Lower Abdominal Fat Reduction After a Diluted Deoxycholic Acid-Based Injection Protocol: Preliminary Findings from a Five-Patient Case Series

Background: Deoxycholic acid (DCA) causes adipocytolysis after subcutaneous injection and is approved for reducing submental fat. Use in the abdomen is off-label, and evidence for low-concentration, cannula-delivered protocols remains limited. Objective: Our objective is to describe clinical and ultrasound outcomes after a diluted DCA-based injection protocol for localized lower abdominal adiposity. Methods: Five healthy adult women aged 31–43 years underwent two lower-abdominal treatments 4 weeks apart. For each treatment, two 2 mL vials of DCA 10 mg/mL were diluted to a final concentration of 2 mg/mL using L-carnitine and a clinic-prepared tumescent solution, yielding 20 mL of total injectate. The formulation was delivered into the subcutaneous layer using a 23-gauge, 50 mm cannula. Body weight, abdominal circumference, caliper thickness, clinical photographs, and ultrasound-measured local tissue depth were reviewed at baseline and final follow-up; caliper thickness and circumference were also recorded at interim visits. Results: All five cases showed reductions in both caliper thickness and ultrasound-measured local tissue depth. Mean caliper thickness decreased from 41.14 ± 4.76 mm to 35.94 ± 5.15 mm, a mean reduction of 5.20 ± 1.20 mm. Mean ultrasound depth decreased from 3.22 ± 0.80 cm to 2.39 ± 0.81 cm, a mean reduction of 0.83 ± 0.15 cm; the mean individual relative reduction was 27.5%. Mean body weight changed by −0.08 kg and mean abdominal circumference by −0.64 cm, with substantial case-to-case variability. The available summary reported procedural pain scores of 0–1 on a 10-point visual analog scale; complete patient-level adverse-event records were unavailable, precluding systematic safety assessment. Conclusion: In this exploratory five-patient series, localized caliper and ultrasound tissue-depth measures decreased after two sessions of a 2 mg/mL diluted DCA-based protocol despite variable changes in body weight and circumference. The uncontrolled design, combined formulation, small sample, and incomplete safety documentation preclude attribution of effect to DCA alone. Controlled studies with standardized imaging and complete adverse-event capture are required.