August 8, 2012

An Overview of Fat-Reduction Options by Dr. Tchelebi

There are many non-invasive treatment options on the market and I am often asked, “Do they really work?” That is the question, because none of us wants to invest large amounts of money for modest results. Not me as a provider, nor you as the consumer.

Reports published by the American Academy of Plastic Surgery between 2000 and 2010 indicate that liposuction procedures decreased by 43% and on the other hand the noninvasive procedures increased by 30%.

This information should not mislead you; it merely indicates that the noninvasive technology is further along than it was 10 years ago. Better nutrition and exercise may have also contributed to these results. The non-invasive techniques cannot, however, completely replace liposuction.

Among the different noninvasive technologies on the market are: lasers, RF devices, ultrasound, or cryo machines.

ZERONA, a low-level diode laser, showed better results when used as an adjunct to liposuction.

Among the RF (radiofrequency) devices, the THERMAGE showed mild to moderate improvements both in circumference and laxity. Some studies report a 20-25% improvement, but treatments tend to be quite expensive because of the need for disposable tips.

Coolsculpting (Zeltiq) is a device which freezes fat cells. The results are modest – a bulge will not completely disappear, but it will be improved. The device cannot be used for large areas because the clamp, utilized to grab the tissue, is not large enough. Treatments are expensive, because one treatment is often not sufficient to offer acceptable results. Clinical trials are now being conducted to determine the number of treatments and spacing. Currently, one or more treatments is recommended every 2 or every 6 months.

The VELASHAPE uses bipolar RF, infrared energy, vacuum pressure and mechanical massage. It removes a minor layer of fat improving cellulite.
Studies reported a reduction of .6 cm in arm circumference and up to 2 cm in abdominal girth. The success of these treatments depends on the technique, operator, and type of regimen, week, by week. The every-other-week regimen did not give such impressive results. The greatest results were noticed at 3 mo. post treatment, which would coincide with neocollagenesis.

Other devices utilize focused Ultrasound like the Ultra Shape.

Several other devices like the LipoSonix are now under investigation by the FDA.

PROMISING results involve Mesotherapy. I have used this technique extensively with lipodisolve and seen excellent results. Circumferential reduction has been impressive in all the areas treated: abdomen, thighs, and arms. I used it successfully in the submental region and even periocular area. The problems related to lipodisolve were mostly pain and temporary swelling.

At present, the FDA is investigating one of the components of Lipodisolve, sodium deoxycholate, which gives equally good results with fewer complications. Hopefully the product, which is now in phase 3 trials, will be released to the market by the end of the year.

In summary, literature review and personal experience indicates that any of the above types of equipment will provide improvement. Some will provide both improvement in texture and circumferential reduction like the Vela Shape. For best results you have to follow a healthy diet and exercise. In the peri- and post-menopausal women evaluation and Hormonal Replacement Therapy must also be considered to improve metabolism and stimulate collagenesesis.

Liposuction should not be considered as a weight loss procedure. It is a good treatment for patients with localized deposits of fat, who have a normal BMI.

Mesotherapy with sodium deoxycholate with or without VelaShape are definitely superior to any of the above and for localized areas, very similar to liposuction.

I hope this short review helps you decide on the best method for you.If you need additional information or would like to have an evaluation contact us at 914-676-8013 and schedule a consultation with me, or one of my technicians specialized in fat reduction procedures.