Trying to Lose Fat but Developed Cushing’s Syndrome? Check for This Ingredient Before Getting Fat-Dissolving Injections

Fat-dissolving injections have become a popular cosmetic treatment for people seeking body contouring or rapid weight loss because they are relatively accessible and minimally invasive.

However, the situation changes dramatically if the injection contains a high-potency corticosteroid. Repeated administration of excessive doses of steroids can lead to serious side effects—including facial swelling, suppression of the body's hormone system, and drug-induced Cushing's syndrome—instead of the desired weight-loss effect.

Based on a mediation case reviewed by the Korea Medical Dispute Mediation and Arbitration Agency, the following case illustrates the potential risks.

Case Summary

A woman in her 40s visited a clinic for fat-dissolving injections to improve obesity-related body contours.

During her first visit, the physician injected a solution containing triamcinolone, a corticosteroid, into the subcutaneous tissue of her arms, thighs, and abdomen.

The injections continued approximately every two weeks, rotating treatment areas. Over the course of four treatment sessions spanning about six weeks, the patient received a total of 196 mg of triamcinolone.

Problems began after the third treatment.

Instead of losing weight, the patient developed noticeable facial swelling and experienced rapid weight gain. Despite her concerns that the treatment appeared ineffective, the clinic recommended another session.

After the fourth injection, her symptoms reportedly worsened.

She later sought evaluation at both a family medicine clinic and an endocrinology department.

Blood tests revealed significantly suppressed ACTH (adrenocorticotropic hormone) and cortisol levels, suggesting that excessive external steroid exposure had suppressed her body's normal hormone production.

She was diagnosed with suspected drug-induced Cushing's syndrome and secondary adrenal insufficiency, requiring ongoing laboratory monitoring and endocrine follow-up.

Patient vs. Clinic

The patient argued that:

• The steroid-containing fat-dissolving injections caused drug-induced Cushing's syndrome.
• The physician continued treatment despite obvious symptoms after the third session.
• She had never been informed that the injections contained steroids or that serious complications such as Cushing's syndrome could occur.

The clinic acknowledged that drug-induced Cushing's syndrome was a possibility but argued that:

• The diagnosis had not been definitively confirmed at that time.
• Drug-induced Cushing's syndrome generally improves after discontinuing steroids.
• The patient's compensation request was therefore excessive.

Medical Arbitration Agency: Excessive Steroid Dosage Exceeded Reasonable Medical Judgment

The arbitration panel ultimately found the clinic to be at fault.

According to the approved prescribing information, triamcinolone injections are intended primarily for localized treatment of conditions such as skin diseases or keloids.

Typical approved doses are 0.2–1 mg per injection, with a maximum weekly dose of approximately 10 mg.

Although physicians may legally use medications "off-label" for aesthetic procedures, the panel concluded that administering nearly 200 mg within a short period greatly exceeded reasonable medical discretion.

Such doses carry a significant risk of suppressing the hypothalamic-pituitary-adrenal (HPA) axis, the body's central hormone regulation system.

The agency also criticized the clinic's medical documentation.

Medical records included only treatment sites and fees, with no documentation of the patient's reported side effects or clinical progress.

The panel determined that the physician should have discontinued steroid treatment after facial swelling developed following the third session instead of proceeding with a fourth injection.

In addition, the consent form mentioned only common side effects such as swelling and bruising, without disclosing:

• that the injections contained corticosteroids,
• the specific steroid used,
• or the potential risk of serious complications such as Cushing's syndrome.

This was considered a violation of the physician's duty to obtain informed consent.

Because drug-induced Cushing's syndrome often improves after steroids are discontinued, the arbitration panel limited the clinic's liability and ultimately approved a settlement requiring the clinic to pay the patient 5 million KRW (approximately USD $3,600).

What Patients Should Know Before Receiving Fat-Dissolving Injections

The ingredients used in fat-dissolving injections vary widely between clinics, making it difficult for patients to know exactly what is being injected.

When steroids are included, excessive dosing may suppress the body's hormonal system and lead to unexpected complications.

According to Dr. Kirk of Onul Plastic Surgery,

"Before receiving fat-dissolving injections, patients should ask whether the formulation contains any corticosteroids. If it does, they should also ask exactly how much steroid is being administered."

Symptoms May Develop Gradually

Hormonal complications from steroid injections are relatively uncommon and usually do not appear immediately.

Instead, symptoms typically develop after repeated or prolonged exposure to high steroid doses.

Dr. Kirk explained,

"Long-term steroid exposure may produce a characteristic 'moon face,' in which the face becomes round and swollen. Patients may also notice rapid weight gain around the neck and trunk."

He added that for patients with diabetes,

"Difficulty controlling blood sugar compared with usual levels may actually be one of the earliest warning signs of steroid-induced hormonal imbalance."

Other warning signs may include:

• Localized skin depression at the injection site
• Gastrointestinal symptoms
• Persistent swelling or unusual physical changes

Patients experiencing these symptoms should seek medical evaluation promptly.

Do Not Stop High-Dose Steroids Abruptly

Patients who have received long-term or high-dose steroid injections should consult an endocrinologist before discontinuing treatment.

Stopping steroids suddenly when adrenal function has already been suppressed may lead to dangerously low blood pressure or even adrenal crisis (shock).

If you have undergone a cosmetic procedure involving steroids, it is advisable to request information about the medication used and consult an endocrinologist to determine whether additional testing or treatment is necessary.

Source: Chosun Health (June 22, 2026)