{"id":6688,"date":"2020-04-22T18:25:40","date_gmt":"2020-04-22T21:25:40","guid":{"rendered":"https:\/\/doctorhoogstra.com\/es\/acido-desoxicolico-en-el-tratamiento-de-la-grasa-submental\/"},"modified":"2020-04-27T17:08:27","modified_gmt":"2020-04-27T20:08:27","slug":"deoxycholic-acid-in-the-treatment-of-submental-fat","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/en\/wiki\/acido-desoxicolico-en-el-tratamiento-de-la-grasa-submental\/","title":{"rendered":"Deoxycholic acid in the treatment of submental fat"},"content":{"rendered":"<p><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_88 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/acido-desoxicolico-en-el-tratamiento-de-la-grasa-submental\/#%C2%BFQue-es-el-acido-desoxicolico\" >What is deoxycholic acid?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/acido-desoxicolico-en-el-tratamiento-de-la-grasa-submental\/#%C2%BFPara-que-se-usa-el-acido-desoxicolico\" >What is deoxycholic acid used for?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/acido-desoxicolico-en-el-tratamiento-de-la-grasa-submental\/#%C2%BFQue-es-la-grasa-submental\" >What is submental fat?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/acido-desoxicolico-en-el-tratamiento-de-la-grasa-submental\/#Precauciones-antes-de-las-inyecciones-de-acido-desoxicolico-en-la-grasa-submental\" >Precautions Before Deoxycholic Acid Injections into Submental Fat<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/acido-desoxicolico-en-el-tratamiento-de-la-grasa-submental\/#%C2%BFComo-se-administra-el-acido-desoxicolico\" >How is deoxycholic acid administered?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/acido-desoxicolico-en-el-tratamiento-de-la-grasa-submental\/#%C2%BFCuales-son-los-beneficios-del-acido-desoxicolico\" >What are the benefits of deoxycholic acid?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/acido-desoxicolico-en-el-tratamiento-de-la-grasa-submental\/#%C2%BFCuales-son-las-desventajas-los-efectos-secundarios-y-los-riesgos-de-las-inyecciones-de-acido-desoxicolico\" >What are the disadvantages, side effects and risks of deoxycholic acid injections?<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQue-es-el-acido-desoxicolico\"><\/span>What is deoxycholic acid?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Deoxycholic acid is a secondary bile acid produced by the intestine. <span class=\"term\" data-term-id=\"935\">bacteria<\/span> acting <span class=\"term\" data-term-id=\"949\">primary<\/span> bile acids secreted by the liver. Deoxycholic acid is also known as deoxycholate and cholanoic acid.<\/p>\n<ul>\n<li>Deoxycholic acid emulsifies fats to help their intestinal absorption.<\/li>\n<li>When injected into <span class=\"term\" data-term-id=\"900\">subcutaneous<\/span> fat, deoxycholic acid destroys <span class=\"term\" data-term-id=\"549\"><span class=\"term\" data-term-id=\"1904\">adipocytes<\/span><\/span>  (fat cells). the <span class=\"term\" data-term-id=\"490\">inflammatory<\/span> The tissue reaction leads to reduced fat and minimal scarring.<\/li>\n<li>Deoxycholic acid is less destructive on skin and muscle tissue due to protein binding.<\/li>\n<li>Kybella<sup>\u00ae<\/sup> (Allergan) is a proprietary formulation of purified synthetic deoxycholic acid initially developed by Kythera Biopharmaceuticals for <span class=\"term\" data-term-id=\"1150\">therapeutic<\/span> use. In some countries, including New Zealand, it is marketed as <span>BELKYRA\u00ae<\/span>.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFPara-que-se-usa-el-acido-desoxicolico\"><\/span>What is deoxycholic acid used for?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Deoxycholic acid and its derivatives have been used:<\/p>\n<ul>\n<li>In the food industry as emulsifiers.<\/li>\n<li>To prevent and dissolve gallstones.<\/li>\n<li>Under investigation as a biological detergent<\/li>\n<li>In mesotherapy to produce <span class=\"term\" data-term-id=\"865\">lipolysis<\/span> (e.g., as a nonsurgical treatment of lipoma)<\/li>\n<li>Kybella is approved by the U.S. Food and Drug Administration as an injectable medication to improve the appearance of moderate to severe convexity or fullness associated with submental fat.<\/li>\n<\/ul>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQue-es-la-grasa-submental\"><\/span>What is submental fat?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Submental fat refers to the fat present in the submental region under the chin and in the front of the neck (preplatsymal fat). Submental fat accumulates with age, <span class=\"term\" data-term-id=\"558\">genetic<\/span> <span class=\"term\" data-term-id=\"1494\">predisposition<\/span> and obesity It is considered cosmetically undesirable and may cause adverse psychological impact.<\/p>\n<p>Options to minimize submental fat include:<\/p>\n<ul>\n<li>Surgical rejuvenation (face and neck lift)<\/li>\n<li>Targeted liposuction\n<\/li>\n<li>Cryolipolysis<\/li>\n<li><span class=\"term\" data-term-id=\"1617\">To be<\/span> <span class=\"term\" data-term-id=\"1754\">ablation<\/span><\/li>\n<li>Radiofrequency contouring<\/li>\n<li>\n<span class=\"term\" data-term-id=\"1378\">Ultrasound<\/span> lipolysis<\/li>\n<li>Submentoplasty<\/li>\n<li>Chin implants<\/li>\n<li>Deoxycholic acid injections.<\/li>\n<\/ul>\n<p>Submental fat can be objectively assessed by physicians by using the Physician-Reported Submental Fat Score <span class=\"term\" data-term-id=\"320\">Scale<\/span> (CR-SMFRS).<\/p>\n<p>The patient&#039;s subjective assessment of their submental fat can be measured by using the following methods:<\/p>\n<ul>\n<li>The Subject Self-Rating Scale (SSRS)<\/li>\n<li>The Patient-Reported Submental Fat Rating Scale (PR-SMFRS).  <\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"Precauciones-antes-de-las-inyecciones-de-acido-desoxicolico-en-la-grasa-submental\"><\/span>Precautions Before Deoxycholic Acid Injections into Submental Fat<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li>Postpone treatment if there is a <span class=\"term\" data-term-id=\"145\">infection<\/span> at the treatment site.<\/li>\n<li>Avoid <span class=\"term\" data-term-id=\"1330\">current<\/span> or local <span class=\"term\" data-term-id=\"1210\">anesthesia<\/span> If the patient is allergic to these.<\/li>\n<li>Make sure the swelling is due to fat (consider cervical thyromegaly <span class=\"term\" data-term-id=\"503\">lymphadenopathy<\/span>, submandibular ptosis, scarring and excessive skin laxity).<\/li>\n<\/ul>\n<p>Careful clinical evaluation to exclude other causes of submental convexity\/fullness (eg, enlarged thyroid, cervical lymphadenopathy) is mandatory before treatment. Treatment with deoxycholic acid is <span class=\"term\" data-term-id=\"1322\">contraindicated<\/span>:<\/p>\n<ul>\n<li>If the patient is sensitive to any component of the treatment medication.<\/li>\n<li>If excess skin (rather than fat) is the cause of an adverse profile<\/li>\n<li>During pregnancy or breast-feeding (there is insufficient safety data)<\/li>\n<li>If there has been previous surgical or aesthetic treatment of the submental region<\/li>\n<li>If the patient has a bleeding disorder or takes anticoagulants or antiplatelet agents.\n<\/li>\n<li>If there is a current or previous history of, <span class=\"term\" data-term-id=\"514\">dysphagia<\/span> (difficulty to swallow)<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFComo-se-administra-el-acido-desoxicolico\"><\/span>How is deoxycholic acid administered?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Deoxycholic acid injections should be performed by a trained physician who understands submental anatomy. The target is the subcutaneous fat between the <span class=\"term\" data-term-id=\"61\">dermis<\/span> and platysma (pre-platysmal fat) within the treatment area. Prior informed consent must be obtained from the patient.<\/p>\n<p>The following steps are a general guide (for specific details and usage recommendations, see the manufacturer&#039;s product information). A topic <span class=\"term\" data-term-id=\"1206\">anesthetic<\/span>Ice or local anesthesia may be used, but is often not required.<\/p>\n<ul>\n<li>A \u201ctattoo grid\u201d of ink can be applied to the area to be treated to guide the administration of injections; This is removed with an alcohol swab after treatment.<\/li>\n<li>Deoxycholic acid is injected subcutaneously in doses of 0.2 ml, 1 cm apart, into the submental fat treatment area. The concentration used is 10 mg\/ml (2 mg\/cm<sup>2<\/sup>) A 30 gauge (or smaller) needle that is 0.5 inches long is used.<\/li>\n<li>Up to 50 individual injections can be injected per treatment session, which is equivalent to a maximum of 10 ml of deoxycholic acid.<\/li>\n<li>Bruising and pain after treatment can be relieved with compression dressings, cold compresses, and oral analgesia.<\/li>\n<li>Treatment may be repeated at intervals of 4 to 8 weeks. Most patients receive 2 to 4 treatments and up to six treatments may be given.<\/li>\n<\/ul>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCuales-son-los-beneficios-del-acido-desoxicolico\"><\/span>What are the benefits of deoxycholic acid?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Five large clinical trials have demonstrated the <span class=\"term\" data-term-id=\"914\">effectiveness<\/span> of deoxycholic acid in the reduction of submental fat measured by validated scales and objective measurements. Patients reported better psychological parameters and feelings. Adverse effects were mild and temporary.<\/p>\n<p>In a randomized trial that included 390 patients, 12 weeks after four treatments with deoxycholic acid, the 65-70% of patients treated with deoxycholic acid were satisfied with the appearance of their face and chin compared to the 30% they had received inert injections. <span class=\"term\" data-term-id=\"1875\">saline<\/span> (<span class=\"term\" data-term-id=\"1103\">placebo<\/span>)<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCuales-son-las-desventajas-los-efectos-secundarios-y-los-riesgos-de-las-inyecciones-de-acido-desoxicolico\"><\/span>What are the disadvantages, side effects and risks of deoxycholic acid injections?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Deoxycholic acid injections into submental fat are generally well tolerated and side effects are usually transient. However, in clinical trials, more patients treated with deoxycholic acid 1 mg\/cm<sup>2<\/sup> and 2 mg\/cm<sup>2 <\/sup>treatment interrupted due to <span class=\"term\" data-term-id=\"909\">adverse events<\/span> (5.8% and 11.5%, respectively) compared to placebo (0.9%).<\/p>\n<p>Side effects of the procedure are common and include:<\/p>\n<ul>\n<li>Pain at the injection site.  <\/li>\n<li>Bruising<\/li>\n<li>Numbness and tenderness<\/li>\n<li>Temporary redness and swelling.<\/li>\n<li>\n<span class=\"term\" data-term-id=\"143\">Hardening<\/span> at the injection site<\/li>\n<li>Depressions at the injection site.<\/li>\n<li>Dysphagia<\/li>\n<li>Nerve injury that causes temporary numbness.<\/li>\n<li>Skin <span class=\"term\" data-term-id=\"1278\">ulceration<\/span> (rare), due to too superficial an injection into the dermis<\/li>\n<li>Temporary or persistent beard <span class=\"term\" data-term-id=\"122\">hair<\/span> The loss has been reported.<\/li>\n<\/ul>\n<p>Submental fat can accumulate again after the procedure.<\/p>\n<p>The safe and effective use of deoxycholic acid outside the submental fatty region has not been established and is not recommended.<\/p>\n<section class=\"textBlock\">\n<div class=\"grey-box\"><em><span style=\"font-size: 0.9em;\">New Zealand approved data sheets are the official source of information for these prescription drugs, including approved uses and risk information. See the New Zealand individual data sheet on the Medsafe website.<\/span><\/em><\/div>\n<\/section>\n<div class=\"clearfix\"><\/div>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>\u00bfQu\u00e9 es el \u00e1cido desoxic\u00f3lico? El \u00e1cido desoxic\u00f3lico es un \u00e1cido biliar secundario producido por el intestino. bacterias actuando primario \u00e1cidos biliares secretados por el h\u00edgado. El \u00e1cido desoxic\u00f3lico tambi\u00e9n&#8230;<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[],"class_list":["post-6688","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/6688","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=6688"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/6688\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=6688"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=6688"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=6688"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}