Guide · Fat dissolving injections
Fat dissolving injections what they are, what is approved, and the risks
Fat dissolving injections are sold as a quick fix for a double chin or a tummy pouch. Here is what is actually in them, what the trials show, what is approved in Singapore and elsewhere, the side effects, and the needle-free alternatives.
Quick answer
- A fat dissolving injection is a drug injected into a small pocket of fat to destroy fat cells, which the body then clears over the following weeks. The type with large trials behind it is deoxycholic acid, a synthetic version of a bile acid; the other common type is a 'lipolysis' cocktail of phosphatidylcholine with deoxycholate.
- In two large placebo-controlled trials, deoxycholic acid reduced fat under the chin in about two in three people over up to six sessions. Swelling, pain, numbness and bruising at the injection site are expected, and about 4% had temporary weakness of the nerve that moves the lower lip.
- Approval is narrow. The US FDA has approved deoxycholic acid only for fat under the chin and warns that unapproved fat-dissolving injections have caused scarring, serious infections and painful lumps. We found no deoxycholic acid injection on HSA's published list of registered medicines, and Singapore's guidelines for doctors no longer allow mesotherapy outside approved trials.
- SkinRev Lab does not inject, and fat-dissolving injections are not among the treatments listed for IN Eternity Clinic. Needle-free options at SkinRev Lab include a SKINSHAPE zone at S$288 (first zone S$88) and SKINLIFT Double Chin at S$488 per session, before GST; fat freezing at IN Eternity Clinic is priced at consultation.
What they are
What a fat dissolving injection actually is
Two quite different products are sold under the same name. Deoxycholic acid injection is a single, purified drug: a synthetic copy of a bile acid that the gut uses to break down dietary fat. Injected into fat, it breaks down fat-cell membranes, and the body's clean-up cells remove the debris over the following weeks, which is why the change is gradual.
The other type is a 'lipolysis', 'lipodissolve' or 'mesolipo' cocktail, usually phosphatidylcholine mixed with sodium deoxycholate, sometimes with other ingredients. Laboratory work found that the deoxycholate does most of the work, acting as a detergent that breaks open cell membranes non-specifically, in fat and in nearby tissue such as muscle. Precise placement in the fat layer is therefore what keeps the effect where it is wanted.
Neither type is a weight-loss treatment. Each session treats a small, defined area, and the amount of fat removed is small compared with liposuction.
Evidence
What the trials show for a double chin
The evidence comes mainly from two large US and Canadian trials of deoxycholic acid for moderate or severe fat under the chin. In REFINE-1, 70.0% of 256 treated people improved by at least one grade on both the doctor's and their own rating, against 18.6% of 250 on placebo, and MRI confirmed volume reduction in 46.3% against 5.3%. In REFINE-2, the figures were 66.5% against 22.2% among 516 people.
People could have up to six sessions, and most who improved did so within two to four. In REFINE-1, 55% had improved by one grade after two treatments and 75% after four. Follow-up in REFINE-2 lasted 44 weeks.
For the tummy, arms, back or bra line there are no comparable large trials, and the US approval does not cover those areas. Treating a large body area would also mean many injections and much more drug.
Approval
What is approved, in Singapore and elsewhere
In the United States, the FDA states that deoxycholic acid is the only FDA-approved fat-dissolving injection, approved only to reduce fat under the chin in adults, and that it has not been evaluated or approved for any other area of the body. It is a prescription drug to be given by a healthcare professional.
In Singapore, medicines must be registered with the Health Sciences Authority (HSA). When we checked HSA's published Listing of Registered Therapeutic Products in October 2026, it did not include a deoxycholic acid injection or a phosphatidylcholine injection. Registrations change, so ask any clinic for the product's Singapore registration number and what it is registered for.
Separately, Singapore's Guidelines on Aesthetic Practices for Doctors state that, after a review of their scientific merit, mesotherapy and similar procedures are no longer allowed except within a formal, approved clinical trial. Fat-melting cocktails are often marketed under the mesotherapy or 'mesolipo' label.
Side effects
Swelling, nerve injury and other risks
Deoxycholic acid causes a deliberate inflammatory reaction, so the treated area usually swells, sometimes markedly, for several days, and may feel sore, numb, bruised or firm for days to weeks. In the trials, most side effects were at the injection site and were mild to moderate and temporary.
The most important specific risk under the chin involves the marginal mandibular nerve, which runs along the jaw and moves the lower lip. In REFINE-1, temporary weakness of this nerve, giving an uneven smile, occurred in 4.3% of treated people (1.0% of sessions) and resolved without lasting effects. Difficulty swallowing has also been reported, and injecting too shallowly or into a blood vessel can damage the skin. A doctor should check whether any of the following apply first.
- An infection, open wound or active skin condition in the area.
- Pregnancy or breastfeeding.
- A bleeding disorder or blood-thinning medicines.
- Previous surgery, threads or filler in the neck, or difficulty swallowing.
- Fullness that is mainly loose skin, fat beneath the neck muscle, glands or a set-back chin, which injections do not change.
Unregistered products
Unregistered 'lipolysis' cocktails and online kits
Phosphatidylcholine and deoxycholate injections are sold through some clinics, beauty salons and websites, sometimes as kits for self-injection. The FDA, which has not approved them, has warned that people using unapproved fat-dissolving injections reported lasting scars, serious infections, changes in skin shape, cysts and deep, painful lumps.
Infection is a real concern with repeated injections outside proper medical settings. In one published outbreak of severe skin infections with slow-growing mycobacteria after mesotherapy, the source was traced to a multi-injection device that had been cleaned with tap water. These infections are slow to heal and can need long courses of antibiotics.
- Sold online or through social media for injecting yourself or a friend.
- Offered at a beauty salon or spa rather than by a doctor.
- No Singapore registration number, or labels only in another language.
- Promises to 'melt' large areas such as the whole tummy or thighs.
- No examination of the area or discussion of risks before injection.
Where it fits
Where injections fit, and where they do not
Whatever the route, an examination of the area comes first, because the cause of the fullness decides what can help.
If a doctor does suggest an injection, ask which product it is, how it is registered, how many sessions are planned and how side effects would be handled.
| Situation | Fat dissolving injection? | Usually a better first step |
|---|---|---|
| A small, soft pocket of fat under the chin, with good skin | The area the drug is approved for in the US; a doctor can advise whether it suits you | Fat freezing or SKINSHAPE as needle-free alternatives |
| Fullness mainly from loose skin | Unlikely to help; skin may look looser | Skin tightening such as SKINLIFT, HIFU or VF Lift |
| Fat beneath the neck muscle, glands or a set-back chin | Does not reach or change these | A doctor's assessment; a surgical or chin-projection opinion |
| Tummy, flanks, back or arms | Not approved for these areas; little trial evidence | Body contouring devices, or liposuction for larger amounts |
| General weight gain | Not a weight-loss treatment | Medical weight management |
Needle-free
Needle-free alternatives and prices
At SkinRev Lab, #B1-28 CityLink Mall by City Hall MRT, SKINSHAPE uses Miglou microwave energy to warm the fat layer and the skin above it. The double chin and lower face count as face zones, and body zones include the abdomen, flanks, thighs, arms, back and bra line and buttocks. Each 15 × 15 cm zone is S$288 per session before GST, with S$88 for a first zone, and takes about 30 minutes.
For an under-chin area with some loose skin, SKINLIFT Double Chin is a 30-minute N-pulse focused ultrasound session at S$488, and SKINTIGHT's neck and double chin zone, for crepey surface skin, is S$588, both before GST. VF Lift, Dr Sin Yong's Volnewmer radiofrequency protocol along the jaw and neck, is performed by him at SkinRev Lab and priced at consultation.
At IN Eternity Clinic, Pacific Plaza, Dr Sin Yong performs fat freezing for under-chin and body fat, Time Freeze Laser LCLR and HIFU, all priced at consultation by the clinic; WhatsApp +65 8815 3008. Each starts with an examination of whether the fullness is fat you can pinch.
Compared
Fat dissolving injection vs other double chin options
Fat cells destroyed by any of these methods do not grow back, but the remaining cells can enlarge with weight gain.
Results vary between people, and the right choice depends on what the fullness is made of.
| Deoxycholic acid injection | Fat freezing | SKINSHAPE (microwave) | Chin liposuction | |
|---|---|---|---|---|
| Who performs it | A doctor | A doctor (IN Eternity Clinic) | Aesthetic Specialist (SkinRev Lab) | A surgeon |
| Sessions | Up to six in trials; most improved within two to four | Usually a short course | A course, a few weeks apart | One operation |
| Downtime | Swelling for days; numbness or firmness for weeks | Redness, numbness, tenderness for days to weeks | Usually little | Swelling, bruising; chin strap for weeks |
| Key specific risk | Temporary lower-lip nerve weakness (4.3% in REFINE-1) | Rare paradoxical fat growth | Temporary warmth or redness | Uneven contour; surgical risks |
| In our network | Not offered | IN Eternity Clinic, priced at consultation | SkinRev Lab, S$288 per zone before GST; first zone S$88 | Not offered; see a plastic surgeon |
Before you book
Questions to ask before any fat dissolving injection
If the answers are vague, or the product cannot be identified, it is reasonable to walk away.
Needle-free and doctor-led alternatives exist for most under-chin and body concerns, and an honest provider will tell you when an injection is not the right tool.
- Which product is it, is it registered with HSA, and for which area?
- Is a doctor injecting, and has the area been examined first?
- Is the fullness fat above the neck muscle, or loose skin, deeper fat or glands?
- How many sessions are expected, how far apart, and what is the total cost?
- How much swelling should I expect, and when can I go back to work?
- What happens if I get nerve weakness, a lump or a wound?
Sources
References & sources
- U.S. Food and Drug Administration. Using fat-dissolving injections that are not FDA approved can be harmful. Content current as of 20 December 2023.
- Jones DH, Carruthers J, Joseph JH, et al. REFINE-1, a multicenter, randomized, double-blind, placebo-controlled, phase 3 trial with ATX-101, an injectable drug for submental fat reduction. Dermatol Surg. 2016;42(1):38-49.
- Humphrey S, Sykes J, Kantor J, et al. ATX-101 for reduction of submental fat: a phase III randomized controlled trial. J Am Acad Dermatol. 2016;75(4):788-797.e7.
- Rotunda AM, Suzuki H, Moy RL, Kolodney MS. Detergent effects of sodium deoxycholate are a major feature of an injectable phosphatidylcholine formulation used for localized fat dissolution. Dermatol Surg. 2004;30(7):1001-1008.
- Carbonne A, Brossier F, Arnaud I, et al. Outbreak of nontuberculous mycobacterial subcutaneous infections related to multiple mesotherapy injections. J Clin Microbiol. 2009;47(6):1961-1964.
- Singapore Medical Council. Guidelines on Aesthetic Practices for Doctors (2016 Edition), paragraphs 23-24. Effective 1 August 2016.
- Health Sciences Authority. Listing of Registered Therapeutic Products. Data.gov.sg dataset, last updated 7 August 2026.
Common questions
Your questions,
answered
Do fat dissolving injections work?
For fat under the chin, deoxycholic acid has good trial evidence: about two in three treated people improved by at least one grade in two large placebo-controlled trials, usually over two to four sessions. For other body areas, and for phosphatidylcholine cocktails, the evidence is much weaker.
Are fat dissolving injections legal in Singapore?
Medicines in Singapore must be registered with HSA. In October 2026 we found no deoxycholic acid or phosphatidylcholine injection on HSA's published list of registered therapeutic products, and Singapore's aesthetic practice guidelines no longer allow mesotherapy outside approved trials. Ask any provider for the product's registration before treatment.
What are the side effects of fat dissolving injections?
Swelling, pain, numbness, bruising and firmness at the injection site are common and usually settle over days to weeks. Temporary weakness of the nerve that moves the lower lip occurred in 4.3% of treated people in one large trial. Unapproved cocktails have been linked to scarring, infections and painful lumps.
How many fat dissolving injection sessions do I need?
In the trials, people could have up to six sessions under the chin, and most who improved did so within two to four. The number depends on how much fat there is and how you respond.
Can fat dissolving injections be used on the tummy or arms?
The US approval covers only fat under the chin, and there are no large trials for the tummy, arms, back or thighs. Larger areas would also need many injections. Body contouring devices and liposuction are better studied for these areas.
Is a fat dissolving injection permanent?
Fat cells that are destroyed do not grow back, so the change is expected to last if your weight stays stable. The remaining fat cells can still enlarge with weight gain.
How much does a fat dissolving injection cost in Singapore?
Doctors who offer injections usually price them by the amount of product and the number of sessions, so ask for the whole-course total. SkinRev Lab and IN Eternity Clinic do not offer them. For comparison, a SKINSHAPE zone at SkinRev Lab is S$288 per session before GST, with S$88 for a first zone.
Fat dissolving injection or fat freezing: which suits a double chin?
Both reduce soft, pinchable fat under the chin gradually. Injections involve needles, marked swelling and a small risk of temporary lip-nerve weakness; fat freezing uses a cooled applicator, with numbness for days to weeks and a rare risk of paradoxical fat growth. A doctor can advise which suits your anatomy.
Does Dr Sin Yong offer fat dissolving injections?
Fat-dissolving injections are not among the treatments listed for IN Eternity Clinic, and SkinRev Lab does not inject. Dr Sin Yong performs fat freezing, Time Freeze Laser LCLR and HIFU at IN Eternity Clinic, and VF Lift at SkinRev Lab, all priced at consultation.