In this episode of the Aesthetics Business Cast, hosts Vicky Eldridge and Eddie Hooker are joined by Dr Arturo Almeida, consultant surgeon, international trainer and one of the leading voices on injectable lipolysis.
Over the last two decades, Dr Arturo has worked across clinical practice, medical education and industry, training practitioners in more than 50 countries and helping shape the medical strategies behind some of the best-known injectable lipolysis products. He's internationally recognised for his work in the prevention and management of complications and has developed the first (and to his knowledge, only) structured training programme in the world dedicated to this area.
Eddie kicks off the discussion by describing fat-dissolving injections as one of the most misunderstood treatment categories in aesthetics, and Dr Arturo agrees, particularly when it comes to the UK. In his view, the confusion comes down to a fundamental misunderstanding of what these products actually do. They are not a substitute for liposuction, they are not weight loss injections, and they are not suitable for every patient or every area.
Dr Arturo introduces what he calls the "3R rule": the right patient, the right area, and the right technique. Miss any of those three, and the results won't just underperform, complications and dissatisfaction will follow.
Vicky raised a timely point about the blurring of lines between fat-dissolving injectables and GLP-1 medications like Ozempic. Both involve injections, both are often referred to loosely as "skinny jabs" in consumer conversation, but they do very different things.
Dr Arturo is clear: GLP-1s are weight loss medications, while injectable lipolysis is an aesthetic treatment for reducing localised pockets of fat in patients who are already at a healthy BMI. The two can complement each other (a patient who has lost significant weight on a GLP-1 may still have stubborn fat pockets that respond well to lipolysis), but confusing the two is where dissatisfaction takes root.
A recurring theme through the episode is the primacy of consultation over technique. As Eddie put it, most complaints Hamilton Fraser sees don't come from the treatment itself but from what happened before and after it.
Dr Arturo agrees emphatically. He tells his students that the actual injection can take five to ten minutes, but the consultation should take an hour. That hour is where expectations are managed, where the patient understands that results take months rather than days, where they learn why swelling is a sign the treatment is working, and where the practitioner learns what the patient actually wants versus what they're asking for.
He also raised a broader industry challenge: doctors are trained to prescribe, not always to listen. Too often, a diagnosis or treatment plan is formed in the practitioner's mind before the patient has finished speaking. In aesthetics, that pattern is particularly dangerous because the whole treatment is elective, expectation-driven and emotional.
Dr Arturo doesn't hold back on the state of training in the UK. In his view, the industry has a serious problem: anyone with a PowerPoint, a laptop and a room can call themselves a trainer, regardless of whether they have any real credentials in the product they're teaching. Combined with counterfeit products purchased online and the temptation to shortcut proper training with YouTube videos, the conditions for poor outcomes are baked in from the start.
The Lemon Bottle trend is Dr Arturo's case study in what happens when the industry stops asking questions. When the product went viral on TikTok, many practitioners adopted it because patients were asking for it, without checking the composition or the science. He argues this was a failure of the medical community. Being a good aesthetic practitioner, he says, doesn't mean abandoning science in favour of trends.
One of the most reassuring parts of the conversation is Dr Arturo's breakdown of complication data. Skin necrosis, the most feared outcome, is significantly rarer with fat-dissolving injectables than with strong chemical peels. The number one "complication" is actually swelling, followed by patients feeling the result didn't match their expectations. Around 85% of complications are mild and resolve spontaneously.
The lesson? Most complications are manageable if practitioners understand them, communicate about them properly and don't hide when they happen. As Dr Arturo puts it, patients rarely turn on a practitioner because a complication occurred, they turn on them because of how the practitioner responded to it.
For practitioners considering adding injectable lipolysis to their portfolio, Dr Arturo shared some critical safeguarding advice. On the face, the only appropriate indication is the submental area (double chin). Injecting around the eyes, the malar fat pad or near the facial nerve can result in devastating outcomes. On the body, areas like the ankles are a red flag: what looks like fat is usually bone, tendon and muscle, and injecting there has resulted in surgical reconstruction cases and even legal consequences for practitioners in the UK.
He also reminded listeners that most fat-dissolving products (with the exception of Allergan's Kybella/Belkyra) are regulated as cosmetics, not drugs, meaning they're used off-label. That needs to be clearly explained in the consent form and understood by the patient.
Dr Arturo's message throughout is that fat-dissolving injectables are safe and effective when used properly, but the industry, and its trainers in particular, carry a real responsibility to teach not just technique but consultation, patient psychology and complication management.
For any practitioner offering or considering offering injectable lipolysis, this is essential listening.
Listen to the full episode here: Fat-dissolving treatments: Understanding the risks and responsibilities with Dr Arturo Almeida
For more on managing complications, running safer consultations and protecting your practice, visit the Hamilton Fraser Content Hub.
You can book a free discovery call with Dr Arturo Almeida here: https://www.arturoalmeida.com or you can contact him via Instagram.
You can also get his course on Fat dissolving complications on a special offer for podcast listeners (RRP is $197, now only $97) here: https://www.arturoalmeida.com/fdi-complications-demystified
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