Non-Surgical Fat Reduction and Topical Modulation of Adipose Tissue Physiology

April 2019 | Volume 18 | Issue 4 | Original Article | 375 | Copyright © April 2019

Alan D. Widgerow MBBCh MMed FCS(Plast) FACS,a Suzanne L. Kilmer MD,b John A. Garruto BS,c W. Grant Stevens MD FACSd

aUniversity of California, Irvine; Alastin Skincare, Inc., Carlsbad, CA bLaser and Skin Surgery of Northern California; University of California Davis Medical Center, Dept of Dermatology, Davis, CA cFree Radical Technology, Inc, Oceanside, CA dUSC Keck School of Medicine, Division of Plastic Surgery, Los Angeles, CA; Marina Plastic Surgery and MedSPA, Marina Del Rey, CA

In summary, a final formulation has been designed including an active peptide targeting lipid droplet breakdown and macrophageclustering, encased in a liposome delivery system ensuring absorption through the hair follicle route, delivery to dWAT and ensuing signaling to sWAT compartments. Clinical tests comparing the formulation with a sham product following hot and cold non-invasive fat reduction procedures have been completed (in submission) and others are underway. Results thus far are extremely exciting and publications will follow.Unresolved issues particularly with cryolipolysis, include ‘Paradoxical adipose hyperplasia’ where unexpected overgrowth ofadipose tissue occurs in the area of treatment in a small number of patients.26,27 Pathogenesis is unknown and may well be related to droplet persistence or exosome stimulation of adipogenesis in these patients although no direct evidence exists for this at this time.


Non-surgical fat reduction remains an extremely popular procedure with varied technologies being used for this indication. When utilizing a technology that accesses a non-invasive closed route to the target tissue, it presents a challenge for removal of waste products created by the process. This paper presents some novel approaches for entry to the target region via topical applications and for subsequent breakdown and repackaging of lipid droplets through the autophagic/lipophagic mechanism. Thus, by designing liposome encased peptides, these may be preferentially delivered via hair follicles to dWAT, a newly recognized fat compartment that communicates directly with sWAT in humans. The peptides, primed to stimulate autophagic processes, result in further lipid droplet breakdown and macrophage clustering. This combination shows promise for facilitating and hastening recovery following non-surgical fat reduction procedures.


Alan D. Widgerow is Chief Medical Officer of Alastin Skincare Inc (Carlsbad CA). Products and funding for trials provided by company. Dr. Suzanne Kilmer is a consultant for Alastin Skincare, Inc. Dr. W. Grant Stevens is a consultant for Alastin Skincare, Inc.


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Alan D. Widgerow