academic.oup.com/asj/article-abstract/33/3/400/2801373?redirectedFrom=fulltext
https://pubmed.ncbi.nlm.nih.gov/18612680/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8520020/

@Vrilltrum @Tesarossa @Orka @Sayori @Morgan


​

amazing thread Bhai. You really deserve BOTB on a few of your threads. It seems to me that a lot of people do aqualyx instead of Lipo. Why may this be?

 

[Vrilltrum]

Really good th

Dissolve Stubborn Facial Fat
By Organ



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Table of Contents:
Abstract
Introduction
Biochemical Mechanisms and Pharmacological Properties
Facial Anatomy
Treatment Protocols and Technique
Post-Treatment Care and Recovery Management
Complications and Adverse Events
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Abstract

Fat dissolving injections have become an increasingly popular alternative to surgical methods for eliminating unwanted areas of body fat. Lipo Vela is one of the most advanced fat reduction treatments on the market today. Not only does Lipo Vela dissolve the fat cells, but it also contains specific growth factors to promote overall health of the skin. In contrast to previous fat dissolving treatments which could take a month to begin working, Lipo Vela will provide noticeable results within approximately two weeks.

This study provides a comprehensive description of how Lipo Vela functions while acting as a reference guide for the people who wish to administer this treatment. The study will cover all aspects of administration including; the most effective method of administering the Lipo Vela treatment, common potential adverse reactions or side effects to monitor during and after the procedure, and how to address these complications. Additionally, because the injection site may be difficult to navigate due to proximity to nerve branches and blood vessels, the study will identify locations of significant nerves and blood vessels in order to assist with avoidance of injury. The study will combine prior research with FDA approved data for related treatments (i.e., Kybella) and data on anatomical studies of the face to ensure that all necessary information is available to allow people to utilize Lipo Vela effectively and safely.

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Introduction

There are numerous new non-surgical body contouring methods available today; however, among them, fat-dissolving treatments have received a great deal of interest due to their ability to be used safely and without surgical risk to remove excess fat from virtually all parts of the body. Fat-dissolving treatments involve the subcutaneous administration of a mixture of various substances below the surface of the skin. Upon administration, the fat dissolver breaks through the fatty cell membrane allowing the fat to be metabolized and removed by the body.

The early injectable fat dissolvers, such as Aqualyx, and others showed that the use of chemical agents to liquefy fat could successfully treat patients. However, there were many shortcomings associated with these early formulations. Some of the shortcomings include extended periods of edema, prolonged post-procedure healing times and variability in post-procedure physical outcomes. Lipo Vela represents a significant advancement in this area of treatment. Unlike earlier treatments, Lipo Vela contains a fast acting liquid formulation that directly attacks and rapidly removes fat cells. Additionally, Lipo Vela includes peptides, vitamins, and growth factors which help maintain the health and firmness of the surrounding skin during the removal process of fat.

The active pharmaceutical components in Lipo Vela (phosphatidylcholine and sodium deoxycholate) have been extensively evaluated in both laboratory experiments and clinical trials. Phosphatidylcholine is a naturally occurring lipid molecule present within the membranes of fat cells and readily binds to the membranes of fat cells. Sodium deoxycholate functions as a detergent-like compound derived from bile acids which effectively destroys the membranes of fat cells by breaking down their outer wall. Studies conducted identified sodium deoxycholate as the sole ingredient in the mixture capable of inducing lipolysis. While phosphatidylcholine serves primarily as an ingredient for delivering the treatment, research suggests that the combination of both compounds may enhance efficacy.

Due to variations in regulatory policies across countries and regions, laws governing fat dissolving treatments vary widely. In the United States, the FDA approved a deoxycholic acid injection called Kybella in April 2015. Specifically. The approval for Kybella was granted solely for reducing moderate to severe submental fullness (fat under the chin). As part of the application process, the manufacturer completed eighteen separate studies to demonstrate its effectiveness and establish safety protocols. Lipo Vela contains the identical primary active ingredient as Kybella. Although Lipo Vela is categorized as a cosmetic product rather than a pharmaceutical, it is therefore exempted from those FDA regulations.

The purpose of this thread is to provide a comprehensive overview of how Lipo Vela functions in terms of its biochemical mechanisms. The guide will also talk about anatomically-based guidelines for ensuring safe delivery of Lipo Vela into the facial tissues. Furthermore, this thread will synthesize existing evidence regarding clinical efficacy and adverse reactions associated with its administration into the face.

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Biochemical Mechanisms and Pharmacological Properties

2.1 Primary Lipolytic Agents
The fat-dissolving properties of Lipo Vela are due primarily to its two key active ingredients; Phosphatidylcholine and Sodium Deoxycholate. Therefore, understanding the mechanism of action of each individual active ingredient as well as how they interact with one another, is crucial to determining the most likely response of a patient to treatment as well as to identifying any possible adverse reactions that may occur.

Phosphatidylcholine is a form of fat, composed of many naturally occurring chemicals (fatty acids and choline) and is one of the primary components of the membranes protecting all human cells. Upon injection into the subcutaneous fat layer, the phosphatidylcholine molecules become incorporated into the membranes of the adipocytes allowing them to weaken and subsequently release the accumulated fat within the cell. Additionally, the phosphatidylcholine serves as an emulsifying agent to help disperse the fat that has been released so that it can be efficiently metabolized and removed by the body.

As stated above, Sodium Deoxycholate is the primary component in Lipo Vela that causes cellular death. Deoxycholate functions in the gastrointestinal tract to break down and solubilize fats from consumed foods. However, upon delivery via injections into the subcutaneous tissue, deoxycholate acts as a potent surfactant breaking down the lipid bilayer structure of the adipocytes thereby causing complete destruction of the fat cells. Studies demonstrated that deoxycholate was capable of killing cells, lysing cell walls, and destroying adipose tissue in experiments. Moreover, the studies demonstrated that deoxycholate performed equally as effective when administered in combination with phosphatidylcholine versus when it was administered in isolation.

Although the exact concentration of sodium deoxycholate employed in these treatments is critical, there are specific limits on the use of deoxycholic acid. For example, Kybella, a U.S. FDA approved product containing 10 mg/mL of deoxycholic acid, is administered in standardized dosages. Concentration levels of deoxycholate found in custom-made products such as Lipo Vela could differ depending on the manufacturer but are typically recommended dosages equivalent to those used in Kybella. Laboratory studies have shown that deoxycholate formulations containing at least 12.5% of the active ingredient are sufficient to effectively destroy adipocytes yet remain safe for patients provided they are properly administered via injection.

2.2 Ancillary Bioactive Components
Beginning with the fat-reducing properties of Lipo Vela, there are a number of other agents included within the solution. These additional components assist in removing excess fat from the body and supporting the health of the skin through-out the fat loss process. The two vitamins included; riboflavin (B2) and cyanocobalamin (B12) aid in enhancing the functioning of cellular metabolic pathways by acting as co-factors for enzymatic processes. In theory, these vitamins will allow the newly formed fatty acids to be burned at a higher rate than would otherwise occur.

L-Carnitine assists in transporting the fatty acid chains to the mitochondria where they can be used as an energy source. This could potentially shorten the time required for removal of the excess fat from the treated regions.

Peptides and Growth Factors make Lipo-Vela different from most all other chemical fat reducing solutions on the market today. Examples of peptides include Syn-Ake. Syn-Ake is a peptide that has been created to mimic the action of a peptide found in cobra venom. Its intended purpose is to soften and reduce facial expressions, thereby preventing the formation of expression lines and wrinkle patterns in areas that were treated. Epidermal Growth Factor (EGF), Fibroblast Growth Factor-1 (FGF-1), Insulin-Like Growth Factor (IGF) and other similar substances have also been added to promote the healing process by stimulating the body's natural repair mechanisms. These substances should provide a means to contract the tissue layers and prevent excessive sagginess after the fat is lost rapidly.

Although the scientific evidence supporting the use of these additives is less extensive than that related to the primary fat dissolving agents, their inclusion represents an effort to correct many common side effects associated with rapid chemical fat loss. Studies have demonstrated that intradermal injection of these solutions does not induce generalized inflammation in the body or adversely affect either fasting glucose levels or total cholesterol concentrations. Therefore, based upon data available to date, if performed properly, these procedures should not produce systemic adverse reactions.

2.3 Adipocyte Response and Clearance Kinetics
After being injected under the skin, Lipo Vela kills fat cells by breaking apart their outer walls. Tissue studies show that the fat cells start breaking down within just hours of the injection. Under ideal conditions, about 72 percent of the treated fat cells show clear signs of being destroyed within 48 hours. The released fat is then slowly cleared away by the body's natural drainage system and normal metabolism.

The body's healing and swelling response to these fat-dissolving injections follows a predictable timeline. Early swelling and redness show that the body is reacting to the destroyed cell parts. This reaction usually hits its peak between 48 and 72 hours after the treatment, during which patients might experience significant swelling and firmness in the treated areas. The next phase, lasting from the third day through the second week, involves the immune system sending out special helper cells to clean up the dead fat cells while the swelling slowly goes down. Physical results begin to show during this time because the swelling fades, revealing the actual loss of fat volume.

Unlike liposuction, which physically vacuums out fat cells through a tube, these injections rely entirely on the body's own natural cleanup systems. This difference is very important when deciding who is a good candidate for the treatment and how they should take care of themselves afterward. People with poor fluid drainage systems or metabolism issues might take longer to clear the fat and could experience longer-lasting swelling. On the other hand, healthy habits that boost the body's drainage and metabolism (such as drinking plenty of water, staying physically active, and using heat treatments like the sauna) might actually help improve the final results.

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Facial Anatomy

3.1 The Facial Nerve and Motor Branches
The majority of the facial nerve exits the base of the skull, branching off into five major divisions, which all supply the muscles involved with facial expression. It is crucial to understand the locations and depths at which these branches lie, to avoid damaging them during the injection process, since accidental injury may lead to significant cosmetic and functional changes of the face.

View attachment 5623275

The temporal branch serves the muscles of the frontal area (forehead), the eyebrows, and surrounding eye areas. Although generally not in line of sight with cheek injections, excessive superior movement of a treatment towards the temporal area increases the risk of encountering the temporal branch.

View attachment 5623277

The zygomatic branch serves the muscles of the upper lip required for smiling. When injecting the upper lateral cheek or cheek bone area, this branch becomes increasingly relevant to monitor.

View attachment 5623509

The intermediate cheek branch supplies the primary muscle of the cheek and also those of the upper lip, lying directly through the center of the face. Due to its proximity to commonly treated areas for reducing fat in the cheeks, injectors must be extremely aware of both the depth of injections and technique.

However, the marginal mandibular branch (also known as the jawline branch) presents the greatest danger to nerve structures when attempting to dissolve facial fat.

View attachment 5623522

This branch follows the inferior border of the jaw, generally crossing above the primary facial artery approximately one-half inch to one inch anteriorly to the primary masticatory muscle. Human anatomical studies have demonstrated great variability in the course of this nerve among individuals; thus some persons have nerves that extend almost an inch beneath the inferior margin of the jaw. At this point where it crosses the artery, the nerve lies extremely superficially to the skin, creating a high potential for physical contact with a needle or mechanical compression by pressure created by the injected substance.

Damage to this branch creates unique deficits in motor function including inability to depress the lower lip unilaterally. The result is a unilateral asymmetry of smile production, impaired articulation and drooling. Most minor nerve damage resulting from injections will recover spontaneously within weeks to months but permanent nerve damage is always possible.

3.2 Vascular Anatomy and Ophthalmic Complications
There are many other health issues involved with having an injury to one of your facial blood vessels (e.g., temporary or permanent blindness) rather than damage to nerves. One of the largest arteries in your head runs across your lower jaw bone in front of the masseter muscle. As you go up each side of your mouth to the middle of your cheeks, this artery divides into several smaller branches. As it approaches the inner corner of your eye, one of these small branches connects with the major blood vessel coming out of your brain. The major blood vessel comes from your brain’s main blood circulation route and provides blood flow to the center of your retina, as well as the surrounding soft tissue.

View attachment 5623563

Vision loss occurs when some amount of the injected solution is pushed backwards into the bloodstream by the force of the injection. If enough force is used to push the solution into a facial blood vessel, such as those located close to the eye, the solution will be pushed backward in opposition to the natural direction of blood flow, into the larger blood vessel that supplies blood to the back of your eye. Once in this location, it is possible to totally obstruct this blood vessel and result in almost immediately occurring and permanent vision loss. Even if you get immediate emergency medical treatment, nearly all of these types of vision losses are irreversible.

According to various scientific research articles there have been documented over 190 reported cases of blindness associated with cosmetic facial injections.

Veins on your face pose additional concerns due to their ability to rapidly transmit infection from one part of your body to another via a primary blood collection site located at the base of your brain.

View attachment 5623569

Dangerous areas involving the potential for blood vessel complications involve space between your eyebrows, where two large facial blood vessels join together to form part of your eye's circulatory system; the bridge of your nose; which has its own separate blood circulatory system; along your smile lines; where your facial artery also has a circulatory pathway into your eye system; and around your eyes, which creates a single continuous circulatory pathway that allows for rapid spread into your eye. Due to the extremely high risks posed by these areas, you must always proceed with caution.

3.3 Subcutaneous Fat Compartments
When we look at the fat directly under the skin on our faces, it doesn't appear as a single, cohesive layer. Instead, the fat under the skin is separated into discrete, individual compartments or "pockets" of fat that are created and defined by walls made up of connective tissue. There are many different types of these individual compartments; they are found in the cheek's inner wall, in the center of the cheeks, in the areas known as the smile lines, and in the area right under the chin, and so forth. As you can imagine each compartment will age independently of all the other compartments, and will therefore respond uniquely to any type of cosmetic treatment applied to them.

One of the most common locations to treat with fat-dissolving injections is the area where the primary fat compartment is located immediately below the skin in the inner part of the cheek. This particular location has a very strategic advantage. This fat compartment rests over several critical structures including the facial expression muscles and the deep layers of facial tissue. Therefore, there is enough volume loss after treating this compartment to be visually apparent, yet safely removed from both larger nerves and larger blood vessels that are located in the deeper tissue layers. On top, this area is bordered by the suborbital fold (under eye); underneath by the bony edge of the mandible (the lower jaw bone), but an injection must remain far enough above this border to prevent harm; on the inside by the nasolabial folds (smile lines) and on the outside by the masseter muscle (chewing muscle).

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Treatment Protocols and Technique

4.1 Right People for This
The most effective way to get optimal results and minimize risks associated with dissolving facial fat is to understand if you are a right candidate. Adults with small, resistant areas of fat that are unresponsive to dietary changes or increased levels of activity and have good elasticity in the skin that will retract to the new dimensions after the removal of excess fat are considered the perfect candidates. Also, it is crucial for patients to understand that the effects of these procedures occur gradually and may necessitate multiple rounds of treatment to achieve desired results.

Certain medical conditions make the use of this type of treatment unacceptable. Infection in the area being treated; pregnancy or breastfeeding; a known history of anaphylaxis to one or more of the ingredients contained in the injectable material; people with hemophilia; people on anticoagulant therapy; and those with significant metabolic problems such as poorly controlled diabetes or significant impairment to healing potential, should all completely refrain from using this type of treatment.

4.2 Treatment Planning and Mapping
Having a good plan to follow when performing treatments helps provide better consistencies in treatments and safer treatments. When you are treating the cheeks, I suggest creating a grid of anywhere from 9 to 25 areas of injection in each cheek, based on the length of your mandible and what type of results you want to obtain. Then space those areas approximately 1/2 inch (or 1 cm.) apart. The spacing and number of areas create a consistent application of the product throughout the shallow fat pocket in the inner cheek while remaining outside the danger zones.

View attachment 5633813

It is very important to note that when injecting this product, never use more than .2ml. of product in each point. The reason for this is because the product expand significantly after being injected and therefore will spread out over the surface area regardless of how much was initially placed in each site. Therefore, by keeping your injections limited to .2ml., you are able to maintain complete control of how much product has been applied to a given site. This ultimately ensures that the amount of product utilized for a treatment is always going to be safe.

By allowing a minimum of 21 days (three to four weeks), prior to another treatment session, you allow sufficient time for all inflammation associated with the first treatment session to resolve. By waiting long enough to observe how well the treatment responded before proceeding with additional treatments, you will also ensure that you are able to determine how many treatment sessions will be required to produce optimal visual results.

4.3 Injection Technique and Safety Measures
Following proper technique will help minimize the chances of complications occurring. Apply a numbing cream (such as 10-20% Lidocaine Cream) 30-45 minutes prior to treating and remove all of it before cleansing the skin.

Cleansing the skin should be performed using a standard facial cleanser followed by alc wipes. The locations where you plan to administer the product should be marked using a marker. The marker will allow you to place the products in accurate locations and assist in maintaining a well-organized approach.

It is extremely important to use the pinch method when administering injections. Using your non-dominant hand, pinch and elevate the fatty layer between your thumb and index finger. Pinching the fatty layer provides two benefits (one is lifting the fatty layer away from underlying structures such as nerve and vascular bundles; the other is providing tactile feedback regarding the thickness of the tissue). To further reduce the risk of inserting the needle too deeply into the body, insert the needle at a 45 degree angle rather than directly vertically. Additionally, you may choose to simply push the needle directly into the dermal layer until you feel resistance from the dermis, then immediately adjust the needle to a 45 degree angle to continue safely into the subcutaneous fat.

View attachment 5627626

Prior to actually injecting the medication, aspirating or pulling back on the syringe plunger (the aspiration) is another optional safety measure. Aspirating allows you to verify whether or not you have entered a vascular bundle. Prior to releasing the spring-loaded mechanism that injects the medication, pull back on the plunger and hold it in position for 5-10 seconds. If you observe blood entering the syringe during this time, you have inserted the needle into a vascular structure and should withdraw the needle immediately. Please note that aspirating does not always identify every instance when a needle has been placed within a blood vessel. Blood may appear in some instances when there is compression of the blood vessel wall against the inner diameter of the needle tip preventing the blood from flowing into the syringe. Therefore, please do not depend solely upon aspiration as your only safety precaution.

View attachment 5627619

When injecting the medication, release it very slowly. It would be ideal to deliver no greater than .05 to .1 ml/sec. Delivering too much volume rapidly creates increased intravascular pressure, significantly increasing the likelihood of having the medication spread beyond its intended location or being forced into vascular bundles. Injecting small volumes at low pressures greatly reduces these occurrences.

Once injected, apply light pressure with a clean alc wipe to sterilize the skin again. Do not press hard on the treated area nor vigorously massage it. Proceed slowly along your drawn lines and quickly wipe away each line once you have completed an injection at that site. This will prevent you from confusing what you previously treated with what you are currently treating and will assure complete coverage of your intended area without unnecessary repeat treatments of already treated sites.

4.4 My Personal DIY Video

Lipo Vela V: This is what I injected. I ordered 10 vials, but you shouldn't need more than 1 vial per session (if only treating cheeks).
Alcohol wipes: I used this to sterilize my vial as well as my face pre and post injection.
8 mm 27-31 G needles: To extract and inject the solution.
Eyeliner Pen: This was used to draw markings on my face. I suggest getting surgical pens, but I could not be bothered.
Facial Cleanser: This was to make sure my face was clean. I used it pre and post lidocaine.
Topical lidocaine: This was used to numb the areas I was treating. I ordered 10.56% and let it sit on my face for 45 minutes.
Surgical gloves: Used these to make sure everything was sterile.

I sourced my Lipo Vela V (the solution) from here and my topical lidocaine (the numbing cream) from here.

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Post-Treatment Care and Recovery Management

5.1 Right After the Procedure
After the procedure, the site will become swollen and tender for a few days. Swelling is expected as it indicates injury to the fat cells and irritation to the tissue caused by the product.

Most people experience the greatest amount of swelling within 48 – 72 hours post procedure. At this point, the swelling may be quite significant and alter the facial contours temporarily. A cold pack could be applied for 10 – 15 minutes in the first hour of recovery to assist with reducing swelling. The cold pack should never be pressed against the skin.

You should sleep with your head elevated for 2 – 3 days to allow fluids to drain from the treatment area. You should also drink a minimum of 2 – 3 liters of water per day. Drinking large amounts of water will aid in flushing out the fat that has been released from the damaged fat cells.

5.2 The First Week
It is common for the area treated to continue feeling slightly firm and/or tender during the first week post-procedure. These sensations typically indicate continued swelling and/or the beginning stages of tissue repair; which are both normal processes.

You are advised to wash your skin lightly for the first several weeks post-procedure. Harsh cleansers or exfoliating agents should be avoided.

Any high-intensity physical activities or activities that significantly elevate your body temperature should be delayed until at least 7 days post-procedure.

Applying any sort of makeup to areas where treatments have taken place should be avoided for at least 24 hours post-procedure.

Early warning signs include increasing redness, worsening pain, or unusual nerve-related symptoms. If these occur, please be aware.

5.3 Later Results and Keeping Them
Long-term results begin to appear approximately 2-4 weeks post-treatment when swelling subsides. Once fat cells are destroyed via Liposuction, they cannot regenerate. However, existing fat cells can grow larger due to weight gain. Therefore, maintaining a consistent weight is important for optimal results.

As mentioned earlier, Lipo Vela contains various types of growth factors and peptides that can potentially help improve skin elasticity over a period of time (months). Skin tightness achieved via Lipo Vela treatments varies based on many factors including patient’s age, skin type and quality, and overall technique during the procedure.

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Complications and Adverse Events

6.1 Normal Swelling And Pain
Understanding what is "normal" vs. needing medical attention is crucial.
Normal things include:

• Peak swelling at approximately day 3; nearly all swelling resolved by 1 week.
• Firmness for about 1-2 wkees.
• Bruising that will take anywhere from 3-10 days to resolve.
• Mild discomfort/pain for 3-7 days.
• Numbness/tingling which typically resolves spontaneously.

6.2 Infection
Infection occurs rarely with clean technique, however infection can be serious.

Look for these:
• Redness and increased temperature greater than 72 hrs.
• Pus formation.
• Fever.
• Feeling unwell generally.
• Increasing pain over time (after initial resolution).

6.3 Nerve Damage
Facial nerves can become involved in injury to the nerve causing difficulty in moving part of the face. The nerve responsible for pulling the lower lip downward is injured most frequently.

Compression or stretching of the nerve commonly results rather than a full cut. Improvement in movement may require weeks-months.

If you have persistent weakness a nerve conduction study (EMG) may be indicated. Surgical intervention is rarely recommended unless significant improvement does not occur after 3-6 months.

6.4 Blindness
Complete loss of sight, often without prior pain. Blindness can occur instantaneously, during or immediately following injection into the vicinity of the eye (between the eyebrows, or along the bridge of the nose).

Blindness due to arterial occlusion is a potentially life-threatening emergency. Even with prompt emergency treatment, restoration of vision is rare.

Prevention of blindness secondary to arterial occlusion can be achieved through avoidance of injection into high risk locations.

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Spoiler: Sources

https://jcasonline.com/injection-li...rs-in-1269-patients-of-indian-and-south-east/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3667690/
https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.841889/full
https://pubmed.ncbi.nlm.nih.gov/27787266/
https://onlinelibrary.wiley.com/doi/10.1111/j.1524-4725.2004.30305.x
https://academic.oup.com/asj/article-abstract/33/3/400/2801373?redirectedFrom=fulltext
https://pubmed.ncbi.nlm.nih.gov/18612680/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8520020/

@Vrilltrum @Tesarossa @Orka @Sayori @Morgan


​

 

[neverbegan88]

God tier effort ngl

 

[Diddihippi09]

Dissolve Stubborn Facial Fat
By Organ



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Table of Contents:
Abstract
Introduction
Biochemical Mechanisms and Pharmacological Properties
Facial Anatomy
Treatment Protocols and Technique
Post-Treatment Care and Recovery Management
Complications and Adverse Events
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Abstract

Fat dissolving injections have become an increasingly popular alternative to surgical methods for eliminating unwanted areas of body fat. Lipo Vela is one of the most advanced fat reduction treatments on the market today. Not only does Lipo Vela dissolve the fat cells, but it also contains specific growth factors to promote overall health of the skin. In contrast to previous fat dissolving treatments which could take a month to begin working, Lipo Vela will provide noticeable results within approximately two weeks.

This study provides a comprehensive description of how Lipo Vela functions while acting as a reference guide for the people who wish to administer this treatment. The study will cover all aspects of administration including; the most effective method of administering the Lipo Vela treatment, common potential adverse reactions or side effects to monitor during and after the procedure, and how to address these complications. Additionally, because the injection site may be difficult to navigate due to proximity to nerve branches and blood vessels, the study will identify locations of significant nerves and blood vessels in order to assist with avoidance of injury. The study will combine prior research with FDA approved data for related treatments (i.e., Kybella) and data on anatomical studies of the face to ensure that all necessary information is available to allow people to utilize Lipo Vela effectively and safely.

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Introduction

There are numerous new non-surgical body contouring methods available today; however, among them, fat-dissolving treatments have received a great deal of interest due to their ability to be used safely and without surgical risk to remove excess fat from virtually all parts of the body. Fat-dissolving treatments involve the subcutaneous administration of a mixture of various substances below the surface of the skin. Upon administration, the fat dissolver breaks through the fatty cell membrane allowing the fat to be metabolized and removed by the body.

The early injectable fat dissolvers, such as Aqualyx, and others showed that the use of chemical agents to liquefy fat could successfully treat patients. However, there were many shortcomings associated with these early formulations. Some of the shortcomings include extended periods of edema, prolonged post-procedure healing times and variability in post-procedure physical outcomes. Lipo Vela represents a significant advancement in this area of treatment. Unlike earlier treatments, Lipo Vela contains a fast acting liquid formulation that directly attacks and rapidly removes fat cells. Additionally, Lipo Vela includes peptides, vitamins, and growth factors which help maintain the health and firmness of the surrounding skin during the removal process of fat.

The active pharmaceutical components in Lipo Vela (phosphatidylcholine and sodium deoxycholate) have been extensively evaluated in both laboratory experiments and clinical trials. Phosphatidylcholine is a naturally occurring lipid molecule present within the membranes of fat cells and readily binds to the membranes of fat cells. Sodium deoxycholate functions as a detergent-like compound derived from bile acids which effectively destroys the membranes of fat cells by breaking down their outer wall. Studies conducted identified sodium deoxycholate as the sole ingredient in the mixture capable of inducing lipolysis. While phosphatidylcholine serves primarily as an ingredient for delivering the treatment, research suggests that the combination of both compounds may enhance efficacy.

Due to variations in regulatory policies across countries and regions, laws governing fat dissolving treatments vary widely. In the United States, the FDA approved a deoxycholic acid injection called Kybella in April 2015. Specifically. The approval for Kybella was granted solely for reducing moderate to severe submental fullness (fat under the chin). As part of the application process, the manufacturer completed eighteen separate studies to demonstrate its effectiveness and establish safety protocols. Lipo Vela contains the identical primary active ingredient as Kybella. Although Lipo Vela is categorized as a cosmetic product rather than a pharmaceutical, it is therefore exempted from those FDA regulations.

The purpose of this thread is to provide a comprehensive overview of how Lipo Vela functions in terms of its biochemical mechanisms. The guide will also talk about anatomically-based guidelines for ensuring safe delivery of Lipo Vela into the facial tissues. Furthermore, this thread will synthesize existing evidence regarding clinical efficacy and adverse reactions associated with its administration into the face.

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Biochemical Mechanisms and Pharmacological Properties

2.1 Primary Lipolytic Agents
The fat-dissolving properties of Lipo Vela are due primarily to its two key active ingredients; Phosphatidylcholine and Sodium Deoxycholate. Therefore, understanding the mechanism of action of each individual active ingredient as well as how they interact with one another, is crucial to determining the most likely response of a patient to treatment as well as to identifying any possible adverse reactions that may occur.

Phosphatidylcholine is a form of fat, composed of many naturally occurring chemicals (fatty acids and choline) and is one of the primary components of the membranes protecting all human cells. Upon injection into the subcutaneous fat layer, the phosphatidylcholine molecules become incorporated into the membranes of the adipocytes allowing them to weaken and subsequently release the accumulated fat within the cell. Additionally, the phosphatidylcholine serves as an emulsifying agent to help disperse the fat that has been released so that it can be efficiently metabolized and removed by the body.

As stated above, Sodium Deoxycholate is the primary component in Lipo Vela that causes cellular death. Deoxycholate functions in the gastrointestinal tract to break down and solubilize fats from consumed foods. However, upon delivery via injections into the subcutaneous tissue, deoxycholate acts as a potent surfactant breaking down the lipid bilayer structure of the adipocytes thereby causing complete destruction of the fat cells. Studies demonstrated that deoxycholate was capable of killing cells, lysing cell walls, and destroying adipose tissue in experiments. Moreover, the studies demonstrated that deoxycholate performed equally as effective when administered in combination with phosphatidylcholine versus when it was administered in isolation.

Although the exact concentration of sodium deoxycholate employed in these treatments is critical, there are specific limits on the use of deoxycholic acid. For example, Kybella, a U.S. FDA approved product containing 10 mg/mL of deoxycholic acid, is administered in standardized dosages. Concentration levels of deoxycholate found in custom-made products such as Lipo Vela could differ depending on the manufacturer but are typically recommended dosages equivalent to those used in Kybella. Laboratory studies have shown that deoxycholate formulations containing at least 12.5% of the active ingredient are sufficient to effectively destroy adipocytes yet remain safe for patients provided they are properly administered via injection.

2.2 Ancillary Bioactive Components
Beginning with the fat-reducing properties of Lipo Vela, there are a number of other agents included within the solution. These additional components assist in removing excess fat from the body and supporting the health of the skin through-out the fat loss process. The two vitamins included; riboflavin (B2) and cyanocobalamin (B12) aid in enhancing the functioning of cellular metabolic pathways by acting as co-factors for enzymatic processes. In theory, these vitamins will allow the newly formed fatty acids to be burned at a higher rate than would otherwise occur.

L-Carnitine assists in transporting the fatty acid chains to the mitochondria where they can be used as an energy source. This could potentially shorten the time required for removal of the excess fat from the treated regions.

Peptides and Growth Factors make Lipo-Vela different from most all other chemical fat reducing solutions on the market today. Examples of peptides include Syn-Ake. Syn-Ake is a peptide that has been created to mimic the action of a peptide found in cobra venom. Its intended purpose is to soften and reduce facial expressions, thereby preventing the formation of expression lines and wrinkle patterns in areas that were treated. Epidermal Growth Factor (EGF), Fibroblast Growth Factor-1 (FGF-1), Insulin-Like Growth Factor (IGF) and other similar substances have also been added to promote the healing process by stimulating the body's natural repair mechanisms. These substances should provide a means to contract the tissue layers and prevent excessive sagginess after the fat is lost rapidly.

Although the scientific evidence supporting the use of these additives is less extensive than that related to the primary fat dissolving agents, their inclusion represents an effort to correct many common side effects associated with rapid chemical fat loss. Studies have demonstrated that intradermal injection of these solutions does not induce generalized inflammation in the body or adversely affect either fasting glucose levels or total cholesterol concentrations. Therefore, based upon data available to date, if performed properly, these procedures should not produce systemic adverse reactions.

2.3 Adipocyte Response and Clearance Kinetics
After being injected under the skin, Lipo Vela kills fat cells by breaking apart their outer walls. Tissue studies show that the fat cells start breaking down within just hours of the injection. Under ideal conditions, about 72 percent of the treated fat cells show clear signs of being destroyed within 48 hours. The released fat is then slowly cleared away by the body's natural drainage system and normal metabolism.

The body's healing and swelling response to these fat-dissolving injections follows a predictable timeline. Early swelling and redness show that the body is reacting to the destroyed cell parts. This reaction usually hits its peak between 48 and 72 hours after the treatment, during which patients might experience significant swelling and firmness in the treated areas. The next phase, lasting from the third day through the second week, involves the immune system sending out special helper cells to clean up the dead fat cells while the swelling slowly goes down. Physical results begin to show during this time because the swelling fades, revealing the actual loss of fat volume.

Unlike liposuction, which physically vacuums out fat cells through a tube, these injections rely entirely on the body's own natural cleanup systems. This difference is very important when deciding who is a good candidate for the treatment and how they should take care of themselves afterward. People with poor fluid drainage systems or metabolism issues might take longer to clear the fat and could experience longer-lasting swelling. On the other hand, healthy habits that boost the body's drainage and metabolism (such as drinking plenty of water, staying physically active, and using heat treatments like the sauna) might actually help improve the final results.

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Facial Anatomy

3.1 The Facial Nerve and Motor Branches
The majority of the facial nerve exits the base of the skull, branching off into five major divisions, which all supply the muscles involved with facial expression. It is crucial to understand the locations and depths at which these branches lie, to avoid damaging them during the injection process, since accidental injury may lead to significant cosmetic and functional changes of the face.

View attachment 5623275

The temporal branch serves the muscles of the frontal area (forehead), the eyebrows, and surrounding eye areas. Although generally not in line of sight with cheek injections, excessive superior movement of a treatment towards the temporal area increases the risk of encountering the temporal branch.

View attachment 5623277

The zygomatic branch serves the muscles of the upper lip required for smiling. When injecting the upper lateral cheek or cheek bone area, this branch becomes increasingly relevant to monitor.

View attachment 5623509

The intermediate cheek branch supplies the primary muscle of the cheek and also those of the upper lip, lying directly through the center of the face. Due to its proximity to commonly treated areas for reducing fat in the cheeks, injectors must be extremely aware of both the depth of injections and technique.

However, the marginal mandibular branch (also known as the jawline branch) presents the greatest danger to nerve structures when attempting to dissolve facial fat.

View attachment 5623522

This branch follows the inferior border of the jaw, generally crossing above the primary facial artery approximately one-half inch to one inch anteriorly to the primary masticatory muscle. Human anatomical studies have demonstrated great variability in the course of this nerve among individuals; thus some persons have nerves that extend almost an inch beneath the inferior margin of the jaw. At this point where it crosses the artery, the nerve lies extremely superficially to the skin, creating a high potential for physical contact with a needle or mechanical compression by pressure created by the injected substance.

Damage to this branch creates unique deficits in motor function including inability to depress the lower lip unilaterally. The result is a unilateral asymmetry of smile production, impaired articulation and drooling. Most minor nerve damage resulting from injections will recover spontaneously within weeks to months but permanent nerve damage is always possible.

3.2 Vascular Anatomy and Ophthalmic Complications
There are many other health issues involved with having an injury to one of your facial blood vessels (e.g., temporary or permanent blindness) rather than damage to nerves. One of the largest arteries in your head runs across your lower jaw bone in front of the masseter muscle. As you go up each side of your mouth to the middle of your cheeks, this artery divides into several smaller branches. As it approaches the inner corner of your eye, one of these small branches connects with the major blood vessel coming out of your brain. The major blood vessel comes from your brain’s main blood circulation route and provides blood flow to the center of your retina, as well as the surrounding soft tissue.

View attachment 5623563

Vision loss occurs when some amount of the injected solution is pushed backwards into the bloodstream by the force of the injection. If enough force is used to push the solution into a facial blood vessel, such as those located close to the eye, the solution will be pushed backward in opposition to the natural direction of blood flow, into the larger blood vessel that supplies blood to the back of your eye. Once in this location, it is possible to totally obstruct this blood vessel and result in almost immediately occurring and permanent vision loss. Even if you get immediate emergency medical treatment, nearly all of these types of vision losses are irreversible.

According to various scientific research articles there have been documented over 190 reported cases of blindness associated with cosmetic facial injections.

Veins on your face pose additional concerns due to their ability to rapidly transmit infection from one part of your body to another via a primary blood collection site located at the base of your brain.

View attachment 5623569

Dangerous areas involving the potential for blood vessel complications involve space between your eyebrows, where two large facial blood vessels join together to form part of your eye's circulatory system; the bridge of your nose; which has its own separate blood circulatory system; along your smile lines; where your facial artery also has a circulatory pathway into your eye system; and around your eyes, which creates a single continuous circulatory pathway that allows for rapid spread into your eye. Due to the extremely high risks posed by these areas, you must always proceed with caution.

3.3 Subcutaneous Fat Compartments
When we look at the fat directly under the skin on our faces, it doesn't appear as a single, cohesive layer. Instead, the fat under the skin is separated into discrete, individual compartments or "pockets" of fat that are created and defined by walls made up of connective tissue. There are many different types of these individual compartments; they are found in the cheek's inner wall, in the center of the cheeks, in the areas known as the smile lines, and in the area right under the chin, and so forth. As you can imagine each compartment will age independently of all the other compartments, and will therefore respond uniquely to any type of cosmetic treatment applied to them.

One of the most common locations to treat with fat-dissolving injections is the area where the primary fat compartment is located immediately below the skin in the inner part of the cheek. This particular location has a very strategic advantage. This fat compartment rests over several critical structures including the facial expression muscles and the deep layers of facial tissue. Therefore, there is enough volume loss after treating this compartment to be visually apparent, yet safely removed from both larger nerves and larger blood vessels that are located in the deeper tissue layers. On top, this area is bordered by the suborbital fold (under eye); underneath by the bony edge of the mandible (the lower jaw bone), but an injection must remain far enough above this border to prevent harm; on the inside by the nasolabial folds (smile lines) and on the outside by the masseter muscle (chewing muscle).

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Treatment Protocols and Technique

4.1 Right People for This
The most effective way to get optimal results and minimize risks associated with dissolving facial fat is to understand if you are a right candidate. Adults with small, resistant areas of fat that are unresponsive to dietary changes or increased levels of activity and have good elasticity in the skin that will retract to the new dimensions after the removal of excess fat are considered the perfect candidates. Also, it is crucial for patients to understand that the effects of these procedures occur gradually and may necessitate multiple rounds of treatment to achieve desired results.

Certain medical conditions make the use of this type of treatment unacceptable. Infection in the area being treated; pregnancy or breastfeeding; a known history of anaphylaxis to one or more of the ingredients contained in the injectable material; people with hemophilia; people on anticoagulant therapy; and those with significant metabolic problems such as poorly controlled diabetes or significant impairment to healing potential, should all completely refrain from using this type of treatment.

4.2 Treatment Planning and Mapping
Having a good plan to follow when performing treatments helps provide better consistencies in treatments and safer treatments. When you are treating the cheeks, I suggest creating a grid of anywhere from 9 to 25 areas of injection in each cheek, based on the length of your mandible and what type of results you want to obtain. Then space those areas approximately 1/2 inch (or 1 cm.) apart. The spacing and number of areas create a consistent application of the product throughout the shallow fat pocket in the inner cheek while remaining outside the danger zones.

View attachment 5633813

It is very important to note that when injecting this product, never use more than .2ml. of product in each point. The reason for this is because the product expand significantly after being injected and therefore will spread out over the surface area regardless of how much was initially placed in each site. Therefore, by keeping your injections limited to .2ml., you are able to maintain complete control of how much product has been applied to a given site. This ultimately ensures that the amount of product utilized for a treatment is always going to be safe.

By allowing a minimum of 21 days (three to four weeks), prior to another treatment session, you allow sufficient time for all inflammation associated with the first treatment session to resolve. By waiting long enough to observe how well the treatment responded before proceeding with additional treatments, you will also ensure that you are able to determine how many treatment sessions will be required to produce optimal visual results.

4.3 Injection Technique and Safety Measures
Following proper technique will help minimize the chances of complications occurring. Apply a numbing cream (such as 10-20% Lidocaine Cream) 30-45 minutes prior to treating and remove all of it before cleansing the skin.

Cleansing the skin should be performed using a standard facial cleanser followed by alc wipes. The locations where you plan to administer the product should be marked using a marker. The marker will allow you to place the products in accurate locations and assist in maintaining a well-organized approach.

It is extremely important to use the pinch method when administering injections. Using your non-dominant hand, pinch and elevate the fatty layer between your thumb and index finger. Pinching the fatty layer provides two benefits (one is lifting the fatty layer away from underlying structures such as nerve and vascular bundles; the other is providing tactile feedback regarding the thickness of the tissue). To further reduce the risk of inserting the needle too deeply into the body, insert the needle at a 45 degree angle rather than directly vertically. Additionally, you may choose to simply push the needle directly into the dermal layer until you feel resistance from the dermis, then immediately adjust the needle to a 45 degree angle to continue safely into the subcutaneous fat.

View attachment 5627626

Prior to actually injecting the medication, aspirating or pulling back on the syringe plunger (the aspiration) is another optional safety measure. Aspirating allows you to verify whether or not you have entered a vascular bundle. Prior to releasing the spring-loaded mechanism that injects the medication, pull back on the plunger and hold it in position for 5-10 seconds. If you observe blood entering the syringe during this time, you have inserted the needle into a vascular structure and should withdraw the needle immediately. Please note that aspirating does not always identify every instance when a needle has been placed within a blood vessel. Blood may appear in some instances when there is compression of the blood vessel wall against the inner diameter of the needle tip preventing the blood from flowing into the syringe. Therefore, please do not depend solely upon aspiration as your only safety precaution.

View attachment 5627619

When injecting the medication, release it very slowly. It would be ideal to deliver no greater than .05 to .1 ml/sec. Delivering too much volume rapidly creates increased intravascular pressure, significantly increasing the likelihood of having the medication spread beyond its intended location or being forced into vascular bundles. Injecting small volumes at low pressures greatly reduces these occurrences.

Once injected, apply light pressure with a clean alc wipe to sterilize the skin again. Do not press hard on the treated area nor vigorously massage it. Proceed slowly along your drawn lines and quickly wipe away each line once you have completed an injection at that site. This will prevent you from confusing what you previously treated with what you are currently treating and will assure complete coverage of your intended area without unnecessary repeat treatments of already treated sites.

4.4 My Personal DIY Video

Lipo Vela V: This is what I injected. I ordered 10 vials, but you shouldn't need more than 1 vial per session (if only treating cheeks).
Alcohol wipes: I used this to sterilize my vial as well as my face pre and post injection.
8 mm 27-31 G needles: To extract and inject the solution.
Eyeliner Pen: This was used to draw markings on my face. I suggest getting surgical pens, but I could not be bothered.
Facial Cleanser: This was to make sure my face was clean. I used it pre and post lidocaine.
Topical lidocaine: This was used to numb the areas I was treating. I ordered 10.56% and let it sit on my face for 45 minutes.
Surgical gloves: Used these to make sure everything was sterile.

I sourced my Lipo Vela V (the solution) from here and my topical lidocaine (the numbing cream) from here.

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Post-Treatment Care and Recovery Management

5.1 Right After the Procedure
After the procedure, the site will become swollen and tender for a few days. Swelling is expected as it indicates injury to the fat cells and irritation to the tissue caused by the product.

Most people experience the greatest amount of swelling within 48 – 72 hours post procedure. At this point, the swelling may be quite significant and alter the facial contours temporarily. A cold pack could be applied for 10 – 15 minutes in the first hour of recovery to assist with reducing swelling. The cold pack should never be pressed against the skin.

You should sleep with your head elevated for 2 – 3 days to allow fluids to drain from the treatment area. You should also drink a minimum of 2 – 3 liters of water per day. Drinking large amounts of water will aid in flushing out the fat that has been released from the damaged fat cells.

5.2 The First Week
It is common for the area treated to continue feeling slightly firm and/or tender during the first week post-procedure. These sensations typically indicate continued swelling and/or the beginning stages of tissue repair; which are both normal processes.

You are advised to wash your skin lightly for the first several weeks post-procedure. Harsh cleansers or exfoliating agents should be avoided.

Any high-intensity physical activities or activities that significantly elevate your body temperature should be delayed until at least 7 days post-procedure.

Applying any sort of makeup to areas where treatments have taken place should be avoided for at least 24 hours post-procedure.

Early warning signs include increasing redness, worsening pain, or unusual nerve-related symptoms. If these occur, please be aware.

5.3 Later Results and Keeping Them
Long-term results begin to appear approximately 2-4 weeks post-treatment when swelling subsides. Once fat cells are destroyed via Liposuction, they cannot regenerate. However, existing fat cells can grow larger due to weight gain. Therefore, maintaining a consistent weight is important for optimal results.

As mentioned earlier, Lipo Vela contains various types of growth factors and peptides that can potentially help improve skin elasticity over a period of time (months). Skin tightness achieved via Lipo Vela treatments varies based on many factors including patient’s age, skin type and quality, and overall technique during the procedure.

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Complications and Adverse Events

6.1 Normal Swelling And Pain
Understanding what is "normal" vs. needing medical attention is crucial.
Normal things include:

• Peak swelling at approximately day 3; nearly all swelling resolved by 1 week.
• Firmness for about 1-2 wkees.
• Bruising that will take anywhere from 3-10 days to resolve.
• Mild discomfort/pain for 3-7 days.
• Numbness/tingling which typically resolves spontaneously.

6.2 Infection
Infection occurs rarely with clean technique, however infection can be serious.

Look for these:
• Redness and increased temperature greater than 72 hrs.
• Pus formation.
• Fever.
• Feeling unwell generally.
• Increasing pain over time (after initial resolution).

6.3 Nerve Damage
Facial nerves can become involved in injury to the nerve causing difficulty in moving part of the face. The nerve responsible for pulling the lower lip downward is injured most frequently.

Compression or stretching of the nerve commonly results rather than a full cut. Improvement in movement may require weeks-months.

If you have persistent weakness a nerve conduction study (EMG) may be indicated. Surgical intervention is rarely recommended unless significant improvement does not occur after 3-6 months.

6.4 Blindness
Complete loss of sight, often without prior pain. Blindness can occur instantaneously, during or immediately following injection into the vicinity of the eye (between the eyebrows, or along the bridge of the nose).

Blindness due to arterial occlusion is a potentially life-threatening emergency. Even with prompt emergency treatment, restoration of vision is rare.

Prevention of blindness secondary to arterial occlusion can be achieved through avoidance of injection into high risk locations.

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Spoiler: Sources

https://jcasonline.com/injection-li...rs-in-1269-patients-of-indian-and-south-east/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3667690/
https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.841889/full
https://pubmed.ncbi.nlm.nih.gov/27787266/
https://onlinelibrary.wiley.com/doi/10.1111/j.1524-4725.2004.30305.x
https://academic.oup.com/asj/article-abstract/33/3/400/2801373?redirectedFrom=fulltext
https://pubmed.ncbi.nlm.nih.gov/18612680/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8520020/

@Vrilltrum @Tesarossa @Orka @Sayori @Morgan


​

Mirin brah bob potential

 

[xye]

botb tier thread

 

[xtract]

Dissolve Stubborn Facial Fat
By Organ



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Table of Contents:
Abstract
Introduction
Biochemical Mechanisms and Pharmacological Properties
Facial Anatomy
Treatment Protocols and Technique
Post-Treatment Care and Recovery Management
Complications and Adverse Events
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Abstract

Fat dissolving injections have become an increasingly popular alternative to surgical methods for eliminating unwanted areas of body fat. Lipo Vela is one of the most advanced fat reduction treatments on the market today. Not only does Lipo Vela dissolve the fat cells, but it also contains specific growth factors to promote overall health of the skin. In contrast to previous fat dissolving treatments which could take a month to begin working, Lipo Vela will provide noticeable results within approximately two weeks.

This study provides a comprehensive description of how Lipo Vela functions while acting as a reference guide for the people who wish to administer this treatment. The study will cover all aspects of administration including; the most effective method of administering the Lipo Vela treatment, common potential adverse reactions or side effects to monitor during and after the procedure, and how to address these complications. Additionally, because the injection site may be difficult to navigate due to proximity to nerve branches and blood vessels, the study will identify locations of significant nerves and blood vessels in order to assist with avoidance of injury. The study will combine prior research with FDA approved data for related treatments (i.e., Kybella) and data on anatomical studies of the face to ensure that all necessary information is available to allow people to utilize Lipo Vela effectively and safely.

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Introduction

There are numerous new non-surgical body contouring methods available today; however, among them, fat-dissolving treatments have received a great deal of interest due to their ability to be used safely and without surgical risk to remove excess fat from virtually all parts of the body. Fat-dissolving treatments involve the subcutaneous administration of a mixture of various substances below the surface of the skin. Upon administration, the fat dissolver breaks through the fatty cell membrane allowing the fat to be metabolized and removed by the body.

The early injectable fat dissolvers, such as Aqualyx, and others showed that the use of chemical agents to liquefy fat could successfully treat patients. However, there were many shortcomings associated with these early formulations. Some of the shortcomings include extended periods of edema, prolonged post-procedure healing times and variability in post-procedure physical outcomes. Lipo Vela represents a significant advancement in this area of treatment. Unlike earlier treatments, Lipo Vela contains a fast acting liquid formulation that directly attacks and rapidly removes fat cells. Additionally, Lipo Vela includes peptides, vitamins, and growth factors which help maintain the health and firmness of the surrounding skin during the removal process of fat.

The active pharmaceutical components in Lipo Vela (phosphatidylcholine and sodium deoxycholate) have been extensively evaluated in both laboratory experiments and clinical trials. Phosphatidylcholine is a naturally occurring lipid molecule present within the membranes of fat cells and readily binds to the membranes of fat cells. Sodium deoxycholate functions as a detergent-like compound derived from bile acids which effectively destroys the membranes of fat cells by breaking down their outer wall. Studies conducted identified sodium deoxycholate as the sole ingredient in the mixture capable of inducing lipolysis. While phosphatidylcholine serves primarily as an ingredient for delivering the treatment, research suggests that the combination of both compounds may enhance efficacy.

Due to variations in regulatory policies across countries and regions, laws governing fat dissolving treatments vary widely. In the United States, the FDA approved a deoxycholic acid injection called Kybella in April 2015. Specifically. The approval for Kybella was granted solely for reducing moderate to severe submental fullness (fat under the chin). As part of the application process, the manufacturer completed eighteen separate studies to demonstrate its effectiveness and establish safety protocols. Lipo Vela contains the identical primary active ingredient as Kybella. Although Lipo Vela is categorized as a cosmetic product rather than a pharmaceutical, it is therefore exempted from those FDA regulations.

The purpose of this thread is to provide a comprehensive overview of how Lipo Vela functions in terms of its biochemical mechanisms. The guide will also talk about anatomically-based guidelines for ensuring safe delivery of Lipo Vela into the facial tissues. Furthermore, this thread will synthesize existing evidence regarding clinical efficacy and adverse reactions associated with its administration into the face.

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Biochemical Mechanisms and Pharmacological Properties

2.1 Primary Lipolytic Agents
The fat-dissolving properties of Lipo Vela are due primarily to its two key active ingredients; Phosphatidylcholine and Sodium Deoxycholate. Therefore, understanding the mechanism of action of each individual active ingredient as well as how they interact with one another, is crucial to determining the most likely response of a patient to treatment as well as to identifying any possible adverse reactions that may occur.

Phosphatidylcholine is a form of fat, composed of many naturally occurring chemicals (fatty acids and choline) and is one of the primary components of the membranes protecting all human cells. Upon injection into the subcutaneous fat layer, the phosphatidylcholine molecules become incorporated into the membranes of the adipocytes allowing them to weaken and subsequently release the accumulated fat within the cell. Additionally, the phosphatidylcholine serves as an emulsifying agent to help disperse the fat that has been released so that it can be efficiently metabolized and removed by the body.

As stated above, Sodium Deoxycholate is the primary component in Lipo Vela that causes cellular death. Deoxycholate functions in the gastrointestinal tract to break down and solubilize fats from consumed foods. However, upon delivery via injections into the subcutaneous tissue, deoxycholate acts as a potent surfactant breaking down the lipid bilayer structure of the adipocytes thereby causing complete destruction of the fat cells. Studies demonstrated that deoxycholate was capable of killing cells, lysing cell walls, and destroying adipose tissue in experiments. Moreover, the studies demonstrated that deoxycholate performed equally as effective when administered in combination with phosphatidylcholine versus when it was administered in isolation.

Although the exact concentration of sodium deoxycholate employed in these treatments is critical, there are specific limits on the use of deoxycholic acid. For example, Kybella, a U.S. FDA approved product containing 10 mg/mL of deoxycholic acid, is administered in standardized dosages. Concentration levels of deoxycholate found in custom-made products such as Lipo Vela could differ depending on the manufacturer but are typically recommended dosages equivalent to those used in Kybella. Laboratory studies have shown that deoxycholate formulations containing at least 12.5% of the active ingredient are sufficient to effectively destroy adipocytes yet remain safe for patients provided they are properly administered via injection.

2.2 Ancillary Bioactive Components
Beginning with the fat-reducing properties of Lipo Vela, there are a number of other agents included within the solution. These additional components assist in removing excess fat from the body and supporting the health of the skin through-out the fat loss process. The two vitamins included; riboflavin (B2) and cyanocobalamin (B12) aid in enhancing the functioning of cellular metabolic pathways by acting as co-factors for enzymatic processes. In theory, these vitamins will allow the newly formed fatty acids to be burned at a higher rate than would otherwise occur.

L-Carnitine assists in transporting the fatty acid chains to the mitochondria where they can be used as an energy source. This could potentially shorten the time required for removal of the excess fat from the treated regions.

Peptides and Growth Factors make Lipo-Vela different from most all other chemical fat reducing solutions on the market today. Examples of peptides include Syn-Ake. Syn-Ake is a peptide that has been created to mimic the action of a peptide found in cobra venom. Its intended purpose is to soften and reduce facial expressions, thereby preventing the formation of expression lines and wrinkle patterns in areas that were treated. Epidermal Growth Factor (EGF), Fibroblast Growth Factor-1 (FGF-1), Insulin-Like Growth Factor (IGF) and other similar substances have also been added to promote the healing process by stimulating the body's natural repair mechanisms. These substances should provide a means to contract the tissue layers and prevent excessive sagginess after the fat is lost rapidly.

Although the scientific evidence supporting the use of these additives is less extensive than that related to the primary fat dissolving agents, their inclusion represents an effort to correct many common side effects associated with rapid chemical fat loss. Studies have demonstrated that intradermal injection of these solutions does not induce generalized inflammation in the body or adversely affect either fasting glucose levels or total cholesterol concentrations. Therefore, based upon data available to date, if performed properly, these procedures should not produce systemic adverse reactions.

2.3 Adipocyte Response and Clearance Kinetics
After being injected under the skin, Lipo Vela kills fat cells by breaking apart their outer walls. Tissue studies show that the fat cells start breaking down within just hours of the injection. Under ideal conditions, about 72 percent of the treated fat cells show clear signs of being destroyed within 48 hours. The released fat is then slowly cleared away by the body's natural drainage system and normal metabolism.

The body's healing and swelling response to these fat-dissolving injections follows a predictable timeline. Early swelling and redness show that the body is reacting to the destroyed cell parts. This reaction usually hits its peak between 48 and 72 hours after the treatment, during which patients might experience significant swelling and firmness in the treated areas. The next phase, lasting from the third day through the second week, involves the immune system sending out special helper cells to clean up the dead fat cells while the swelling slowly goes down. Physical results begin to show during this time because the swelling fades, revealing the actual loss of fat volume.

Unlike liposuction, which physically vacuums out fat cells through a tube, these injections rely entirely on the body's own natural cleanup systems. This difference is very important when deciding who is a good candidate for the treatment and how they should take care of themselves afterward. People with poor fluid drainage systems or metabolism issues might take longer to clear the fat and could experience longer-lasting swelling. On the other hand, healthy habits that boost the body's drainage and metabolism (such as drinking plenty of water, staying physically active, and using heat treatments like the sauna) might actually help improve the final results.

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Facial Anatomy

3.1 The Facial Nerve and Motor Branches
The majority of the facial nerve exits the base of the skull, branching off into five major divisions, which all supply the muscles involved with facial expression. It is crucial to understand the locations and depths at which these branches lie, to avoid damaging them during the injection process, since accidental injury may lead to significant cosmetic and functional changes of the face.

View attachment 5623275

The temporal branch serves the muscles of the frontal area (forehead), the eyebrows, and surrounding eye areas. Although generally not in line of sight with cheek injections, excessive superior movement of a treatment towards the temporal area increases the risk of encountering the temporal branch.

View attachment 5623277

The zygomatic branch serves the muscles of the upper lip required for smiling. When injecting the upper lateral cheek or cheek bone area, this branch becomes increasingly relevant to monitor.

View attachment 5623509

The intermediate cheek branch supplies the primary muscle of the cheek and also those of the upper lip, lying directly through the center of the face. Due to its proximity to commonly treated areas for reducing fat in the cheeks, injectors must be extremely aware of both the depth of injections and technique.

However, the marginal mandibular branch (also known as the jawline branch) presents the greatest danger to nerve structures when attempting to dissolve facial fat.

View attachment 5623522

This branch follows the inferior border of the jaw, generally crossing above the primary facial artery approximately one-half inch to one inch anteriorly to the primary masticatory muscle. Human anatomical studies have demonstrated great variability in the course of this nerve among individuals; thus some persons have nerves that extend almost an inch beneath the inferior margin of the jaw. At this point where it crosses the artery, the nerve lies extremely superficially to the skin, creating a high potential for physical contact with a needle or mechanical compression by pressure created by the injected substance.

Damage to this branch creates unique deficits in motor function including inability to depress the lower lip unilaterally. The result is a unilateral asymmetry of smile production, impaired articulation and drooling. Most minor nerve damage resulting from injections will recover spontaneously within weeks to months but permanent nerve damage is always possible.

3.2 Vascular Anatomy and Ophthalmic Complications
There are many other health issues involved with having an injury to one of your facial blood vessels (e.g., temporary or permanent blindness) rather than damage to nerves. One of the largest arteries in your head runs across your lower jaw bone in front of the masseter muscle. As you go up each side of your mouth to the middle of your cheeks, this artery divides into several smaller branches. As it approaches the inner corner of your eye, one of these small branches connects with the major blood vessel coming out of your brain. The major blood vessel comes from your brain’s main blood circulation route and provides blood flow to the center of your retina, as well as the surrounding soft tissue.

View attachment 5623563

Vision loss occurs when some amount of the injected solution is pushed backwards into the bloodstream by the force of the injection. If enough force is used to push the solution into a facial blood vessel, such as those located close to the eye, the solution will be pushed backward in opposition to the natural direction of blood flow, into the larger blood vessel that supplies blood to the back of your eye. Once in this location, it is possible to totally obstruct this blood vessel and result in almost immediately occurring and permanent vision loss. Even if you get immediate emergency medical treatment, nearly all of these types of vision losses are irreversible.

According to various scientific research articles there have been documented over 190 reported cases of blindness associated with cosmetic facial injections.

Veins on your face pose additional concerns due to their ability to rapidly transmit infection from one part of your body to another via a primary blood collection site located at the base of your brain.

View attachment 5623569

Dangerous areas involving the potential for blood vessel complications involve space between your eyebrows, where two large facial blood vessels join together to form part of your eye's circulatory system; the bridge of your nose; which has its own separate blood circulatory system; along your smile lines; where your facial artery also has a circulatory pathway into your eye system; and around your eyes, which creates a single continuous circulatory pathway that allows for rapid spread into your eye. Due to the extremely high risks posed by these areas, you must always proceed with caution.

3.3 Subcutaneous Fat Compartments
When we look at the fat directly under the skin on our faces, it doesn't appear as a single, cohesive layer. Instead, the fat under the skin is separated into discrete, individual compartments or "pockets" of fat that are created and defined by walls made up of connective tissue. There are many different types of these individual compartments; they are found in the cheek's inner wall, in the center of the cheeks, in the areas known as the smile lines, and in the area right under the chin, and so forth. As you can imagine each compartment will age independently of all the other compartments, and will therefore respond uniquely to any type of cosmetic treatment applied to them.

One of the most common locations to treat with fat-dissolving injections is the area where the primary fat compartment is located immediately below the skin in the inner part of the cheek. This particular location has a very strategic advantage. This fat compartment rests over several critical structures including the facial expression muscles and the deep layers of facial tissue. Therefore, there is enough volume loss after treating this compartment to be visually apparent, yet safely removed from both larger nerves and larger blood vessels that are located in the deeper tissue layers. On top, this area is bordered by the suborbital fold (under eye); underneath by the bony edge of the mandible (the lower jaw bone), but an injection must remain far enough above this border to prevent harm; on the inside by the nasolabial folds (smile lines) and on the outside by the masseter muscle (chewing muscle).

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Treatment Protocols and Technique

4.1 Right People for This
The most effective way to get optimal results and minimize risks associated with dissolving facial fat is to understand if you are a right candidate. Adults with small, resistant areas of fat that are unresponsive to dietary changes or increased levels of activity and have good elasticity in the skin that will retract to the new dimensions after the removal of excess fat are considered the perfect candidates. Also, it is crucial for patients to understand that the effects of these procedures occur gradually and may necessitate multiple rounds of treatment to achieve desired results.

Certain medical conditions make the use of this type of treatment unacceptable. Infection in the area being treated; pregnancy or breastfeeding; a known history of anaphylaxis to one or more of the ingredients contained in the injectable material; people with hemophilia; people on anticoagulant therapy; and those with significant metabolic problems such as poorly controlled diabetes or significant impairment to healing potential, should all completely refrain from using this type of treatment.

4.2 Treatment Planning and Mapping
Having a good plan to follow when performing treatments helps provide better consistencies in treatments and safer treatments. When you are treating the cheeks, I suggest creating a grid of anywhere from 9 to 25 areas of injection in each cheek, based on the length of your mandible and what type of results you want to obtain. Then space those areas approximately 1/2 inch (or 1 cm.) apart. The spacing and number of areas create a consistent application of the product throughout the shallow fat pocket in the inner cheek while remaining outside the danger zones.

View attachment 5633813

It is very important to note that when injecting this product, never use more than .2ml. of product in each point. The reason for this is because the product expand significantly after being injected and therefore will spread out over the surface area regardless of how much was initially placed in each site. Therefore, by keeping your injections limited to .2ml., you are able to maintain complete control of how much product has been applied to a given site. This ultimately ensures that the amount of product utilized for a treatment is always going to be safe.

By allowing a minimum of 21 days (three to four weeks), prior to another treatment session, you allow sufficient time for all inflammation associated with the first treatment session to resolve. By waiting long enough to observe how well the treatment responded before proceeding with additional treatments, you will also ensure that you are able to determine how many treatment sessions will be required to produce optimal visual results.

4.3 Injection Technique and Safety Measures
Following proper technique will help minimize the chances of complications occurring. Apply a numbing cream (such as 10-20% Lidocaine Cream) 30-45 minutes prior to treating and remove all of it before cleansing the skin.

Cleansing the skin should be performed using a standard facial cleanser followed by alc wipes. The locations where you plan to administer the product should be marked using a marker. The marker will allow you to place the products in accurate locations and assist in maintaining a well-organized approach.

It is extremely important to use the pinch method when administering injections. Using your non-dominant hand, pinch and elevate the fatty layer between your thumb and index finger. Pinching the fatty layer provides two benefits (one is lifting the fatty layer away from underlying structures such as nerve and vascular bundles; the other is providing tactile feedback regarding the thickness of the tissue). To further reduce the risk of inserting the needle too deeply into the body, insert the needle at a 45 degree angle rather than directly vertically. Additionally, you may choose to simply push the needle directly into the dermal layer until you feel resistance from the dermis, then immediately adjust the needle to a 45 degree angle to continue safely into the subcutaneous fat.

View attachment 5627626

Prior to actually injecting the medication, aspirating or pulling back on the syringe plunger (the aspiration) is another optional safety measure. Aspirating allows you to verify whether or not you have entered a vascular bundle. Prior to releasing the spring-loaded mechanism that injects the medication, pull back on the plunger and hold it in position for 5-10 seconds. If you observe blood entering the syringe during this time, you have inserted the needle into a vascular structure and should withdraw the needle immediately. Please note that aspirating does not always identify every instance when a needle has been placed within a blood vessel. Blood may appear in some instances when there is compression of the blood vessel wall against the inner diameter of the needle tip preventing the blood from flowing into the syringe. Therefore, please do not depend solely upon aspiration as your only safety precaution.

View attachment 5627619

When injecting the medication, release it very slowly. It would be ideal to deliver no greater than .05 to .1 ml/sec. Delivering too much volume rapidly creates increased intravascular pressure, significantly increasing the likelihood of having the medication spread beyond its intended location or being forced into vascular bundles. Injecting small volumes at low pressures greatly reduces these occurrences.

Once injected, apply light pressure with a clean alc wipe to sterilize the skin again. Do not press hard on the treated area nor vigorously massage it. Proceed slowly along your drawn lines and quickly wipe away each line once you have completed an injection at that site. This will prevent you from confusing what you previously treated with what you are currently treating and will assure complete coverage of your intended area without unnecessary repeat treatments of already treated sites.

4.4 My Personal DIY Video

Lipo Vela V: This is what I injected. I ordered 10 vials, but you shouldn't need more than 1 vial per session (if only treating cheeks).
Alcohol wipes: I used this to sterilize my vial as well as my face pre and post injection.
8 mm 27-31 G needles: To extract and inject the solution.
Eyeliner Pen: This was used to draw markings on my face. I suggest getting surgical pens, but I could not be bothered.
Facial Cleanser: This was to make sure my face was clean. I used it pre and post lidocaine.
Topical lidocaine: This was used to numb the areas I was treating. I ordered 10.56% and let it sit on my face for 45 minutes.
Surgical gloves: Used these to make sure everything was sterile.

I sourced my Lipo Vela V (the solution) from here and my topical lidocaine (the numbing cream) from here.

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Post-Treatment Care and Recovery Management

5.1 Right After the Procedure
After the procedure, the site will become swollen and tender for a few days. Swelling is expected as it indicates injury to the fat cells and irritation to the tissue caused by the product.

Most people experience the greatest amount of swelling within 48 – 72 hours post procedure. At this point, the swelling may be quite significant and alter the facial contours temporarily. A cold pack could be applied for 10 – 15 minutes in the first hour of recovery to assist with reducing swelling. The cold pack should never be pressed against the skin.

You should sleep with your head elevated for 2 – 3 days to allow fluids to drain from the treatment area. You should also drink a minimum of 2 – 3 liters of water per day. Drinking large amounts of water will aid in flushing out the fat that has been released from the damaged fat cells.

5.2 The First Week
It is common for the area treated to continue feeling slightly firm and/or tender during the first week post-procedure. These sensations typically indicate continued swelling and/or the beginning stages of tissue repair; which are both normal processes.

You are advised to wash your skin lightly for the first several weeks post-procedure. Harsh cleansers or exfoliating agents should be avoided.

Any high-intensity physical activities or activities that significantly elevate your body temperature should be delayed until at least 7 days post-procedure.

Applying any sort of makeup to areas where treatments have taken place should be avoided for at least 24 hours post-procedure.

Early warning signs include increasing redness, worsening pain, or unusual nerve-related symptoms. If these occur, please be aware.

5.3 Later Results and Keeping Them
Long-term results begin to appear approximately 2-4 weeks post-treatment when swelling subsides. Once fat cells are destroyed via Liposuction, they cannot regenerate. However, existing fat cells can grow larger due to weight gain. Therefore, maintaining a consistent weight is important for optimal results.

As mentioned earlier, Lipo Vela contains various types of growth factors and peptides that can potentially help improve skin elasticity over a period of time (months). Skin tightness achieved via Lipo Vela treatments varies based on many factors including patient’s age, skin type and quality, and overall technique during the procedure.

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Complications and Adverse Events

6.1 Normal Swelling And Pain
Understanding what is "normal" vs. needing medical attention is crucial.
Normal things include:

• Peak swelling at approximately day 3; nearly all swelling resolved by 1 week.
• Firmness for about 1-2 wkees.
• Bruising that will take anywhere from 3-10 days to resolve.
• Mild discomfort/pain for 3-7 days.
• Numbness/tingling which typically resolves spontaneously.

6.2 Infection
Infection occurs rarely with clean technique, however infection can be serious.

Look for these:
• Redness and increased temperature greater than 72 hrs.
• Pus formation.
• Fever.
• Feeling unwell generally.
• Increasing pain over time (after initial resolution).

6.3 Nerve Damage
Facial nerves can become involved in injury to the nerve causing difficulty in moving part of the face. The nerve responsible for pulling the lower lip downward is injured most frequently.

Compression or stretching of the nerve commonly results rather than a full cut. Improvement in movement may require weeks-months.

If you have persistent weakness a nerve conduction study (EMG) may be indicated. Surgical intervention is rarely recommended unless significant improvement does not occur after 3-6 months.

6.4 Blindness
Complete loss of sight, often without prior pain. Blindness can occur instantaneously, during or immediately following injection into the vicinity of the eye (between the eyebrows, or along the bridge of the nose).

Blindness due to arterial occlusion is a potentially life-threatening emergency. Even with prompt emergency treatment, restoration of vision is rare.

Prevention of blindness secondary to arterial occlusion can be achieved through avoidance of injection into high risk locations.

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Spoiler: Sources

https://jcasonline.com/injection-li...rs-in-1269-patients-of-indian-and-south-east/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3667690/
https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.841889/full
https://pubmed.ncbi.nlm.nih.gov/27787266/
https://onlinelibrary.wiley.com/doi/10.1111/j.1524-4725.2004.30305.x
https://academic.oup.com/asj/article-abstract/33/3/400/2801373?redirectedFrom=fulltext
https://pubmed.ncbi.nlm.nih.gov/18612680/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8520020/

@Vrilltrum @Tesarossa @Orka @Sayori @Morgan


​

holy shit

bookmarked will read later
thanks for the tag sir

 

[subhuman wasian]

Dissolve Stubborn Facial Fat
By Organ



◆━━━━━━━━━━━━━━━━━━━━◆━━━━━━━━━━━━━━━━━━━━◆
Table of Contents:
Abstract
Introduction
Biochemical Mechanisms and Pharmacological Properties
Facial Anatomy
Treatment Protocols and Technique
Post-Treatment Care and Recovery Management
Complications and Adverse Events
◆━━━━━━━━━━━━━━━━━━━━◆━━━━━━━━━━━━━━━━━━━━◆
Abstract

Fat dissolving injections have become an increasingly popular alternative to surgical methods for eliminating unwanted areas of body fat. Lipo Vela is one of the most advanced fat reduction treatments on the market today. Not only does Lipo Vela dissolve the fat cells, but it also contains specific growth factors to promote overall health of the skin. In contrast to previous fat dissolving treatments which could take a month to begin working, Lipo Vela will provide noticeable results within approximately two weeks.

This study provides a comprehensive description of how Lipo Vela functions while acting as a reference guide for the people who wish to administer this treatment. The study will cover all aspects of administration including; the most effective method of administering the Lipo Vela treatment, common potential adverse reactions or side effects to monitor during and after the procedure, and how to address these complications. Additionally, because the injection site may be difficult to navigate due to proximity to nerve branches and blood vessels, the study will identify locations of significant nerves and blood vessels in order to assist with avoidance of injury. The study will combine prior research with FDA approved data for related treatments (i.e., Kybella) and data on anatomical studies of the face to ensure that all necessary information is available to allow people to utilize Lipo Vela effectively and safely.

◆━━━━━━━━━━━━━━━━━━━━◆━━━━━━━━━━━━━━━━━━━━◆

Introduction

There are numerous new non-surgical body contouring methods available today; however, among them, fat-dissolving treatments have received a great deal of interest due to their ability to be used safely and without surgical risk to remove excess fat from virtually all parts of the body. Fat-dissolving treatments involve the subcutaneous administration of a mixture of various substances below the surface of the skin. Upon administration, the fat dissolver breaks through the fatty cell membrane allowing the fat to be metabolized and removed by the body.

The early injectable fat dissolvers, such as Aqualyx, and others showed that the use of chemical agents to liquefy fat could successfully treat patients. However, there were many shortcomings associated with these early formulations. Some of the shortcomings include extended periods of edema, prolonged post-procedure healing times and variability in post-procedure physical outcomes. Lipo Vela represents a significant advancement in this area of treatment. Unlike earlier treatments, Lipo Vela contains a fast acting liquid formulation that directly attacks and rapidly removes fat cells. Additionally, Lipo Vela includes peptides, vitamins, and growth factors which help maintain the health and firmness of the surrounding skin during the removal process of fat.

The active pharmaceutical components in Lipo Vela (phosphatidylcholine and sodium deoxycholate) have been extensively evaluated in both laboratory experiments and clinical trials. Phosphatidylcholine is a naturally occurring lipid molecule present within the membranes of fat cells and readily binds to the membranes of fat cells. Sodium deoxycholate functions as a detergent-like compound derived from bile acids which effectively destroys the membranes of fat cells by breaking down their outer wall. Studies conducted identified sodium deoxycholate as the sole ingredient in the mixture capable of inducing lipolysis. While phosphatidylcholine serves primarily as an ingredient for delivering the treatment, research suggests that the combination of both compounds may enhance efficacy.

Due to variations in regulatory policies across countries and regions, laws governing fat dissolving treatments vary widely. In the United States, the FDA approved a deoxycholic acid injection called Kybella in April 2015. Specifically. The approval for Kybella was granted solely for reducing moderate to severe submental fullness (fat under the chin). As part of the application process, the manufacturer completed eighteen separate studies to demonstrate its effectiveness and establish safety protocols. Lipo Vela contains the identical primary active ingredient as Kybella. Although Lipo Vela is categorized as a cosmetic product rather than a pharmaceutical, it is therefore exempted from those FDA regulations.

The purpose of this thread is to provide a comprehensive overview of how Lipo Vela functions in terms of its biochemical mechanisms. The guide will also talk about anatomically-based guidelines for ensuring safe delivery of Lipo Vela into the facial tissues. Furthermore, this thread will synthesize existing evidence regarding clinical efficacy and adverse reactions associated with its administration into the face.

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Biochemical Mechanisms and Pharmacological Properties

2.1 Primary Lipolytic Agents
The fat-dissolving properties of Lipo Vela are due primarily to its two key active ingredients; Phosphatidylcholine and Sodium Deoxycholate. Therefore, understanding the mechanism of action of each individual active ingredient as well as how they interact with one another, is crucial to determining the most likely response of a patient to treatment as well as to identifying any possible adverse reactions that may occur.

Phosphatidylcholine is a form of fat, composed of many naturally occurring chemicals (fatty acids and choline) and is one of the primary components of the membranes protecting all human cells. Upon injection into the subcutaneous fat layer, the phosphatidylcholine molecules become incorporated into the membranes of the adipocytes allowing them to weaken and subsequently release the accumulated fat within the cell. Additionally, the phosphatidylcholine serves as an emulsifying agent to help disperse the fat that has been released so that it can be efficiently metabolized and removed by the body.

As stated above, Sodium Deoxycholate is the primary component in Lipo Vela that causes cellular death. Deoxycholate functions in the gastrointestinal tract to break down and solubilize fats from consumed foods. However, upon delivery via injections into the subcutaneous tissue, deoxycholate acts as a potent surfactant breaking down the lipid bilayer structure of the adipocytes thereby causing complete destruction of the fat cells. Studies demonstrated that deoxycholate was capable of killing cells, lysing cell walls, and destroying adipose tissue in experiments. Moreover, the studies demonstrated that deoxycholate performed equally as effective when administered in combination with phosphatidylcholine versus when it was administered in isolation.

Although the exact concentration of sodium deoxycholate employed in these treatments is critical, there are specific limits on the use of deoxycholic acid. For example, Kybella, a U.S. FDA approved product containing 10 mg/mL of deoxycholic acid, is administered in standardized dosages. Concentration levels of deoxycholate found in custom-made products such as Lipo Vela could differ depending on the manufacturer but are typically recommended dosages equivalent to those used in Kybella. Laboratory studies have shown that deoxycholate formulations containing at least 12.5% of the active ingredient are sufficient to effectively destroy adipocytes yet remain safe for patients provided they are properly administered via injection.

2.2 Ancillary Bioactive Components
Beginning with the fat-reducing properties of Lipo Vela, there are a number of other agents included within the solution. These additional components assist in removing excess fat from the body and supporting the health of the skin through-out the fat loss process. The two vitamins included; riboflavin (B2) and cyanocobalamin (B12) aid in enhancing the functioning of cellular metabolic pathways by acting as co-factors for enzymatic processes. In theory, these vitamins will allow the newly formed fatty acids to be burned at a higher rate than would otherwise occur.

L-Carnitine assists in transporting the fatty acid chains to the mitochondria where they can be used as an energy source. This could potentially shorten the time required for removal of the excess fat from the treated regions.

Peptides and Growth Factors make Lipo-Vela different from most all other chemical fat reducing solutions on the market today. Examples of peptides include Syn-Ake. Syn-Ake is a peptide that has been created to mimic the action of a peptide found in cobra venom. Its intended purpose is to soften and reduce facial expressions, thereby preventing the formation of expression lines and wrinkle patterns in areas that were treated. Epidermal Growth Factor (EGF), Fibroblast Growth Factor-1 (FGF-1), Insulin-Like Growth Factor (IGF) and other similar substances have also been added to promote the healing process by stimulating the body's natural repair mechanisms. These substances should provide a means to contract the tissue layers and prevent excessive sagginess after the fat is lost rapidly.

Although the scientific evidence supporting the use of these additives is less extensive than that related to the primary fat dissolving agents, their inclusion represents an effort to correct many common side effects associated with rapid chemical fat loss. Studies have demonstrated that intradermal injection of these solutions does not induce generalized inflammation in the body or adversely affect either fasting glucose levels or total cholesterol concentrations. Therefore, based upon data available to date, if performed properly, these procedures should not produce systemic adverse reactions.

2.3 Adipocyte Response and Clearance Kinetics
After being injected under the skin, Lipo Vela kills fat cells by breaking apart their outer walls. Tissue studies show that the fat cells start breaking down within just hours of the injection. Under ideal conditions, about 72 percent of the treated fat cells show clear signs of being destroyed within 48 hours. The released fat is then slowly cleared away by the body's natural drainage system and normal metabolism.

The body's healing and swelling response to these fat-dissolving injections follows a predictable timeline. Early swelling and redness show that the body is reacting to the destroyed cell parts. This reaction usually hits its peak between 48 and 72 hours after the treatment, during which patients might experience significant swelling and firmness in the treated areas. The next phase, lasting from the third day through the second week, involves the immune system sending out special helper cells to clean up the dead fat cells while the swelling slowly goes down. Physical results begin to show during this time because the swelling fades, revealing the actual loss of fat volume.

Unlike liposuction, which physically vacuums out fat cells through a tube, these injections rely entirely on the body's own natural cleanup systems. This difference is very important when deciding who is a good candidate for the treatment and how they should take care of themselves afterward. People with poor fluid drainage systems or metabolism issues might take longer to clear the fat and could experience longer-lasting swelling. On the other hand, healthy habits that boost the body's drainage and metabolism (such as drinking plenty of water, staying physically active, and using heat treatments like the sauna) might actually help improve the final results.

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Facial Anatomy

3.1 The Facial Nerve and Motor Branches
The majority of the facial nerve exits the base of the skull, branching off into five major divisions, which all supply the muscles involved with facial expression. It is crucial to understand the locations and depths at which these branches lie, to avoid damaging them during the injection process, since accidental injury may lead to significant cosmetic and functional changes of the face.

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The temporal branch serves the muscles of the frontal area (forehead), the eyebrows, and surrounding eye areas. Although generally not in line of sight with cheek injections, excessive superior movement of a treatment towards the temporal area increases the risk of encountering the temporal branch.

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The zygomatic branch serves the muscles of the upper lip required for smiling. When injecting the upper lateral cheek or cheek bone area, this branch becomes increasingly relevant to monitor.

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The intermediate cheek branch supplies the primary muscle of the cheek and also those of the upper lip, lying directly through the center of the face. Due to its proximity to commonly treated areas for reducing fat in the cheeks, injectors must be extremely aware of both the depth of injections and technique.

However, the marginal mandibular branch (also known as the jawline branch) presents the greatest danger to nerve structures when attempting to dissolve facial fat.

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This branch follows the inferior border of the jaw, generally crossing above the primary facial artery approximately one-half inch to one inch anteriorly to the primary masticatory muscle. Human anatomical studies have demonstrated great variability in the course of this nerve among individuals; thus some persons have nerves that extend almost an inch beneath the inferior margin of the jaw. At this point where it crosses the artery, the nerve lies extremely superficially to the skin, creating a high potential for physical contact with a needle or mechanical compression by pressure created by the injected substance.

Damage to this branch creates unique deficits in motor function including inability to depress the lower lip unilaterally. The result is a unilateral asymmetry of smile production, impaired articulation and drooling. Most minor nerve damage resulting from injections will recover spontaneously within weeks to months but permanent nerve damage is always possible.

3.2 Vascular Anatomy and Ophthalmic Complications
There are many other health issues involved with having an injury to one of your facial blood vessels (e.g., temporary or permanent blindness) rather than damage to nerves. One of the largest arteries in your head runs across your lower jaw bone in front of the masseter muscle. As you go up each side of your mouth to the middle of your cheeks, this artery divides into several smaller branches. As it approaches the inner corner of your eye, one of these small branches connects with the major blood vessel coming out of your brain. The major blood vessel comes from your brain’s main blood circulation route and provides blood flow to the center of your retina, as well as the surrounding soft tissue.

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Vision loss occurs when some amount of the injected solution is pushed backwards into the bloodstream by the force of the injection. If enough force is used to push the solution into a facial blood vessel, such as those located close to the eye, the solution will be pushed backward in opposition to the natural direction of blood flow, into the larger blood vessel that supplies blood to the back of your eye. Once in this location, it is possible to totally obstruct this blood vessel and result in almost immediately occurring and permanent vision loss. Even if you get immediate emergency medical treatment, nearly all of these types of vision losses are irreversible.

According to various scientific research articles there have been documented over 190 reported cases of blindness associated with cosmetic facial injections.

Veins on your face pose additional concerns due to their ability to rapidly transmit infection from one part of your body to another via a primary blood collection site located at the base of your brain.

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Dangerous areas involving the potential for blood vessel complications involve space between your eyebrows, where two large facial blood vessels join together to form part of your eye's circulatory system; the bridge of your nose; which has its own separate blood circulatory system; along your smile lines; where your facial artery also has a circulatory pathway into your eye system; and around your eyes, which creates a single continuous circulatory pathway that allows for rapid spread into your eye. Due to the extremely high risks posed by these areas, you must always proceed with caution.

3.3 Subcutaneous Fat Compartments
When we look at the fat directly under the skin on our faces, it doesn't appear as a single, cohesive layer. Instead, the fat under the skin is separated into discrete, individual compartments or "pockets" of fat that are created and defined by walls made up of connective tissue. There are many different types of these individual compartments; they are found in the cheek's inner wall, in the center of the cheeks, in the areas known as the smile lines, and in the area right under the chin, and so forth. As you can imagine each compartment will age independently of all the other compartments, and will therefore respond uniquely to any type of cosmetic treatment applied to them.

One of the most common locations to treat with fat-dissolving injections is the area where the primary fat compartment is located immediately below the skin in the inner part of the cheek. This particular location has a very strategic advantage. This fat compartment rests over several critical structures including the facial expression muscles and the deep layers of facial tissue. Therefore, there is enough volume loss after treating this compartment to be visually apparent, yet safely removed from both larger nerves and larger blood vessels that are located in the deeper tissue layers. On top, this area is bordered by the suborbital fold (under eye); underneath by the bony edge of the mandible (the lower jaw bone), but an injection must remain far enough above this border to prevent harm; on the inside by the nasolabial folds (smile lines) and on the outside by the masseter muscle (chewing muscle).

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Treatment Protocols and Technique

4.1 Right People for This
The most effective way to get optimal results and minimize risks associated with dissolving facial fat is to understand if you are a right candidate. Adults with small, resistant areas of fat that are unresponsive to dietary changes or increased levels of activity and have good elasticity in the skin that will retract to the new dimensions after the removal of excess fat are considered the perfect candidates. Also, it is crucial for patients to understand that the effects of these procedures occur gradually and may necessitate multiple rounds of treatment to achieve desired results.

Certain medical conditions make the use of this type of treatment unacceptable. Infection in the area being treated; pregnancy or breastfeeding; a known history of anaphylaxis to one or more of the ingredients contained in the injectable material; people with hemophilia; people on anticoagulant therapy; and those with significant metabolic problems such as poorly controlled diabetes or significant impairment to healing potential, should all completely refrain from using this type of treatment.

4.2 Treatment Planning and Mapping
Having a good plan to follow when performing treatments helps provide better consistencies in treatments and safer treatments. When you are treating the cheeks, I suggest creating a grid of anywhere from 9 to 25 areas of injection in each cheek, based on the length of your mandible and what type of results you want to obtain. Then space those areas approximately 1/2 inch (or 1 cm.) apart. The spacing and number of areas create a consistent application of the product throughout the shallow fat pocket in the inner cheek while remaining outside the danger zones.

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It is very important to note that when injecting this product, never use more than .2ml. of product in each point. The reason for this is because the product expand significantly after being injected and therefore will spread out over the surface area regardless of how much was initially placed in each site. Therefore, by keeping your injections limited to .2ml., you are able to maintain complete control of how much product has been applied to a given site. This ultimately ensures that the amount of product utilized for a treatment is always going to be safe.

By allowing a minimum of 21 days (three to four weeks), prior to another treatment session, you allow sufficient time for all inflammation associated with the first treatment session to resolve. By waiting long enough to observe how well the treatment responded before proceeding with additional treatments, you will also ensure that you are able to determine how many treatment sessions will be required to produce optimal visual results.

4.3 Injection Technique and Safety Measures
Following proper technique will help minimize the chances of complications occurring. Apply a numbing cream (such as 10-20% Lidocaine Cream) 30-45 minutes prior to treating and remove all of it before cleansing the skin.

Cleansing the skin should be performed using a standard facial cleanser followed by alc wipes. The locations where you plan to administer the product should be marked using a marker. The marker will allow you to place the products in accurate locations and assist in maintaining a well-organized approach.

It is extremely important to use the pinch method when administering injections. Using your non-dominant hand, pinch and elevate the fatty layer between your thumb and index finger. Pinching the fatty layer provides two benefits (one is lifting the fatty layer away from underlying structures such as nerve and vascular bundles; the other is providing tactile feedback regarding the thickness of the tissue). To further reduce the risk of inserting the needle too deeply into the body, insert the needle at a 45 degree angle rather than directly vertically. Additionally, you may choose to simply push the needle directly into the dermal layer until you feel resistance from the dermis, then immediately adjust the needle to a 45 degree angle to continue safely into the subcutaneous fat.

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Prior to actually injecting the medication, aspirating or pulling back on the syringe plunger (the aspiration) is another optional safety measure. Aspirating allows you to verify whether or not you have entered a vascular bundle. Prior to releasing the spring-loaded mechanism that injects the medication, pull back on the plunger and hold it in position for 5-10 seconds. If you observe blood entering the syringe during this time, you have inserted the needle into a vascular structure and should withdraw the needle immediately. Please note that aspirating does not always identify every instance when a needle has been placed within a blood vessel. Blood may appear in some instances when there is compression of the blood vessel wall against the inner diameter of the needle tip preventing the blood from flowing into the syringe. Therefore, please do not depend solely upon aspiration as your only safety precaution.

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When injecting the medication, release it very slowly. It would be ideal to deliver no greater than .05 to .1 ml/sec. Delivering too much volume rapidly creates increased intravascular pressure, significantly increasing the likelihood of having the medication spread beyond its intended location or being forced into vascular bundles. Injecting small volumes at low pressures greatly reduces these occurrences.

Once injected, apply light pressure with a clean alc wipe to sterilize the skin again. Do not press hard on the treated area nor vigorously massage it. Proceed slowly along your drawn lines and quickly wipe away each line once you have completed an injection at that site. This will prevent you from confusing what you previously treated with what you are currently treating and will assure complete coverage of your intended area without unnecessary repeat treatments of already treated sites.

4.4 My Personal DIY Video

Lipo Vela V: This is what I injected. I ordered 10 vials, but you shouldn't need more than 1 vial per session (if only treating cheeks).
Alcohol wipes: I used this to sterilize my vial as well as my face pre and post injection.
8 mm 27-31 G needles: To extract and inject the solution.
Eyeliner Pen: This was used to draw markings on my face. I suggest getting surgical pens, but I could not be bothered.
Facial Cleanser: This was to make sure my face was clean. I used it pre and post lidocaine.
Topical lidocaine: This was used to numb the areas I was treating. I ordered 10.56% and let it sit on my face for 45 minutes.
Surgical gloves: Used these to make sure everything was sterile.

I sourced my Lipo Vela V (the solution) from here and my topical lidocaine (the numbing cream) from here.

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Post-Treatment Care and Recovery Management

5.1 Right After the Procedure
After the procedure, the site will become swollen and tender for a few days. Swelling is expected as it indicates injury to the fat cells and irritation to the tissue caused by the product.

Most people experience the greatest amount of swelling within 48 – 72 hours post procedure. At this point, the swelling may be quite significant and alter the facial contours temporarily. A cold pack could be applied for 10 – 15 minutes in the first hour of recovery to assist with reducing swelling. The cold pack should never be pressed against the skin.

You should sleep with your head elevated for 2 – 3 days to allow fluids to drain from the treatment area. You should also drink a minimum of 2 – 3 liters of water per day. Drinking large amounts of water will aid in flushing out the fat that has been released from the damaged fat cells.

5.2 The First Week
It is common for the area treated to continue feeling slightly firm and/or tender during the first week post-procedure. These sensations typically indicate continued swelling and/or the beginning stages of tissue repair; which are both normal processes.

You are advised to wash your skin lightly for the first several weeks post-procedure. Harsh cleansers or exfoliating agents should be avoided.

Any high-intensity physical activities or activities that significantly elevate your body temperature should be delayed until at least 7 days post-procedure.

Applying any sort of makeup to areas where treatments have taken place should be avoided for at least 24 hours post-procedure.

Early warning signs include increasing redness, worsening pain, or unusual nerve-related symptoms. If these occur, please be aware.

5.3 Later Results and Keeping Them
Long-term results begin to appear approximately 2-4 weeks post-treatment when swelling subsides. Once fat cells are destroyed via Liposuction, they cannot regenerate. However, existing fat cells can grow larger due to weight gain. Therefore, maintaining a consistent weight is important for optimal results.

As mentioned earlier, Lipo Vela contains various types of growth factors and peptides that can potentially help improve skin elasticity over a period of time (months). Skin tightness achieved via Lipo Vela treatments varies based on many factors including patient’s age, skin type and quality, and overall technique during the procedure.

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Complications and Adverse Events

6.1 Normal Swelling And Pain
Understanding what is "normal" vs. needing medical attention is crucial.
Normal things include:

• Peak swelling at approximately day 3; nearly all swelling resolved by 1 week.
• Firmness for about 1-2 wkees.
• Bruising that will take anywhere from 3-10 days to resolve.
• Mild discomfort/pain for 3-7 days.
• Numbness/tingling which typically resolves spontaneously.

6.2 Infection
Infection occurs rarely with clean technique, however infection can be serious.

Look for these:
• Redness and increased temperature greater than 72 hrs.
• Pus formation.
• Fever.
• Feeling unwell generally.
• Increasing pain over time (after initial resolution).

6.3 Nerve Damage
Facial nerves can become involved in injury to the nerve causing difficulty in moving part of the face. The nerve responsible for pulling the lower lip downward is injured most frequently.

Compression or stretching of the nerve commonly results rather than a full cut. Improvement in movement may require weeks-months.

If you have persistent weakness a nerve conduction study (EMG) may be indicated. Surgical intervention is rarely recommended unless significant improvement does not occur after 3-6 months.

6.4 Blindness
Complete loss of sight, often without prior pain. Blindness can occur instantaneously, during or immediately following injection into the vicinity of the eye (between the eyebrows, or along the bridge of the nose).

Blindness due to arterial occlusion is a potentially life-threatening emergency. Even with prompt emergency treatment, restoration of vision is rare.

Prevention of blindness secondary to arterial occlusion can be achieved through avoidance of injection into high risk locations.

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Spoiler: Sources

https://jcasonline.com/injection-li...rs-in-1269-patients-of-indian-and-south-east/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3667690/
https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.841889/full
https://pubmed.ncbi.nlm.nih.gov/27787266/
https://onlinelibrary.wiley.com/doi/10.1111/j.1524-4725.2004.30305.x
https://academic.oup.com/asj/article-abstract/33/3/400/2801373?redirectedFrom=fulltext
https://pubmed.ncbi.nlm.nih.gov/18612680/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8520020/

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