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Fat reduction: Carboxitherapy complements liposuction to get rid of fatty tissues


Carboxitherapy involves the administration of gaseous carbon dioxide to penetrate the skin and reach subcutaneous tissues, thereby, reducing localized deposits of fat. It can be used as an adjunct to proceduressuch as liposuction.

Key Points

Buenos Aires, Argentina - Carboxitherapy can be used as an adjunct treatment modality to liposuction to optimize results and to treat stubborn conditions such as cellulitis, according to the founder and former president of the Argentinean Aesthetic Medicine Society.

"The release of CO2 increases microcirculation," said Gustavo Leibaschoff, M.D., a cosmetic surgeon in Buenos Aires, Argentina, and director of the International School of Carboxitherapy.

Mechanism of action

The effect of wider vessels is stronger blood flow to the area, which means more oxygen. The increase in oxygen is key, because it eliminates the built up fluid from between the cells. The result is fewer fat cells and firmer subcutaneous tissue.

Carboxitherapy works by gaseous carbon dioxide being administered below the skin to penetrate subcutaneous tissues and reduce or eliminate localized postoperative accumulations of fat, says Dr. Leibaschoff, a member of the American Academy of Cosmetic Surgery. Typically, a 30-gauge needle measuring 0.3 mm in diameter is used in the procedure.

Indeed, the carbon dioxide injection improves oxygenation of skin layers with enhanced lipolysis capabilities, described as the Bohr Effect, the mechanism that allows tissular carbon dioxide transfer to lungs and lung oxygen transfer to tissues through the oxy-hemoglobin dissociation curve. The skin is also stimulated to produce more collagen.

Complementing liposuction

Carboxitherapy can be effective in treating areas of the body where there are fatty tissue irregularities that liposuction alone cannot address, Dr. Leibaschoff tells Dermatology Times.

"It can be a complement that can be used before and after liposuction," says Dr. Leibaschoff, who has used carboxitherapy for about 16 years in his practice in Argentina.

"What often happens with liposuction or other techniques that work over the fat, such as radiofrequency and external ultrasound, is that the fat is in the extracellular matrix remains there, so the results with liposuction may not be good. We need to help clean the extracellular matrix to allow the lymphatic system to work, and this helps with CO2," Dr. Leibaschoff says.


One of the appropriate uses of carboxitherapy is to treat cellulite, according to Dr. Leibaschoff, who estimates that 15 to 20 sessions are necessary to treat cellulite. Ideally, these sessions should take place every other day. Depending on the extent of the cellulite, sometimes two sessions or one session will suffice. Each session lasts 10 to 15 minutes.

The result of carboxitherapy is not permanent, but if patients comply with a healthful lifestyle through proper diet and exercise, unwanted fatty tissue such as cellulite will be slower to return, Dr. Leibaschoff says.

Other possible applications include reducing the appearance of stretch marks and skin tightening, added Dr. Leibaschoff.

Treating under-eye circles (often triggered by vascular pooling or poor circulation beneath the lower eyelids) is an application for carboxitherapy.

Localized adiposities

Italian researchers have investigated the impact of carbon dioxide therapy on the treatment of localized adiposities. Investigators performed biopsies of tissues before and after treatment to study changes brought on by the use of carbon dioxide on adipose and connective tissues.

Side effects

Side effects may include some degree of pain at the injection site, but the devices that are used today make the injection virtually painless, Dr. Leibaschoff says. There may be a crackling sensation of the skin and possible bruising of skin tissues. The site surrounding the injection may feel warmer temporarily because of increased circulation.

One of the advantages of the procedure is that it does not demand the use of anesthesia, Dr. Leibaschoff says.

Disclosure: Dr. Leibaschoff reports no relevant financial disclosures.

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