Body contouring, also sometimes called body sculpting, is a term referring to methods of strategically removing fat from specific problem areas, typically over the abdomen, love handles, hips and sometimes thighs and occasionally arms, or even back. There is a great deal of buzz these days about nonsurgical methods to achieve this, so much so that it can get very confusing. Ultrashape, Velashape, CoolSculpting™ by ZELTIQ™, and Zerona are just some of the technologies you may read about. What are they and what do they do? Should you consider one of these treatments, or is there another option?
Essentially what all these treatments aim to do is destroy fat cells non-invasively, ie without any incision, and without any harm to surrounding tissues, such as the skin, or deeper organs. It is important to realize right off the bat that none of these treatments is intended as a method of weight loss. What about people who are a reasonable weight, but have a particular problem area or areas where stubborn fat has accumulated? if the amount of fat is not too great, and the skin tone is reasonable, a liposuction or a nonsurgical fat reduction method can be considered.
So, how do these noninvasive methods destroy fat cells? Most of these machines attempt to kill these cells by sending different forms of energy into the tissues, which, at the cellular level is transformed into thermal, or heat energy which in turn essentially burns the fat. The forms of energy in these machines include laser, radio frequency, and ultrasound. Some of the criticisms leveled at these machines are the amounts of energy are very low, poorly controlled and not focused directly at the fat layer of tissue. As a result, the benefits may be very slight, or none at all, or there may be uneven effects. If one looks at patient reviews of these different machines online, on Realself for example, one will see that patient satisfaction with most of these methods was only in the 26-32% range! Many physicians who have tried some of these machines with their patients have become disenchanted with the limited results as well.
CoolSculpting™ by ZELTIQ™ is somewhat different in that it uses the fact that fat freezes at a higher temperature than surrounding water-based tissues, and it damages the fat through freezing. It seems to have a much higher patient satisfaction rating but does require there is sufficient fat to be able to suction the treatment area into the treatment head.
Because of these limitations, Dr. Weinberg has waited for a noninvasive treatment that in his view shows more promise of success before offering noninvasive fat contouring to his patients. He believes Liposonix shows that promise, and results from European physicians who have been using this technology for some time bares this out. Liposonix differs significantly from the other ultrasound methods of fat reduction out there in that it uses high-frequency ultrasound energy that can be focused quite precisely at the fat layer. Because the amounts of energy are quite high, there is some discomfort associated with the treatment, but the degree of discomfort has been decreased since it was shown that multiple passes at a slightly lower energy level are as effective as fewer passes with the higher energy settings initially used in Europe. In a recent study performed here in Canada in which some of Dr. Weinberg’s patients took part, patient satisfaction was 90%. At the moment Liposonix is approved for use for tummy fat and is also used for “love handles” in an “off-label” use. More areas for use are likely to emerge in the near future.