Non Invasive Fat Reduction


Losing inches without surgery and downtime has become incredibly popular in recent years, and why wouldn’t it? Today’s plastic surgery patients want legitimate methods for fat reduction that are quick, easy, and fit into their busy schedules.

The gold standard for total body contouring has been some type of liposuction. Numerous methods of liposuction are being used today including laser-assisted, ultrasound-assisted, power-assisted, and water pressure-assisted. Most of these require a general anesthetic or at least a local anesthetic with an oral or intravenous sedation. Non-invasive fat reduction usually does not require any type of anesthetic and very little– if any– downtime. Most patients can return to their normal activities the next day or even the same day.

Without liposuction, there are basically three different ways that one can reduce body fat: freezing, heating, or chemical dissolution. The freezing of fat is called CoolSculpting® and has been around for several years. During treatment, an applicator is placed over the area of undesired fat and, with suction, the fat and skin are drawn into a chamber that becomes cold very quickly. Each application takes one hour. Typically, more than one application in an overlapping type of fashion is used to obtain a smooth result. Up to 50% of the fat exposed to cold will undergo programmed cell death in a 2 to 3 month time period. The remnants of the fat cell, as well as their intracellular fat stores, are excreted by the normal metabolic pathways of the body. To fully benefit from the procedure, our spa incorporates acoustic sound wave therapy as an addition to fat freezing. The addition of sound waves from a machine called Z-wave breaks up more cells, causing their ultimate death than freezing would alone. We call this CoolSculpting® Plus.

Another method used to reduce fat non-invasively uses heat; most commonly using some type of a radiofrequency generator. Radiofrequency waves bombard the treatment area, causing small molecules to vibrate very quickly and create internal friction that generates heat. By heating the fat to around 46° for more than 10 to 20 minutes, it has been shown that up to 60% of the fat cells exposed to that degree of heat will undergo programmed cell death at 10 to 15 days after exposure. Again, the remnants of the fat are excreted by the body. Many machines on the market today utilize this heating concept; our spa includes Exilis and Vanquish. Exilis has the ability to not only heat the fat but also to heat the skin, causing it to contract and shrink. Vanquish uses an array of multiple radiofrequency antennae that apply the energy over the surface area of the entire abdomen. The fat is heated while the skin remains a tolerable temperature, usually no more than 43°C.

Heat can also be generated through focused ultrasound. The heat generated by focused ultrasound causes immediate fat destruction. However, the heat generated by these machines makes them more uncomfortable than other non-invasive modalities. Because of the pain associated with this treatment, we have chosen not to include them in our array of machines.

Chemicals such as deoxycholic acid and phosphatidylcholine have been used in the past in a mixture called Lipodissolve, to chemically dissolve fat. After just a few years of its use, most practitioners have abandoned it due to the marginal results and painful recovery. That mixture was then banned for use by the FDA. Recently, Kybella® has been introduced using only deoxycholic acid in a lower concentration than what was available in Lipodissolve, making it far more tolerable. Kybella is mainly used today for small, fatty accumulations below the chin, sometimes called a double chin. It is injected very comfortably through a very small needle in multiple areas based on the patient’s fat distribution and sometimes requires multiple treatments at 4- to 6-week intervals. Some patients may need one treatment while other patients may need as many as four.

With so many choices in non-invasive fat reduction today, patients need to rely on sound guidance from a practice like ours that offers many options. We provide a variety of options from the most invasive treatments such as a tummy tuck to the least the invasive options like CoolSculpting® Plus. All options are always more beneficial with a healthy diet and regular exercise.

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