Dermal Necrosis and Chronic Abscess Formation Following Fat Dissolving Injections Administered by a Non-Medical Practitioner: A Case Report

Introduction:Injectable lipolysis agents marketed as “fat-dissolving” products are increasingly used in cosmetic practice despite limited clinical evidence and minimal regulatory oversight. In the UK many of these substances are classified as cosmetic products and are frequently administered by non-medical practitioners. Adverse events may therefore be under-recognised and under-reported. We present a case of dermal necrosis and chronic abscess formation following administration of an unlicensed fat-dissolving injectable.Case: Presentation:A 33-year-old woman developed painful subcutaneous nodules following the injection of ten vials of a lipolytic agent, purported to be “Lemon Bottle”, into the abdomen and thighs by a non-medical practitioner. Over several months she experienced progressive symptoms including persistent nodules, purulent discharge, and necrotic skin lesions. Multiple healthcare encounters initially excluded malignancy but did not identify the underlying chemical soft-tissue injury. The patient received several courses of antibiotics without improvement.Management and Outcome: Clinical assessment revealed chronic abdominal wall abscesses and necrotic lesions of the left thigh. Aspiration and microbiological investigation showed sterile purulent material. Definitive management involved incision and drainage of a persistent abdominal abscess and surgical excision of necrotic thigh lesions using an S-plasty technique. Histopathology demonstrated dermal necrosis, ulceration, chronic inflammation, and dense scar tissue consistent with chemical injury. Postoperative healing was uncomplicated with complete resolution of symptoms.Conclusion:Unregulated injectable lipolytic agents can cause severe complications including dermal necrosis and chronic abscess formation. Delayed recognition may prolong morbidity. Increased clinical awareness, improved reporting, and stronger regulation of cosmetic injectable procedures are needed as aesthetic complications increasingly present to healthcare services.