Nonsurgical and minimally invasive options for fat reduction include technology that uses heat or cooling or an injected medication to reduce fat cells. While none of these treatments are a replacement for liposuction, they provide options for patients unwilling or unable to undergo surgery. Nonsurgical fat reduction options use a variety of modalities, including ultrasound, radio frequency, infrared light, vacuum massage and injectable medication.
Patients who are pregnant or breastfeeding should not have any of the aforementioned procedures.
Cryolipolysis, commonly referred to as “CoolSculpting” by patients, uses cold temperature to break down fat cells. The fat cells are particularly susceptible to the effects of cold, unlike other types of cells. While the fat cells freeze, the skin and other structures are spared from injury.
Patients who wish to reduce a localized fat bulge that has persisted despite diet and exercise may be interested in Cryolipolysis.
Patients with cold-related conditions, like cryoglobulinemia, cold urticaris and paroxysmal cold hemoglobulinuria should not have Cryolipolysis. Patients with loose skin or poor tone may not be suitable candidates for the procedure.
The goal of Cryolipolysis is to reduce the volume of fat in a fatty bulge. Some patients may opt to have more than one area treated or to retreat an area more than once.
This procedure is done without anesthesia.
After an assessment of the dimensions and shape of the fatty bulge to be treated, an applicator of the appropriate size and curvature is chosen. The area of concern is marked to identify the site for applicator placement. A gel pad is placed to protect the skin. The applicator is applied and the bulge is vacuumed into the hollow of the applicator. The temperature inside the applicator drops, and as it does so, the area numbs. Patients sometimes experience discomfort from the vacuum’s pull on their tissue, but this resolves within minutes, once the area is numb.
Patients typically watch TV, use their smart phone or read during the procedure. After the hour-long treatment, the vacuum turns off, the applicator is removed and the area is massaged, which may improve the final results.
The complication rate is low and the satisfaction rate is high. There is a risk of surface irregularities and asymmetry. Patients may not get the result they’d hoped for. Rarely, in less than 1 percent, patients may have paradoxical fat hyperplasia, which is an unexpected increase in the number of fat cells. This is three times more likely in men than in women and is seen more in those of Hispanic or Latino descent.
There are no activity restrictions. Patients sometimes feel sore, as if they had worked out. Rarely do patients experience pain. If that happens the patient should contact the plastic surgeon, who may prescribe medication for a few days.
The injured fat cells are gradually eliminated by the body over 4 to 6 months. During that time the fatty bulge decreases in size, with an average fat reduction of about 20 percent.
Injection lipolysis chemically reduces the number of fat cells around the injection site. The chemical, called deoxycholic acid, results in fat cell disruption and death. Currently, it is FDA-approved for treatment of the area underneath the chin to eliminate what is known as a “double chin, or in other areas of the body.
Patients with loose skin or poor tone may not be suitable candidates for the procedure.
This procedure can be done under local anesthesia.
After the local anesthesia has been injected, a precise amount of medication is injected in a grid pattern that has been pre-marked on the skin.
Complications are uncommon and include nerve injury that can result in an uneven smile.
There is no downtime, but patients may experience swelling, bruising, pain, redness and feel areas of hardness that typically soften with time. Fat reduction is typically visible by eight weeks.
Most patients have two to three treatments spaced 4 to 6 weeks apart, which is the typical duration of swelling. During the period of swelling the area can look fuller than it did before treatment, but as the fat cells are disrupted and the inflammation subsides, most patients see results by 6 to 8 weeks after a treatment. Unless a patient were to gain weight, the results should be long-lasting.
Radiofrequency lipolysis is a procedure which uses a radio frequency to heat the fat without an instrument making physical contact with the patient. The applicator heats from a distance of one centimeter from the skin. Fat cells are preferentially heated without impacting other types of cells in the skin or other structures. A common type of radiofrequency lipolysis is Vanquish.
Patients who wish to reduce a localized fat bulge that has persisted despite diet and exercise may be interested in radiofrequency lipolysis. Risks are minimal.
Patients with loose skin or poor tone may not be suitable candidates for the procedure.
The goal of radiofrequency lipolysis is to reduce the volume of fat in a fatty bulge. Some patients may opt to have more than one area treated or to retreat an area more than once.
This procedure is done without anesthesia.
The treatment takes approximately thirty minutes and is repeated once a week for four weeks or as determined during the assessment.
Mild erythema has been reported.
There are no activity restrictions and no downtime.
Patients with treatment to the abdomen have averaged a reduction of just under two inches, though not all patients have a measurable, perceptible reduction.
During your nonsurgical fat reduction consultation be prepared to discuss:
Your plastic surgeon will also:
It’s very important to understand all aspects of your nonsurgical fat reduction procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.
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