Hailed as a miracle cure for flabby stomachs and double chins, the "flab jab" is the latest cosmetic procedure for removing unsightly fat. It has even been demonstrated on Richard and Judy. But the clinics that use it do so by exploiting a loophole in the law.
The cosmetic surgery industry is divided over the safety of the drug, Lipostabil. There are fears that it can cause nerve damage or skin complaints, and it has undergone no long-term tests. Even the company that makes it says the drug is being misused.
Earlier this year the Medicines and Healthcare products Regulatory Authority (MHRA) wrote to at least 50 clinics ordering them to stop advertising the treatment. Many, however, are defying the ban, and the MHRA is considering further action that could result in unlimited fines or two years in jail.
Mel Braham, chairman of the Harley Medical Group of cosmetic surgeons, denounced those who continue to offer the treatment as "rogues".
"I think it's absolutely horrific that people are giving the injections when there has been no clinical research done to observe the long-term effect," he said. "They're rogues, cowboy-type people and very unprofessional."
But Duncan Williams, managing director of Lipomed Ltd, whose 12 clinics offer the treatment at £500 a time, argued it is "safer than Botox".
"We've treated 800 to 1,000 patients in two years. About 90 per cent of those are happy with the results," he said.
The drug is injected into deposits under the chin, on the hips or below the eyes. An enzyme breaks down the outer walls of the fat cells, which then melt away.
Lipostabil was developed to remove fatty blockages in arteries to treat heart problems. It is licensed only for this use, and then by prescription only. Doctors who order it must give the name of the patient and details of their condition. It cannot be advertised, but there is no law against administering the drug and it can be ordered over the internet by anybody.
The drug is widely used in Germany, but is banned in Brazil, where it has been linked to serious skin infections. Canadian health officials have also banned it amid fears it could cause nerve damage.
The Brazilian dermatologist Patricia Rittes, who pioneered the treatment, claims to have treated 25,000 patients without problems, however.
A spokesman for the MHRA admitted that it was aware of only three adverse reactions, all mild allergic reactions to soya. He also said that they were aware of no adverse reactions abroad.
He added: "Lack of licence is the bottom line. If the drug is suitable and being used effectively and safely for cosmetic purposes, then why have the manufacturers not tried to add it to the licence? If something goes wrong we will be the first to be blamed. That's why we have to take precautionary measures. A handful of clinics are not complying. Details have been passed to an enforcement team."
But Mr Williams argued that advertising on the internet is not the same as conventional advertising as "people still have to find you".
He added: "Twenty per cent of our customers are men, and a lot of gay men have had the treatment. We know of no adverse effects caused by the drug, although there have been some problems due to infections or allergies.
"I believe that the MHRA want bad press about the product so that people won't self-inject it, like people in Brazil and the US have done, which causes the problems. I'm confident that Lipostabil won't cause any adverse reactions so long as it is administered in the right way by trained doctors."
Other cosmetic surgeons are sceptical. Marion Shapiro, a leading US practitioner of a similar treatment, Mesotherapy, said: "I don't use Lipostabil. It's not pH stable, and it's been banned in Brazil. That should tell you something."
Helen Roberts, senior administrator at the British Association of Plastic Surgeons, said their 300 members "don't use Lipostabil". But she added: "There are lots of cowboy clinics out there that do."
Problems that have come up on internet discussion boards due to the treatment include the growth of facial hair, lingering sensitivity and lumpy deposits.
A spokesman for Sanofi-Aventis, the French company that makes the drug, said it "does not condone cosmetic use". She said the company recommended the drug only for unblocking arteries.
THE REAPPEARING JAW LINE
'I had 16 flabjabs to remove my extra chin'
Debbie Oliver, 41, was so self-conscious about her flabby chin that she refused to be pictured in family photographs. Dieting and exercise did little to improve her appearance so she paid £500 for 16 "flab jabs".
Ms Oliver, who works for a food company and lives in Cardiff, said the treatment on her chin and her midriff was painless and has dramatically improved her appearance.
"Before, my double chin really depressed and upset me, now [the injections] have changed my life," she said.
The day after the procedure, there was some swelling and tightness, but she was able to go straight back to work and even attended an interview.
Ms Oliver said: "The jab was quite painless although it caused a little bit of swelling, like with any injection. I kept checking every day after the treatment to see the effect, and then one day I woke up and I felt a tightness in the skin, and the fat had gone, just like that."
Ms Oliver has booked further treatment on her thighs and stomach. "There have been no adverse consequences," she said.
THE DISAPPEARING MIDRIFF
'The doctor pinches an inch of fat, and then he injects the drug directly into it'
Justine Tassey, 38, started "flab jab" treatment 18 months ago. Her job as a company director entailed driving for four or five hours a day and the weight of her 34F breasts was becoming uncomfortable on her stomach.
"I wanted to get rid of a layer of fat at the top of my stomach," she said.
A friend recommended a clinic and she underwent three sessions - a month apart - which cost £700 and consisted of five injections beneath each breast during each session.
"By the time I went back for the second session I could already notice the difference," Ms Tassey said. "The fat had totally dissolved.
"The doctor pinches an inch of fat and then injects directly into it. I am absolutely 100 per cent happy with the treatment and have been recommending it to loads of people.
"I've had no adverse consequences whatsoever, apart from the swelling that you would expect. I certainly think the drug should be more widely available and properly licensed and 100 per cent legal."