Is this lipo for the face?

Whenever a cosmetic doctor approaches a patient with a syringe, we can pretty much guess that the outcome is going to be a bigger face. Filler injections designed to plump out ageing faces are now almost mandatory for celebrities of a certain age and we have become used to spotting the mountainous cheeks of certain stars hoping to keep the years at bay.

But not everyone has a gaunt face that needs fleshing out. In fact, many women have round faces and double chins they can’t fix, even with weight loss. And as we age, fat tends to slip down the face, settling on our widening jowls. “This is one of the most obvious signs of ageing,” says London cosmetic doctor Georges Roman. “It can make a woman’s face look quite masculine.”

The most common solutions include surgery in the form of a facelift to hoik everything back up or mesotherapy injections of natural substances such as artichoke extract. But there is now an alternative. It’s a controversial treatment known variously as the flab jab, the thinjection, or lipodissolve, where injections of tiny quantities of fat-burning medication can cause jowls and chubby chins simply to melt away. Britney Spears is rumoured to be a fan after she was spotted leaving an LA lipodissolve clinic.

Dr Barbara Kubicka, an aesthetic medical specialist who has just opened a clinic in Belgravia, is an expert in the jab. “These injections offer a non-surgical alternative to liposuction. They can be used even in delicate areas such as the face, neck or chin, as well as body areas such as the knees, arms or abdomen,” she says.

So where did the flab jab come from? The story begins with a German drug called Lipostabil, which was used to break down fatty deposits in the arteries. Then doctors found it could reduce fat under the skin, such as in eyebags. “When injected directly into fat deposits, its ingredients start to break down and emulsify the fat cells, which are then naturally absorbed and metabolised by the body,” says Dr Kubicka.

But if fat-melting injections are a modern miracle, why isn’t everyone offering them? Rajiv Grover, plastic surgeon and president elect of the British Association of Aesthetic Plastic Surgeons, says that Lipostabil was initially introduced without studies to show its safety as a cosmetic fat-buster. “In the US, especially, it was used by non-doctors, in vast quantities, and side effects began to appear, such as lumps under the skin and even severe skin infections.” As a result, the UK regulatory authority, the MHRA, put out a warning against Lipostabil and banned advertising for it.

So while it was still legal for doctors to perform the treatment, they were now only able to import the medication for specific named patients. But it was still in high demand across the capital.

“My patients very often hear of me by recommendation. The word of mouth started with my London-based Russian patients, as the procedure is very popular there,” says Dr Kubicka. But are Lipostabil-type drugs actually safe?

“There are now a number of studies in South America and Germany treating several thousand patients with good outcomes, and relatively few serious side effects when used under careful supervision,” says Grover.

London cosmetic doctor Mervyn Patterson, of Woodford Medical Aesthetics, agrees: “Lipodissolve was a fantastic treatment for small pockets of fat, such as the submental fat area, which is the little podgy bit under the chin. Side effects in the hands of a proper doctor, properly trained, were usually transient and of no great significance.