It is an enormous pleasure and privilege to present a collated Special Issue of Dermatologic Surgery. This treatment was initially developed in Dermatology1 and is a biologic that, like the botulinum neuromodulators, really works!!!
For many years, reduction of submental fat required a surgical procedure, as this area is not usually amenable to dieting and exercise. Submental fullness can be misconstrued as the patient being overweight, which is not always the case; in fact, many individuals have a family history of neck fullness despite normal body mass index.
The introduction of an FDA-approved and Health Canada–approved nonsurgical injection treatment option has opened the treatment doors to many subjects who would otherwise have remained frustrated as they did not wish to undergo surgery. The patients are all very busy with family, work, and social commitments and appreciate the limited downtime as well as the excellent effect and safety of this new injection procedure.2,3
The 2016 Procedural Survey from the American Society for Dermatologic Surgery (ASDS)4 confirms the results of previous ASDS surveys—that the submental contour is a significant cosmetic and social concern to nearly 3 quarters of individuals contacted.
In this exciting compendium, the world class authors explore the entire issue from many points of view in the following: beauty, self-esteem, and a detailed appreciation of neck, submental, and lower facial anatomy. As with all the procedures, proper injection technique and postinjection follow-up is very important in the avoidance and management of potential adverse events.
As the sodium deoxycholate treatment was FDA approved (2015) before it was Health Canada approved (Canadian launch early 2016), the Canadian physicians were very grateful for the guidance given to the authors by their American colleagues who pointed out that treatments could successfully be spaced out further apart than the 28-day interval the authors had all used in the pivotal trials.
The authors hope that this will be the first of many special issues on this novel injection treatment for submental fullness. The authors predict that the technique will be further refined for other body areas as the opportunities for other applications are appreciated.
1. Rotunda AM. Injectable treatments for adipose tissue: terminology, mechanism, and tissue interaction. Lasers Surg Med 2009;41:714–20.
2. Rzany B, Griffiths T, Walker P, Lippert S, et al.. Reduction of unwanted submental fat with ATX-101 (deoxycholic acid), an adipocytolytic injectable treatment: results from a phase III, randomized, placebo-controlled study. Br J Dermatol 2014;170:454–3.
3. Dayan SH, Jones DH, Carruthers J, Humphrey S, et al.. A Pooled analysis of the safety and efficacy results of the multicenter, double-blind, randomized, placebo-controlled phase 3 REFINE-1 and REFINE-2 trials of ATX-101, a submental contouring injectable drug for the reduction of submental fat. Plast Reconstr Surg 2014;134(4 Suppl 1):123.