Lipolysis is the process of the breakdown of fatty acids or lipids by a chemical reaction with water involving triglycerides. Due to hydrolysis, lipids and triglycerides are further broken down chemically into metabolic molecules known as acetyl units. Ketones are then produced as a by-product and indicator of the breakdown of lipids and triglycerides.
The breakdown of lipids is induced chemically by hormones or phospholipids. Hormones such as cortisol, epinephrine and testosterone trigger protein receptors to activate hormone sensitive enzymes. A chemical chain reaction involving a messenger molecule activates protein kinase A (PKA), which regulates sugar and lipid metabolism. PKA then activates a water-soluble enzyme called lipase that breaks down fats in adipose tissue, or body fat.
Triglycerides aid the lipolysis process in the body further by using lipoproteins or cholesterol molecules to transport the fat in the blood to adipose and muscle tissue. The breakdown of triglycerides by lipase cells in body fat produces free fatty acids. Usually, remaining free fatty acids bind to proteins and enzymes to either be absorbed or discarded from the body.
As a result of lipolysis’ fat dissolving process, it is used in controversial cosmetic applications. In the cosmetic setting, the fat dissolving procedure is used to break down diet or exercise resistant fat in the body. Generally, only localized small to medium sized areas of fat are dissolved due to the risk of developing ketosis — an elevated level of ketones in the blood associated with abnormal fat metabolism. Since the fat dissolving process occurs chemically, the cosmetic procedure is non-surgical in nature.
A cosmetic professional will directly inject phosphatidylcholine (PPC), a type of phospholipid, subcutaneously into the fat tissue. Much like the hormones the body produces, PPC will help to induce lipolysis in order to dissolve unwanted fat. To avoid ketosis, PPC injections are administered over the span of a few months. Treatment length will largely depend on the amount of fat that needs to be removed.
Minor to moderate side effects have been known to occur with the lipolysis cosmetic procedure. Common minor side effects include soreness, bruising and mild swelling. Some patients have experienced nausea, gastrointestinal distributions and infection after treatment. The US Food and Drug Administration (FDA) has reported that permanent scarring, skin deformation and painful subcutaneous knots were experienced by some people after undergoing the fat dissolving procedure. To avoid serious side effects, people who have allergies, blood disorders or kidney diseases should not undergo the procedure.