With visions of slimmer waists and leaner thighs, dozens of people each day are scheduling brief, expensive appointments where a series of controversial injections are making them skinnier.

Lipodissolve, an ambiguously advertised cosmetic procedure, is gaining popularity. Television commercials promising trimmer midsections and tighter chins are catching the attention of those who are frustrated with dieting but don't want to go under the knife in the name of beauty.

Physicians from family practice to dermatology are getting certified to perform the procedure in their offices as patients continue to ask for it.

HOW IT WORKS

Developed to break apart dangerous fatty plaque that clogs arteries, the solution used in the Lipodissolve procedure essentially does the same thing for unwanted flab around the stomach, arms, thighs, chin and backside.

There's no anesthesia, no scalpels and essentially no downtime. In fact, one local provider of Lipodissolve advertises "Lunch Time Lipo."

A Google search on the procedure turns up more than 73,000 results. Britney Spears apparently can thank Lipodissolve for her trim physique after rehab, according to Us Weekly magazine.

Lipodissolve is officially mainstream, yet many people don't know what it really is. The Food and Drug Administration has not approved the procedure, a footnote that gives some physicians pause and detractors reason to criticize.

What is it?

Lipodissolve treatment consists of a series of injections of synthetically produced but biologically natural entities into areas of unwanted fat. The active ingredient is phosphatidylcholine deoxycholate, aka PCDC. The PCDC is absorbed into fat cells, which then become inflamed and break apart within a few weeks. The cells are metabolized and exit the body with normal waste.

"It shrinks fat," says Andrew Wolin, medical director at Fig in Scottsdale, Ariz., a Lipodissolve clinic that sees about 100 patients a day.

'REALLY WORTH IT'

Jodi Kusick, 62, didn't even wince when Wolin began the injections.

"I'm on a high right now," Kusick says as Wolin began sticking her abdomen several times with a needle, injecting small amounts of the solution.

Droplets of blood appeared, but Kusick didn't mind. It was over in a couple of minutes.

"This is really worth it because I feel so much better about myself," she says.

After six treatments, all a few weeks apart, Kusick has gone from a size 16-18 to a size 10. Her results are typical. She has had a little swelling and tenderness, but that's to be expected; side effects also include inflammation.

The fat won't come back. When fat cells in the human body are destroyed, Wolin says, they are gone for good. Of course, you can still gain fat in other areas to which you were genetically predisposed.

"It just doesn't come up in the area you treat," he says.

Other Fig patients, a majority of whom are women, are seeing more defined arms and slimmer thighs.

But there's a catch.

SKEPTICS ABOUND

The FDA has not approved the use of PCDC for cosmetic purposes but is aware of the practice and is investigating, according to FDA spokeswoman Karen Riley.

Critics say there is no history with Lipodissolve and no knowledge of long-term effects of its use.

"The gold standard is still liposuction," says Alan Matarasso, a New York plastic surgeon. "What people will tell you is the individual ingredients are approved. The individual ingredients for dynamite are approved, but put them together and you get dynamite."

Doctors in Brazil were the first to begin using PCDC for cosmetic purposes more than a decade ago.

However, reports have surfaced during the past couple of years that Brazil has banned the drug. Robert Pitera, president of the American Board of Mesotherapy and Cosmetic Medicine, says the ban in Brazil should not be misunderstood.

"The market in Brazil is loosely regulated. You have people in gyms injecting themselves," says Pitera, a New York cosmetic surgeon. "My understanding is the medication itself is still in use but only physicians can use it, but that's the way it's supposed to be."

NOT EASY TO MEASURE

Since it isn't approved in the U.S., it's hard to know how many physicians are offering Lipodissolve. Pitera estimates the number is close to 10,000 nationwide.

Doctors who offer Lipodissolve don't have to register with a board. And physicians can be trained on the procedure at seminars.

For about $2,500, physicians receive eight hours of hands-on training, a certificate of training and a starter kit of supplies.

Anyone can purchase a kit online for less than $400.

Marshall Block, a Scottsdale endocrinologist and medical director at Crescent Clinical Research, says he is leery of new procedures until they are approved by the FDA. Block says that without studies to back up the claims made by doctors and patients, it's hard to examine the big picture related to long-term success and side effects of Lipodissolve.

Matarasso feels the same way. He says too many questions remain.

"You don't see plastic surgeons dying to go out and do gynecology, but you will see emergency-room doctors dying to do this and the reason is it's financial," Matarasso says. "If all you own is a hammer, the whole world is going to be a nail."

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