The demand for non-surgical body contouring solutions continues to grow, with many patients seeking alternatives to invasive procedures like liposuction for stubborn, localized fat deposits that are resistant to diet and exercise. Injectable treatments utilizing deoxycholic acid have emerged as a significant modality in this space, offering targeted reduction of adiposity.

Aqualyx®, developed by Marllor Biomedical, is a well-recognized injectable solution in many international markets, specifically designed for the non-surgical treatment of localized fat. Its active ingredient, a deoxycholic acid derivative, works by disrupting fat cell membranes, leading to adipocytolysis. This article aims to provide a comprehensive overview of Aqualyx® for licensed medical professionals, detailing its composition, mechanism of action, common treatment areas, patient selection criteria, administration protocols including intralipotherapy, and crucial safety considerations.

(This guide is intended for trained medical professionals ONLY, experienced in intralipotherapy or similar injectable fat reduction techniques. Adherence to local regulations, product Instructions For Use (IFU), and specialized training protocols is essential for the safe and effective use of Aqualyx®. This information does not substitute for such formal training.)

Understanding Aqualyx®: Composition and Mechanism of Action

Composition:

Aqualyx® is a micro-gelatinous aqueous solution. Its principal active component is a derivative of deoxycholic acid, a secondary bile acid that occurs naturally in the human body and plays a role in the emulsification and absorption of dietary fats. The specific formulation often includes a slow-release sugar-based system (e.g., containing galactose and other components) and buffers to optimize its action and tolerability within the adipose tissue.

Mechanism of Adipocytolysis:

When Aqualyx® is injected directly into subcutaneous adipose tissue, the deoxycholic acid component acts as a detergent, disrupting the integrity of adipocyte (fat cell) cell membranes. This action causes:

1. Cell Lysis: The fat cell membrane ruptures, releasing the intracellular triglycerides (lipids).
2. Inflammatory Response: The body mounts a localized, controlled inflammatory response to the cellular debris and released lipids. Macrophages are recruited to the site to clear these components.
3. Metabolism and Elimination: The released triglycerides are processed by the body’s natural metabolic pathways (transported to the liver) and eventually eliminated.
4. Fibrosis and Tissue Contraction: The inflammatory response can also lead to a degree of fibrosis and tissue contraction in the treated area, which may contribute to skin tightening over time.

This process results in a permanent reduction in the number of fat cells in the treated area, as mature adipocytes have limited regenerative capacity.

Common Clinical Indications and Treatment Areas for Aqualyx®

Aqualyx® is designed for the treatment of localized, stubborn subcutaneous fat deposits that are well-defined and resistant to conventional weight loss methods like diet and exercise. It is not suitable for treating obesity or for widespread fat reduction.

Commonly treated areas (based on global clinical practice) include:

• Submental Region (“Double Chin”)
• Abdomen (small, localized pockets)
• Flanks (“Love Handles”)
• Hips (“Saddlebags”)
• Inner and Outer Thighs
• Knees (suprapatellar or medial knee fat)
• Upper Arms (“bingo wings” – in appropriate candidates with good skin)
• Back Rolls (e.g., bra line fat)
• Pseudo-gynecomastia (localized male chest fat – careful assessment needed)
• Lipomas (benign fatty tumors – requires careful diagnosis and is an off-label consideration)

The selection of treatment areas must be based on a careful assessment of the patient’s anatomy, the nature of the fat deposit (ensuring it is subcutaneous and pinchable), and skin quality.

Off-Label Uses and Considerations

While Aqualyx® has established protocols for the aforementioned areas in many regions, experienced practitioners may sometimes consider its use for other small, localized fat deposits. However, such off-label applications require exceptional clinical judgment, advanced anatomical knowledge, meticulous technique, and a very detailed risk-benefit discussion with the patient, including comprehensive informed consent. Evidence for off-label uses may be limited or anecdotal, and practitioners assume greater responsibility.

Patient Selection Criteria: Identifying Ideal Candidates

Careful patient selection is paramount for achieving satisfactory outcomes and ensuring safety with Aqualyx®:

• Body Weight: Patients should be at or close to their ideal body weight. Aqualyx® is for body contouring, not weight reduction. A Body Mass Index (BMI) under 25-30 is often cited, but individual assessment is more critical.
• Localized Fat: The presence of distinct, “pinchable” pockets of subcutaneous fat that are truly resistant to diet and exercise is key.
• Skin Elasticity: Good to moderate skin elasticity in the treatment area is preferred. If skin laxity is significant, fat reduction may exacerbate sagging. Combination with skin tightening procedures might be considered in such cases.
• Realistic Expectations: Patients must understand that Aqualyx® provides gradual results, typically appearing over several weeks to months as the body eliminates the disrupted fat cells. Multiple treatment sessions are almost always necessary. The inflammatory phase (swelling, tenderness) is an expected part of the process.
• Good General Health: Patients should be in good overall health.
• Commitment: Willingness to undergo the full recommended course of treatment and adhere to post-treatment care instructions.

Contraindications and Precautions

Practitioners must thoroughly screen patients for contraindications and observe necessary precautions:

Absolute Contraindications:

• Pregnancy and breastfeeding.
• Known allergy or hypersensitivity to deoxycholic acid or any other component of Aqualyx®.
• Active infection or skin disease (e.g., eczema, psoriasis) at or near the proposed injection site.
• Significant liver disease (as the liver is involved in metabolizing released fats).
• Significant kidney disease.
• Autoimmune diseases, particularly those affecting connective tissue or fat metabolism (e.g., lupus, scleroderma).
• Bleeding disorders or current anticoagulant/antiplatelet therapy that cannot be safely paused.
• History of severe anaphylactic reactions.
• Patients under 18 years of age.

Precautions/Relative Contraindications:

• Poorly controlled diabetes (impaired healing, infection risk).
• Significant skin laxity in the treatment area.
• Unrealistic patient expectations.
• History of keloid or hypertrophic scarring (use with caution, test patch may be considered).
• Areas with minimal subcutaneous fat.

Medication Review: Discuss pausing medications or supplements that increase bleeding risk (e.g., aspirin, NSAIDs, high-dose Vitamin E, fish oils, Ginkgo Biloba) for a recommended period before treatment, with the prescribing physician’s approval if applicable, to minimize bruising.

Administration Principles: The Intralipotherapy Technique

The administration of Aqualyx® requires specialized training in the intralipotherapy technique, which is distinct from standard dermal filler injections.

• Specialized Training: Practitioners must receive specific, certified training on Aqualyx® and the intralipotherapy technique before performing treatments.
• Injection Depth: Aqualyx® must be injected directly and exclusively into the subcutaneous fat layer. Intradermal or intramuscular injection must be avoided, as this can lead to skin necrosis or muscle damage.
• Tool: Specialized, long intralipotherapy needles (e.g., Lipoinject needles) are typically used.
• Technique: A fanning or linear retrograde injection technique is employed to distribute the product evenly throughout the targeted fat pocket. Often, a grid pattern is marked on the skin to guide injection points, ensuring even coverage. The needle is advanced through a single entry point per small area to reach multiple tracks within the fat.
• Volume and Spacing: Strict adherence to recommended maximum volumes per injection point (e.g., 0.2-0.5ml), spacing between injection points (e.g., 1-2cm), and maximum volume per anatomical region per session is crucial. These guidelines are provided in training and product literature and are designed to manage the inflammatory response and minimize adverse events.
• Anesthesia: Aqualyx® itself can cause significant stinging/burning. Many practitioners mix Aqualyx® with a small amount of lidocaine (e.g., 2% without epinephrine) immediately prior to injection, if this is permitted by local guidelines and the product’s specific IFU in their region. Topical anesthetics are generally not sufficient due to the depth of injection. Cooling the area before and after can also help.
• Number of Sessions: Typically, 2-4 treatment sessions (or more for larger areas or greater fat thickness) are required, spaced approximately 3-6 weeks apart. The exact number depends on the treatment area, the volume of fat, and the individual patient’s response.

Expected Results & Post-Treatment Care

• Timeline: Results are not immediate. A noticeable inflammatory response (swelling, redness, tenderness) is expected and indicates the product is working. The gradual reduction in fat thickness typically becomes apparent over 4-8 weeks following each treatment session as the body processes and eliminates the lysed fat cells.
• Post-Treatment Effects (Expected):
  • Significant Swelling: This is the most common and expected side effect, often peaking at 24-72 hours and gradually subsiding over 1-3 weeks.
  • Bruising: Common, can last 1-2 weeks.
  • Tenderness/Pain: Usually manageable with simple analgesics.
  • Erythema (Redness) & Warmth: Due to inflammation.
  • Nodularity/Firmness: Palpable firmness or small nodules in the treated area are common as the fat breaks down and the inflammatory response occurs. These usually resolve spontaneously over several weeks with massage.
• Aftercare Advice:
  • Compression Garments: Often recommended for areas like the abdomen or thighs to help manage swelling and provide comfort.
  • Gentle Massage: Some protocols recommend gentle massage of the treated area starting a few days post-treatment to aid in even distribution and resolution of firmness (follow specific training guidelines).
  • Avoid: Strenuous exercise, excessive heat (saunas, hot tubs), and alcohol for a few days to a week post-treatment, as these can exacerbate swelling.
  • Hydration: Encourage good fluid intake.
• Follow-up: Schedule follow-up appointments to assess the response, manage any concerns, and plan subsequent sessions.

Potential Side Effects & Complication Management

While Aqualyx® is generally considered safe when administered correctly by a trained professional to appropriate candidates, potential side effects and complications exist:

• Common/Expected (as above): Swelling, bruising, pain/tenderness, erythema, itching, temporary firmness/nodularity.
• Less Common/More Serious:
  • Persistent pain or nodules.
  • Skin irregularities or contour deformities (if unevenly injected or poor skin laxity).
  • Temporary sensory disturbances (numbness/tingling).
  • Skin ulceration or necrosis (a rare but serious risk if the product is injected too superficially or if there is vascular compromise).
  • Infection.
  • Allergic/hypersensitivity reactions.
  • Post-Inflammatory Hyperpigmentation (PIH), especially in individuals with darker skin types.
  • Systemic effects like dizziness or lightheadedness immediately post-injection (rare).

It is imperative that practitioners are trained to recognize and manage potential complications. Early intervention is key for more serious adverse events.

Sourcing Authentic Aqualyx®

The use of genuine, sterile Aqualyx® sourced from reputable B2B suppliers is paramount for ensuring patient safety, product efficacy, and achieving predictable results. The risks associated with counterfeit or improperly stored and handled injectable products are significant.

Conclusion: Aqualyx® as a Tool for Targeted Body Contouring

Aqualyx® offers a valuable non-surgical option for licensed medical professionals to address localized subcutaneous fat deposits in appropriately selected patients. Its deoxycholic acid-based formulation effectively induces adipocytolysis, leading to a permanent reduction of fat cells in the treated area and offering a viable alternative to surgical contouring for many individuals.

However, successful and safe outcomes with Aqualyx® are critically dependent on:

• Comprehensive, specialized training in the intralipotherapy technique.
• Meticulous patient selection and thorough assessment.
• Strict adherence to administration protocols regarding injection depth, volume, and spacing.
• Effective management of patient expectations concerning the gradual nature of results and the expected inflammatory post-treatment phase.
• Sourcing authentic, high-quality product from trusted suppliers.

When utilized with expertise and within its intended scope, Aqualyx® can be a powerful tool for enhancing body contours and improving patient satisfaction.

Doris Dickson

About the Author: Doris Dickson is a specialist writer for Health Supplies Plus, focusing on the aesthetic medicine industry. She diligently researches cosmetic treatments and products to provide clear, concise information relevant to licensed medical professionals. Her work supports Health Supplies Plus’s commitment to being a reliable informational resource and trusted supplier for the aesthetic community.

 

Disclaimer: The content provided in this article is intended for informational purposes only and is directed towards licensed medical professionals. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment, nor does it constitute an endorsement of any specific product or technique. Practitioners must rely on their own professional judgment, clinical experience, and knowledge of patient needs, and should always consult the full product prescribing information and relevant clinical guidelines before use. Health Supplies Plus does not provide medical advice.