The ideal shape of a young female face has been described as an inverted triangle with a wide middle tapering towards the chin. Likewise, the shape and contour of the chin and neck play an important role in the aesthetics of the face, a pronounced chin is associated with self-confidence, while a submental fullness adds age to a person and makes a person visually fuller. One of the common causes of submental fullness is the accumulation of submental fat (SMF), which is often presented in the form of a double chin. Although weight gain associated with diet and lifestyle may contribute to the accumulation of submental fat, aging and genetics also play a role. In the article on estet-portal.com, you will learn about effective lipolytics to combat submental fat deposits.
- Correction methods for the second chin and submental area
- Mechanism of action of lipolytics based on deoxycholic acid
- Expert evaluation of the effectiveness of deoxycholic acid as a lipolytic
Correction methods for the second chin and submental area
According to the American Society for Dermatological Surgery in 2015, 67% of 7,315 respondents indicated that they were overly concerned about excess fat under the chin/neck. In addition, the number of chin augmentation procedures increased by 71% between 2010 and 2011 based on statistics from the American Society of Plastic Surgeons.
Read also: Surgical correction of neck aging problems.
The cervicocleidomastoideus muscle of the neck is divided into anterior and posterior triangles, with the submental area being part of the anterior triangle. Within the submental region, the fat is divided into two separate compartments by the platysma, which consists of two broad muscles located on either side of the neck. Preplatysmal (supraplatysmal) fat is located between the dermis and platysma, and postplatysmal (subplatysmal) fat is located between the platysma and submental muscles.
While devices such as lasers and ultrasound offer a non-invasive option for double chin correction, these procedures are still more focused on tightening the skin and less on reducing body fat.
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Current double chin and submental correction options often target preplatysmal fat, as extensive removal of postplatysmal fat can result in a concave and distorted neck shape and may include invasive procedures such as surgical rejuvenation and targeted liposuction.
The mechanism of action of lipolytics based on deoxycholic acid
ATX-101 (Deoxycholic Acid [DCA]) is the first injectable to be approved by the FDA and Health Canada to improve facial appearance and reduce double chin and submental fat.
Read also: Injectable lipolitics.
Endogenous deoxycholic acid is a secondary bile acid that serves to emulsify and utilize dietary fat, facilitating its breakdown and absorption in the gastrointestinal tract. The initial mechanism of action proposed for this lipolytic was that the introduction of exogenous deoxycholic acid into subcutaneous fat (adipose tissue) within the submental region leads to the lysis of adipocytes, the targeted destruction of fat cells and, ultimately, a decrease in submental fat and volumes of the second chin.
Deoxycholic acid has been shown to mediate adipocyte lysis through disruption of the cell membrane, resulting in fat cell death and a decrease in the total number of adipocytes in the treated area (preplatysmal fat).
In line with the proposed mechanism of action for deoxycholic acid, adipocyte lysis was noted as early as 1 day after lipolytic administration, followed by local tissue response and septal thickening.
Read also: A modern view on the composition and mechanism of action of lipopolitics.
Neutrophil infiltration was observed on days 1 and 3, with an abundance of macrophage lipids and mild septal inflammation of the adipocyte layer on day 7. On the 28th day, the inflammation almost disappeared, while neovascularization and thickening of the fibrous septa indicate collagen production (neocollagenesis) and atrophy of the fat lobules. The effects of deoxycholic acid were dose dependent and limited to the subcutaneous fat layer.
Expert evaluation of the effectiveness of deoxycholic acid as a lipolytic
Scientific and clinical studies of deoxycholic acid as a lipolytic took 10 years to finally provide objective evidence of efficacy and safety. The results were so overwhelming that the Advisory Committee on Dermatological and Ophthalmic Products gave 100% agreement to recommend deoxycholic acid as a lipolytic.
The submental area is an area of increased attention among patients and cosmetologists/dermatologists, since the extension of injection treatment to the neck and submental area is an important criterion for the prevention of age-related changes in cosmetology. The use of deoxycholic acid as a lipolytic reduces the volume of the submental area and, when used correctly, can reshape the chin and neck to give a more youthful and refined appearance. Deoxycholic acid is a safe, non-aggressive lipolytic that can be a good alternative to surgery.
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