title: Use of phosphatidylcholine for the correction of lower lid bulging due to prominent fat pads.
abstract: BACKGROUND
  Orbital fat tissue, while important in protecting the eye, can protrude during aging, making a patient look 'tired'. Surgical correction, although traditionally the treatment of choice, can lead to scarring. Phosphatidylcholine (PPT) has been shown to reduce the size of these fat pads after direct injection. The compound, licensed in Europe for intravenous treatment of fat embolism, has recently gained interest for reducing localized fat by subcutaneous injection. However, there is a dearth of clinical data relating to efficacy and side effects.
  
  
  OBJECTIVE
  An open-label study was conducted in 21 subjects with the goal of reducing the infraorbital fat pad size. The objective of this study was to evaluate the efficacy and safety of PPT after injection into infraorbital fat pads.
  
  
  METHODS
  Twenty-one subjects were injected with 0.4 ml of PPT every 6 weeks to reduce prominent infraorbital fat pads. Pre- and post-treatment digital photographs were taken to document efficacy. In addition, side effects were recorded on a follow-up questionnaire.
  
  
  RESULTS
  In all, 74% of the subjects showed significant improvement after two to three treatments. Five of the enrolled subjects (23%) were non-responsive after two or more procedures and their treatment was discontinued. None of the patients had adverse side effects other than mild burning, erythema and swelling at the injection site. Nearly every patient maintained the results with no evidence of tissue damage after 6 months.
  
  
  CONCLUSIONS
  PPT injection into infraorbital fat pads resulted in a satisfactory cosmetic effect in most treated subjects. Most subjects required more than one treatment. This simple, office-based treatment provides a non-surgical alternative to patients with prominent infraorbital fat pads. More clinical data are required to fully assess the long-term safety and efficacy of this procedure.
authors.affiliation: Department of Skin Research, Ailesbury Clinic, Dublin, Ireland.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Treacy
authors.forename: David J
authors.initials: DJ
authors.lastname: Goldberg
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects*; D000328:Adult; D003357:Cosmetic Techniques; D005143:Eyelids; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010713:Phosphatidylcholines / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D010713:Phosphatidylcholines