The staff at Parkcrest recommended a treatment called Lipodissolve. It involves injecting a substance beneath the skin to get rid of small pockets of fat.

Lipodissolve is the trade name given to a process called injection lipolysis -- doctor-speak for getting rid of body fat by injecting a chemical under the skin and over fat cells. Six to 12 weeks after the doctor injects the drug the fat dissolves, and the trouble spot is gone.

Lipodissolve is designed to remove small, stubborn pockets of fat that refuse to disappear with exercise and diet. It's not a cure for obesity. People with a high body mass index are not candidates for the procedure.

The compounds used for Lipodissolve have not been approved or intensely tested by the U.S. Food and Drug Administration for any sort of fat reduction. That means it's off-label use. Off-label means that it has been approved by the FDA for one purpose, but doctors are using it for a different purpose.

Off-label use of drugs is common, however. The medical community has a history of such medication use if the off-label treatment is similar to the approved treatment. Using Botox to remove facial wrinkles, for example, is an off-label treatment. Botox is approved to relieve muscle spasms due to neurological problems.

While off-label use of a drug is legal unless specifically banned by the FDA, it accounts for the reluctance by many cosmetic practitioners to use Lipodissolve.

Doctors agree that no American studies based on American standards exist. The only validation for Lipodissolve's use comes from Europe, where it has been used for years, and from the experience of doctors who have used it in the United States for the past several years.

"We just don't know," said Dr. Thomas Francel, chief of plastic surgery at St. John's Mercy Medical Center. Francel is considering offering the process in his practice and plans to take training. But he says he is hesitant. "I just haven't seen any science behind it."

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