Muffin top, love handles, banana rolls, double chin….
What’s a person to do with those extra fat deposits that persist despite good diet and exercise? Although liposuction has been a reliable way to treat these areas of extra fat, non-invasive alternatives have recently been developed for fat reduction.
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CoolSculpting (Zeltiq) has been FDA-approved since 2010 for non-surgical fat reduction. Common treatment areas include abdomen, love handles, back, arms, and under the chin. It can be performed by a physician or even a nurse or physician assistant under the supervision of a physician. It works by applying a handheld device to the target area, which freezes and destroys the fat below the surface of the skin. Immediately after the procedure, the treated skin area is red, and there is some lumpiness under the skin that soon goes away.
In general, patients can lose 20-30 percent of the fat in the treated area. Although patients can achieve moderate fat reduction, it generally requires multiple treatments, yet only results in partial fat reduction. Patients can experience some pain during the procedure, which can last up to 10 days following the procedure. Paradoxically, there have even been reports of fat actually increasing in areas treated with CoolSculpting. In my own practice, I have successfully treated such patients with liposuction with excellent results.
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SculpSure (Cynosure) is a more recently developed procedure that uses a laser for non-surgical fat reduction, and is FDA-approved for the treatment of flanks and abdomen. Laser treatment panels are applied directly to the skin over the problem areas, delivering hot and cold treatment cycles for 25 minutes. The laser targets the fat with heat, and after the fat cells are damaged, your body then clears them away. As with CoolSculpting, multiple treatment sessions are usually required, and there is only a partial fat reduction, generally in the 20 percent range.
Patient before and after SmartLipo liposuction
Kybella (Allergan) is a recently FDA-approved injection used to reduce fat under the chin. The active ingredient is a chemical deoxycholic acid, which destroys fat cells. It often requires multiple injections one month apart, and the results can take up to four weeks to be seen. There have been some reports of temporary nerve damage causing uneven smile or facial muscle weakness, which can take up to several weeks or more to resolve.
Liposuction remains the gold standard for cosmetic fat reduction, and is still one of the most popular plastic surgical procedures performed. Unlike CoolSculpting, SculpSure, and Kybella, liposuction is meant to be a procedure performed in a single session. Since the surgeon can control how much fat is removed, there is much more precision with liposuction, as well as a more complete, predictable fat reduction.
For most patients, the recovery time is just a few days or less, with patients quickly able to return to work and resume all activities. I usually perform liposuction under local or sedation anesthesia. Since liposuction is performed as a single session procedure, the cost of liposuction is often comparable to that of CoolSculpting, SculpSure, and Kybella, but with substantially more complete results. In my own practice, I use SmartLipo Triplex liposuction, which uses a laser to melt the fat and tighten the skin during the liposuction procedure.
The development of multiple procedures for cosmetic fat reduction has offered patients many choices for treatment. For those patients who want to avoid a surgical liposuction procedure, CoolSculpting, SculpSure, and Kybella may be good options. However, patients should realize that these non-surgical procedures may only result in partial improvement, usually much less so that can be achieved with liposuction.
Dr. Arnold Breitbart is a board-certified plastic surgeon practicing in Long Island and Manhattan. For more information, visit DrBreitbart.com, or call 516-365-3511