Treatment of lower eyelid fat pads using phosphatidylcholine: clinical trial and review.
BACKGROUND
Injectable phosphatidylcholine, a lecithin-derived phospholipid, has been previously demonstrated to improve the appearance of infraorbital fat pad herniation. Current use internationally has led to a significant interest in this novel substance.


OBJECTIVE
To evaluate the efficacy and safety of injectable phosphatidylcholine, we conducted an open-label study for the treatment of infraorbital fat pad herniation.


METHODS
Patients received 0.4-mL phosphatidylcholine (50 mg/mL) injections within infraorbital fat pads every 2 weeks. Patient and physician grading of fat herniation, side effects, digital photographs, and a follow-up questionnaire was recorded.


RESULTS
Ten of the 13 enrolled patients had three to five treatments. Improvements in fat herniation were reported in 80% and 70% of patients as graded by the physician and patients, respectively. Sixty percent of patients assessed their improvement as equal or greater than 5 points (on a 10-point fat herniation scale); however, the physician judged 40% of patients improving to this degree. Little or no response was seen in three patients. Side effects included burning, erythema, and swelling at the injection site. At follow-up averaging 9 months, 50% of patients reported persistence of benefit, 20% experienced some fading, and 30% were the nonresponders.


CONCLUSIONS
Injectable phosphatidylcholine is a novel treatment for infraorbital fat herniation that may benefit some patients who are considering blepharoplasty. Larger studies evaluating long-term safety and efficacy of phosphatidylcholine for cosmetic purposes are warranted.
West Los Angeles Veteran Administration Medical Center, Los Angeles, CA, USA. glynisandsteve@aol.com
Glynis
G
Ablon
Adam M
AM
Rotunda
D000273:Adipose Tissue; D000328:Adult; D000368:Aged; D003240:Connective Tissue Diseases / Q000188:drug therapy; D005143:Eyelids; D005260:Female; D005500:Follow-Up Studies; D006547:Hernia / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010713:Phosphatidylcholines / Q000627:therapeutic use*
D010713:Phosphatidylcholines