AQUALYX LIPOSUCTION WITH-OUT THE USE OF SCALPELS NON SURGICAL REDUCTION OF LOCALIZED FAT DEPOSITS
INTRALIPOTHERAPY AQUALYX Contents 1. Historical review 10. Pricing recommendation 2. Composition 11. before & after Photo-Gallery 3. Mode of action 12. Medical training and intralipotherapy 4. Histological evidence course 5. Clinical evidence 6. Indications 7. Contra-indications 8. Safety data 9. Protocol of injection
1. Historical review of non surgical treatments • Meso-therapy • Electro-lipolyse past • O2O3-therapy • Ultrasound “cavitation” • Phosphatidylcholine preparations Recent past • Laserlysis • Aqualysis “ Intralipo- therapy” present • Cryo-lipolysis
Phosphatidylcholine , Misconception and calrification “ Lipostabil _ Lipolight _ Lipodisolve _ Lipolyse _ Lipomelt _ Flabjap ” MISCONCEPTION COMPOSITION CLARIFICATION Phosphatidylcholine Deoxycholate as active Phosphatidylcholine as ingredient. active ingredient. Sodium deoxycholate Benzilic alchol Lipolysis as functional Adipocytolysis as Tocopherol activity. functional activity. saline Meso-therapy as Intralipo-therapy as injection technique. injection technique.
Phosphatidylcholine “ lipostabil ” • On 1966 , germany approve the use of lipostabil (5% phosphatedylcholine , 4.75% deoxycholate) as intravenous infusion for the treatment of intravascular fat embolism, dyslipidemia and liver cirrhosis). • Few years later, a growing trend of off-label usage of lipostabil in reduction of infra-orbital fat without any clinical evidence. • Few years later, many generics to lipostabil introduced commercially to the market under different names such as: lipodissolve , lipolight , lipolyse. • 2010, FDA take restrictive action against these formulations which used for the treatment of localized adiposity after increasing reports of permanent scarring , skin deformations , deep painful nodules. • Now, phosphatedylcholine is totally banned in Europe.
2. AQUALYX Composition aqueous micro-gelatinous solution containing a polymer of 3:6-anhydro-l-galactose and D-galactose, buffer systems, 3,12-Dihydroxy-5-24-oico Cholanic Acid sodium Salt, physiologic solution
2. AQUALYX Composition cont., • Aqueous micro gelatinous solution with a slowly released, short half life time, biocompatible, fat selective and re-absorbable system of modified detergent compound; “ sodium deoxycholate ”. • The adipocytolytic action is enhanced by associated use of external ultrasound. • AQUALYX must be injected exclusively and only by lipoinject needles with an injection technique called intralipotheraby .
3. AQUALYX mode of action • The biocompatible , short half life time , highly selective sodium deoxycholate _without PC_ selectively destroy fat cell membrane initiating the process of adipocitolysis and liberating: 1. the water “absorbed by blood vessels and then excreted through urine” 2. triglycerides “ absorbed by lymphatic drainage system toward the liver where it excreted through stools”.
3. AQUALYX mode of action cont., Sodium Deoxycholate’s biocompatibility DC is endogenous bile salt ,in the same time a compatible detergent ….. HOW !!? • Metabolically inert • Excreted in same formula in which they are administrated • Tissue specific activity
3. AQUALYX mode of action cont., Sodium Deoxycholate’s fat selectivity DC preferentially targets fat tissue while sparing non fat tissues ... ….. WHY !!!? • Albumin is a physiological protein, show very high affinity to Deoxycholate , bind to DC forming inactive complex ,absorbed by blood vessels, carry DC. to liver where it rejoins the endogenous bile acid pool. • Albumin physiological levels in adipose tissue is 0.7% while 1.3% in muscle tissue & 4% in plasma “the sufficient level to completely deactivate the instantly cytotoxic level of DC.”. • The physiological conc. of albumin in protein rich tissues such as “skin , muscles , vessels and plasma” deactivates DC-mediated cell lysis , while protein poor tissues “fat” is highly sensitive to DC. Cause of low albumin level. • The rapid neutralization of DC. Into DC-albumin inactive complex , rapid absorption prevents DC. From accumulation in injection site and produces extensive tissue lysis.
3. AQUALYX mode of action cont., Sodium Deoxycholate’s fat selectivity
4. AQUALYX Histological Evidence Histological studies performed ex-vivo show how AQUALYX is capable of producing adipose tissue alterations such as : • Rupture of fat cell wall • Homogenization of cytoplasmic vacuoles • Liberation of triglycerides A_ normal adipose tissue. B_1% DC treated adipose tissue. C_ foamy macrophages “grey arrows”. D_ free lipid droplets “blue arrow” & remnants of destroyed adipocytes “black arrow” .
4. AQUALYX Histological Evidence cont., Histological section under high power electronic microscope
INTRALIPOTHERAPY
5. AQUALYX clinical evidences • Dr.Raffaele Rauso AUTHOR • Dr.Antonio Rusciani • Dr.GiuseppeCuringa • Maxillo-Facial Surgery ,Centro Polispecialistico Santa Apollonian, Italy. • University Of Foggi, Foggia , Italy. LOCATION • Department Of Plastic Surgery, La Sapienza, University Rome, Italy. • Skinlaser, Plastic Surgery Center, Rome, Italy. • Venuslab, Plastic Surgery Center, Rome, Italy. PUPLICATION & • Journal Of Drugs In Dermatology , October2014, Volume 13 , Issue 10. • Dr.raffaele rauso ……………………………Dr.raffaelle.rauso@gmail.com . Author correspondence
5. AQUALYX clinical evidences CONT., • Dr. Hernan Pento • Dr. Carlota Hernandez • Dr. Cinara Turra AUTHOR • Dr. Marisa Manzano • Dr. Laura Salvador • Dr. Paloma Tejero • Instituto de Investigaciones para las Especialidades Esteticas y del Envejecimiento , Barcelona , Spain. • Clinica Arts Medica, Valencia, Spain. LOCATION • Beyou Medical Group, Malaga, Spain. • Antiaging Group, Barcelona, Spain. • Clinica Mediestetic, Toledo, Spain. PUPLICATION & • Journal Of Drugs In Dermatology , December 2014, Volume 13 , Issue 12. • Dr.Hernan Pento……………………………………………...hpinto@ageback.es Author Correspondence
5. AQUALYX clinical evidences CONT., • Dr. Giovanni Salti. AUTHOR • Dr. Pasquale Motolese . • Instituto Medilight, Florence, Italy. LOCATION • Professor FORMEST university of ferrara, Italy . PUPLICATION & • The European Journal of Aesthetic Medicine and Dermatology, Feb. 2012. • Dr. Giovanni Salti…………………………..giosal@fol.it. Author Correspondence
5. AQUALYX clinical evidences CONT., • Dr. Hernan Pinto AUTHOR • Dr. Graciela Melamed • Dr.Luca Fioravanti • Age back, Barcelona • MEG Group, Buenos Aires LOCATION • Thermalift Centre, Pavia PUPLICATION • The European Journal of Aesthetic Medicine and Dermatology, Feb. 2012. & • Dr.Hernan Pento ………………………………….…………...hpinto@ageback.es. Author Correspondence
5. AQUALYX clinical evidences CONT., AUTHOR • Dr. Raffaele Rauso LOCATION • Consultant Aesthetic & Maxillo-Facial Surgery, Centro Polispecialistico Santa Apollonia, S.M.C.V (CE), Italy PUPLICATION & • The European Journal of Aesthetic Medicine and Dermatology, Jan. 2011. • Dr.Raffaele Rauso ………………………….…………...raffaelerauso@virgilio.it. Author Correspondence
5. AQUALYX clinical evidences CONT., • Dr. El KamshoushyA. AUTHOR • Dr. Adel Maksoud R. • Dr. El Mahdy N. LOCATION • Department of Dermatology , Venereology and Andrology , Faculty of Medicine , University of Alexandria , Egypt. PUPLICATION & • Journal of Clinical and Experimental Dermatology Research , 2012 Volume 3 Issue 2. Author Correspondence
5. AQUALYX clinical evidences CONT., • Dr. Rattapon Thuangtong • Dr. Jason J. Bentow • Dr. Kristeene Knopp AUTHOR • Dr. Nader A. Mahmood • Dr.Nathaniel E. David • Dr. Michael S. Kolodney • Department of Dermatology , Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical LOCATION Research Institute , Torrance , California. PUPLICATION • the American Society for Dermatologic Surgeries , 2010 , Published by Wiley Periodicals Inc.. & • Dr. Michael S. Kolodney……………………………………………………..mkolodney@labiomed.org.. Author Correspondence
5. AQUALYX clinical evidences CONT., AUTHOR • Dr. Adam M. Rotunda • Department of Dermatology , Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical LOCATION Research Institute , Torrance , California. PUPLICATION & • the American Society for Dermatologic Surgeries , 2009 , Published in Dermatologic Surgery May 2009 Volume 35 Issue. Author Correspondence
5. AQUALYX clinical evidences CONT., • Dr. Roberto Amore • Dr. Kostas Gritzalas AUTHOR • Dr. DomenicoAmuso • Dr.LoredanaTanzarella • Dr. Vincenza Leonardi LOCATION • Department of Dermatology , University of Palermo , Italy . • the European Journal of Aesthetic and Dermatology , Dec. 2015 Volume 3. PUPLICATION • Dr. Roberto Amore…………………..robertoamore@Hotmail.com. & • Dr. Kostas Gritzzalas…………………….kostas.gritzalas@yahoo.com. Author Correspondence
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