Professor Pasquale Motoles

WHAT IS AQUALYX:_:

AQUALYX^TM is the result of an intense research performed by Prof. Pasquale Motolese that led to the development of this unique formulation and a special technique called “Intralipotherapy”

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The active substance is a sodium salt of deoxycholic acid embedded in agarose gel, which makes it very safe and effective, compared to other fat dissolving agents.

WHAT IS AQUALYX:

Deoxycholic acid (DCA) is a naturally occurring bile acid, and as such, has an essential function concerning the digestion of fat. When DCA is used within a formulation, it possesses an adipocytolytic action.

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AQUALYX^TM is presented as a hydrous, micro-gelatinous solution sterilized with Gamma rays, with a total concentration of 0.75% of active DCA.

WORLDWIDE PRESENCE

65 countries

3+ million vials sold

6000+ trained practitioners worldwide

Why AQUALYX?

• Effective treatment, with visible results after the first session
• More than 15 years of experience, with many scientific data published, including a multicentre European study
• A painless procedure, which provides a great patient experience
• Minimal injection sites and more efficient when treating body parts thanks to the intralipotherapy technique
• A unique, online and CPD accredited training program, that allows easy access to practitioners from all over the world

What_t can be treated by AQUALYX?

Almost any stubborn fat depot

Some exceptions

Eye bags, Malar fat, Ankles

It is NOT a weight-loss treatment

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HOW DOES AQUALYX WORK?

Adipocyte gets unstable

AQUALYX^TM docks at the adipocyte

Cellular swelling: Fluid enters the cell from the ECM

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AQUALYX^TM starts to dissolve the membrane of the adipocyte

Adipocyte breaks down and liberates tryglicerides & fatty acids

Fat released enters lymphatic system and it‘s eliminated via the kidneys and liver

Macrophages start to eliminate cytoplasma and membrane of the adipocyte= INFLAMMATORY RESPONSE

“It is an adi_ipocytol_lytic process,

Not a lipolysi_is”

LIPOLYSIS ADIPOCYTOLYSIS

PATIENT ASSESSMENT

Contraindications

• Absolute
• Pregnancy and lactation
• Patients with medical Hx of anaphylactic reaction and/or severe allergies
• Acute skin problems at the area to be treated
• Patients with severe organic diseases
• Body dysmorphic disorder (BDD)

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• Relative
• Patients on blood thinners
• Autoimmune diseases

Who is the best candidate _for

Aqualyx?

Aqualyx is a treatment designed to treat pockets of localised fat. Prof. Pasquale Motolese developed a Classification for these fat depots to help with the assessment, as they could be related to diet, genetics or iatrogenic causes.

Motolese’_’s Classification of adiposities

• CLASS 1
• Alteration of silhouette in the middle-lower body area
• Related to hormonal or genetic factors
• Non-sensitive to caloric restriction
• CLASS 2
• Related with eating behavior
• Sensitive to caloric restriction
• Often related to overweight
• CLASS 3
• Iatrogenic conditions (i.e., post surgical liposuction)
• Related to pathologic conditions or intake of certain drugs

Who is the best cand_idate for Aqualyx?

The ideal candidate for this treatment is a healthy patient with normal BMI, who has a healthy lifestyle, but still struggles to get rid of those stubborn fat pockets, and who is fully aware about the need of several sessions to achieve the desired results.

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Aqualyx can also be used to treat other conditions such as lipomas, “Buffalo humps” and iatrogenic fat accumulations such as lumps after a surgical liposuction or long-term steroid treatments.

Who is NOT the best candidate for Aqualyx?

Patients suffering from systemic and acute comorbidities, history of anaphylactic reactions or have a BMI over 35 are not suitable for Aqualyx treatment

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Also, patients showing symptoms and behaviour suggesting of Body Dysmorphic Disorder (BDD) are not candidates for any aesthetic treatment and should be referred to the appropriate medical professional.

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Patients that are clearly overweight and who do not follow a healthy lifestyle must commit to a weight loss treatment before considering any Aqualyx

The _importance of assessing the fat pocket

It is key to make sure that your patient will have enough fat to be treated. For this, the “pinch manoeuvre” is an excellent tool to assess the fat pocket to be treated. A minimum of 2 to 3 cm need to be pinched to go ahead with AQUALYX treatment

The importance of assessing the fat

For the submental area, also known as

double chin, a pinch of fat tissue – not skin – between of 1.5 to 2 cm is needed. Also, bear in mind that other structures may contribute to a visible fat pocket, such as skin sagging or the laxity of other anatomical structure. This is particularly true for submental fullness (i.e., platysma muscle laxity, or ptosis of the submandibular glands), and has to be always considered

pocket

TREATMENT PLAN

How many vials per session?

The standard number of vials to be used per Aqualyx session is 2 vials (16ml), which means 1 vial (8ml) per side (right and left) of the body.

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Some of the exceptions to this rule are the submental area, (double chin), where half a vial (4ml) will be used per session, which will be enough to achieve results and also, will prevent too much of swelling happening in the area.

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If needed, you can decide to use more vials per session and per area, but bearing in mind that the manufacturer recommends to use a maximum of 5 vials per session (40ml) and 4 vials (32ml) per treated area.

How many sessions and how often?

Although Aqualyx exerts its adipocytolytic action every time we use it, it is required a number of sessions to achieve the desired results. On average, 3 sessions using 2 vials each are required. The time between sessions is 4 weeks, which is the time the inflammatory response will settle

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For the submental area, (double chin), half a vial (4ml) will be used per session. Time between sessions will be between 4 to 6 weeks, as the inflammatory response may take a bit longer to settle.

Before the treatment

All patients should undergo a through medical consultation, where all their medical data will be evaluated, but also, we will get clear understanding of their expectations. That will be the time where we will explain them how this treatment works and also the need of a number of treatments to achieve the results

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One week prior to the procedure, patients should stop taking any NSAID (when possible) and vitamin supplements that may alter their coagulations status

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The day of the treatment patients can use arnica-based creams to minimize the swelling

AFTERCARE

AQUALYX Aftercare

After a successful treatment with Aqualyx, patients may expect some swelling and discomfort, which is easily relieve with standard compression garments (recommended, not compulsory)

To relieve the discomfort, patients

can take Paracetamol

(Acetaminophen), but NOT Ibuprofen nor NSAIDs (unless medically indicated), as we rely on the inflammatory process occurring after Aqualyx

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Although patients can resume their daily activities, exercise is not recommended for 3 to 4 days after the treatment. And similarly to most aesthetic procedures, the treated area should not be exposed to direct heat or severe cold.

AQUALYX Aftercare

For faster healing and an enhanced experience, we recommend using the advanced infratherapy machine, Vital Dome after 48 hours and continue for 4-6 weeks and 3 sessions a week. Vital Dome’s unique technology utilizes natural, internal heat generated by infrared therapy

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We don’t recommend using a sauna due to the direct heat. The external heat from a sauna may interfere with the treatment process and potentially compromise the desired results.

AQUALYX + VITAL DOME

By incorporating Vital Dome into your treatment plan, you can elevate your outcomes to a whole new level of effectiveness. Here’s how:

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1. Accelerated fat breakdown
2. Targeted Sculpting.

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• Enhanced Detoxification
• Holistic Wellness Boost

AQUALYX RESULTS

AQUALYX results

Although results may be seen after the first session (50% of patients), an average of 3 sessions every 4 to

6 weeks are recommended to achieve the desired results.

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Also it is important that patients understand that in order to achieve long term results, they should commit to a healthy lifestyle, with a balanced diet and exercise plan.

BEFORE

AQUALYX

results after 3 sessions

AFTER

BEFORE

AQUALYX

results after 5 sessions

AFTER

BEFORE

AQUALYX

results after 4 sessions

AFTER

References

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Amore R, Amuso D, Leonardi V, Leva F, Carnovale Sibaud A, Guida A, Costa E et al. Evaluation of safe and effectiveness of an injectable solution acid deoxycholic based for reduction of localized adiposities. Plast Reconstr Surg Glob Open 2018;6:e1794

Salti G, Motolese P. Cavitational adipocytolysis with a new micro- gelatinous injectable for subcutaneous tissue volume reduction: ex-vivo histological findings. Eur J Aesth Medicine and Dermatology 2012;2:94- 97

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Motolese P. Phospholipids do not have lipolytic activity. A critical review. J Cosmet Laser Ther 2008;10:114-118

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Amore R, Pinto H, Gritzalas K et al. Intralipotherapy, the State of the Art. Plast Reconstr Surg Glob Open 2016;4:e1085

FAQ about Aqualyx and its technique

How many treatments are needed until the desired results are achieved? Can AQUALYX^TM be administered during pregnancy & lactation?

Do dissolved fat cells return or redevelop?

Which measures can assist the success of a treatment with AQUALYX^TM ? In which cases is AQUALYX^TM contra-indicated?

Can other local anaesthetics be used in combination with AQUALYX^TM? What are the advantages of the Lipo Inject needles?

Which parameter influences the effectiveness of AQUALYX^TM?

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