Areas of unwanted, diet- and exercise-resistant fat are a common concern for many cosmetic surgery patients. Whether it comes in the form of a persistent stomach “pooch” after pregnancy, areas of fat around the thighs that won’t budge, or bulges along the flanks and back, localized fat can be difficult to get rid of permanently. Liposuction has been one of the most popular and top performed cosmetic procedures for many years, with good reason. This surgical procedure safely, effectively, and permanently reduces fat and refines the body contour.
In recent years, nonsurgical or minimally invasive alternatives to liposuction have been gaining popularity. These body contouring treatments typically do not require an incision or anesthesia, and they often come with less downtime.
We all have our share of them those spots on our bodies where fat loves to hang out. For some, it might be areas in the lower body with lovely nicknames like “bubble butt,” “thunder thighs,” “cankles,” “saddlebags,” “love handles” or “FUPA” (you’ll have to look that one up). Then there’s that fat which accumulates in areas above the belly, known affectionately as “bat wings” or “turkey neck.
Despite eating proportionally fewer calories than our male counterparts, it’s a fact that women store fat more efficiently than do men. It’s quite the paradox: Despite burning off more fat than men during exercise, women have more body fat than menâ€”6 percent to 11 percent more.
One likely culprit: estrogen, finds a study from the University of New South Wales. The likely reason is to prime women for childbearing, the review suggests.” (Another thing you can say to your child the next time you want to lay on some good old mommy-guilt.)
In a perfect world, we’d go to the gym, do some targeted work aimed at blasting those bulges away and whittle away all the extra fat on our (choose your dream) abs, thighs, butts, triceps, chins. But contrary to common belief, you cannot spot reduce. While fats do get broken down during exercise, those fats get broken down throughout the body not just in the spot you wish for.
But and here’s a bit of encouraging news usually the spot where you gain weight first will be the same spot where you’ll lose it first.
Every little bit helps, no?
What all of this means is that sometimes exercise is not enough; you might want a little extra assistance.
There are surgical ways, but those require things like anesthesia, sutures, bruising, healing and risk of infection, as most surgeries do.
What if you want to reduce your fat, but don’t want surgery? You’re not alone: Nonsurgical fat-reduction procedures rate among the fastest-growing categories in the aesthetics market. There’s been a 42 percent increase in procedures performed between 2013 and 2014, according to the American Society for Aesthetic Plastic Surgery. There are things like liposuction (which, like it sounds, suctions excess fat from under the skin) and CoolSculpting (a technique that freezes the fat away).
There’s a new kid in town
I recently learned about a new body contouring system called SculpSure for removing stubborn fat. You know that kind of fat the kind that, despite our best efforts at diet and exercise, remains obstinately present. Both clinically tested and FDA-cleared, SculpSure is a light-based procedure that yields results in six to 12 weeks.
How it works
Developed by Cynosure, this noninvasive procedure uses a laser that precisely targets fat cells under the skin. The temperature of the body fat is raised, the subcutaneous fat cells are disrupted and destroyed, and then, presto! The cells are naturally eliminated over time.
Bye-bye and sayonara. Gone forever.
SculpSure requires no downtime, other than sitting or lying comfortably for 25 minutes during the procedure. Board-certified plastic surgeon Dr. Lawrence Bass, who was a lead investigator in SculpSure’s clinical trials, says, “SculpSure is also comfortable and well-tolerated, with most patients feeling nothing more than a deep warming sensation.”
Some patients feel a bit of tenderness for a few days after the procedure, but there’s nothing stopping you from having the procedure performed and getting right up and back to work and your normal schedule.
The procedure, which claims to produce up to a 24 percent reduction in stubborn fat, uses no suction to pull the tissues like CoolSculpting does. Instead, the applicators lay flat on top of the treatment area. Depending on how much fat you’re after, between one and five sessions might be necessary, each taking 25 minutes and costing an average of $1,500.
Read on to learn the difference between the two fat reduction approaches and discover which one might be right for you.
What is Liposuction?
Liposuction is a surgical fat removal procedure that first became popular in the 1980s. During the procedure, a board certified cosmetic surgeon carefully and precisely removes excess fat through a small, hollow tube called a cannula. Suction is applied as the surgeon moves the cannula through the fat deposit, removing excess fat cells and sculpting a slimmer body contour.
Liposuction is particularly effective at removing fat in the legs, abdomen, back, arms, face, and neck. It provides more dramatic results than other noninvasive fat reduction procedures, however, it has a longer recovery period (up to six weeks) and typically costs more than its nonsurgical counterparts.
How do CoolSculpting , Zerona, and Other Noninvasive Procedures Work?
Nonsurgical fat reduction treatments use different modalities to target and eliminate unwanted fat cells through a topical, rather than surgical, procedure. Popular nonsurgical body contouring treatments include:
CoolSculpting is a good match for people who are close to their target weight, but want to reduce small, localized trouble spots on the hips, abdomen, or thighs. This treatment uses a specialized cryolipolysis device to cool unwanted fat cells to the point of death without affecting surrounding tissues. Once the fat cells die, they are flushed from the body during the days and weeks following the procedure. The final result is seen after three months.
TruSculpt is a similar treatment that utilizes controlled radiofrequency technology to eliminate fat cells on the hips, thighs, buttocks, and abdomen. Treatment typically lasts around an hour, and most patients require one to two treatments to see noticeable results.
Zerona cold laser differs from the above noninvasive treatments in that the results are usually seen within several weeks or less. The cold laser targets superficial fat cells, causing the storage form of fat to leak out into the cell. This is then flushed out of the patient’s system, which results in shrinkage of the fat cell itself.
Both treatments are recommended for individuals who are happy with their current weight, but want to reduce fat in areas that are difficult to tone through diet and exercise. Patients should expect no more than about a 25% reduction of fat in the treated areas from nonsurgical treatments. Additionally, these treatments do not result in additional skin contracture which occurs with traditional liposculpture methods.
Liposuction vs. Nonsurgical Fat Reduction: Pros & Cons
There are advantages and disadvantages to both liposuction and nonsurgical body contouring.
Liposuction is a more aggressive method of fat reduction and creates a trauma in the treatment area. Patients will experience soreness, bruising, and swelling for up to 10 days after the procedure. CoolSculpting and truSculpt treatments are typically gentle with minimal discomfort, both during and after treatment.
Liposuction results are visible after the swelling goes down and the treated area heals, although the final result is not seen for 6 months. It takes longer to see results from CoolSculpting and other noninvasive fat reduction treatments, which become increasingly noticeable in the weeks and months following the procedure. While neither liposuction or nonsurgical body contouring treatments are a replacement for weight loss, liposuction does offer more dramatic and longer-lasting results, in addition to some skin shrinkage.
The healing process after liposuction requires patients to restrict everyday activities for several days after the procedure and to use caution when restarting exercise. CoolSculpting and truSculpt do not require an extended healing period and patients can return to normal activities immediately, though slight soreness and swelling are to be expected. Though your results will be less noticeable with nonsurgical fat reduction, you will be able to return to work and get back to your life much sooner.
Which is Right for Me?
Liposuction may be an excellent option for reducing larger deposits of excess fat. It can significantly improve your figure in several areas at once. Some negatives include a higher cost and greater risk for health complications than noninvasive techniques.
Nonsurgical fat reduction may be a better fit if you are already at your ideal weight, have good skin elasticity, and want to target smaller, stubborn trouble spots. However, the results will not be as dramatic and multiple treatments may be necessary.
What’s the next step?
The best way to make a choice between liposuction, CoolSculpting, Zerona, truSculpt, and other noninvasive forms of fat reduction is to seek the advice of a board certified cosmetic surgeon. They can walk you through your options during a personalized cosmetic surgery consultation and help you determine which might be the best fit for you. Use our Find a Surgeon tool to help discovered board certified cosmetic surgeons in your area.
Leftover Roast Chicken Stock
Makes 6 cups
- 2 chicken carcasses left over from roast (or rotisserie) chicken, any herbs in cavities discarded
- 1 onion, quartered
- 2 celery ribs, chopped
- 1 large carrot, chopped
- 1 head of garlic, halved crosswise
- Scant 1/4 teaspoon black peppercorns
- 2 thyme sprigs
- 8 parsley sprigs including long stems
- 4 quarts water
How to Lose Body Fat in 5 New Ways, According to Dermatologists
1. The Deep Freeze
You’ve got to love 2010. “Before that, there were no effective noninvasive ways to contour the body,” says Robert Anolik, a dermatologist in New York City. Then the world got cryolipolysis don’t worry about pronouncing it; just know that it means freezing fat to death by suctioning it into a rectangular (and very chilly) handpiece.
When Zeltiq’s CoolSculpting device (currently the only one offering this technology) was approved by the FDA to dissolve belly fat, it sounded like a dream: 25 percent less fat, zapped away during your lunch break. And it’s lived up to the hype. Provided you’re spot-treating on a relatively fit frame, it really works. And now it works on more places than ever and faster.
“New software allows us to operate one degree cooler than before, so we can treat an area in 35 minutes instead of an hour,” Anolik says. And a flat applicator, about the size of a Ping-Pong paddle, can slim areas that can’t be squished between the original machine’s plates specifically the outer thighs. Thinking even smaller? The CoolMini (a shrunken version of the original handpiece) can treat even more diminutive pockets of fat. Officially, it’s approved for use under the chin. Unofficially, plastic surgeons such as Glenn Vallecillos in Beverly Hills are testing it out on bulges above the knees and next to the armpits, which celebrities reportedly hit up before big red carpet events.
2. The Heat Wave
If you’re still wondering how to lose body fat, cold isn’t the only game in town; treatments that use heat also cause fat cells to rupture, says Roy Geronemus, a dermatologist in New York City. There are several devices in this class: the infrared light– and radio frequency fueled VelaShape III, the radio frequency–leveraging Vanquish, and SculpSure, which uses laser energy.
Regardless of the technology behind each one, the aim is consistent across the board: to create a high enough temperature to destroy fat. And while they don’t have the years of solid data that stand behind CoolSculpting, these fat-heating options are gaining ground among some doctors, like New York City dermatologist Dennis Gross, who favors SculpSure.
“It has given my patients great results, and the new, smaller applicators that came out last year have made it possible to contour really tricky areas, such as the arms,” he says. The applicators which lie flat on the skin and are about the size of a Kit Kat allow the device the flexibility to treat areas that are too bony (hips, upper abdomen) for other devices to get at, explains Gross. Like Cool Sculpting, the treatment has moments of some discomfort but is considered quite tolerable.
3. A Fine Point
If you’ve heard of Kybella and if you’re reading this website, we’re going to go ahead and assume you have you probably know that it dissolves fat. Here’s where we get all geeky about it: Kybella employs deoxycholic acid, a synthetic form of the acid that breaks down fat in the gut, to remove fat from the chin, explains Jeannette Graf, a dermatologist in Great Neck, New York.
It’s delivered in a series of injections. But not as many as it once was: In the nearly two years since its arrival, many dermatologists have noticed that by spacing Kybella treatments six to eight weeks apart, instead of the previously accepted four, they can get the same results in two or three appointments rather than four, says San Francisco dermatologist Richard Glogau.
And though technically it’s FDA-approved only for use under the chin, some dermatologists are experimenting with Kybella on other areas, like the fat that sits above your knees or hangs over your bra. In fact, since it’s such a targeted treatment, some doctors are even using Kybella to create muscle definition.
“Right now my most exciting work is sculpting the stomach’s six-pack with Kybella,” says S. Manjula Jegasothy, a dermatologist in Miami. “For patients who are within 10 to 15 percent of their ideal body weight, I’m seeing an 80 to 90 percent reduction in fat when I use Kybella on the stomach or back,” Jegasothy says. Whatever area you treat, though, expect it to be tender and puffy for up to a week. “Swelling is very much a part of the process,” Graf says.
4. The Dream Cream
Rub on a cream and watch as the unwanted fat simply disappears from your body? Nope, this is not a dispatch from the Pulling My Leg department. Allergan recently shelled out $85 million for the company behind an ointment called XAF5. Like lash-growing Latisse, its active ingredient was originally designed to help glaucoma patients. Only this time, the welcome side effect appears to be dissolving undereye fat pads.
The active ingredient in XAF5 (and yes, we’re waiting for a sexier name, too), a prostaglandin known as latanoprost, binds to fat- cell receptors and triggers the release of their oil contents, causing the fat cells to shrink. Hold off on your happy dance for a minute, though: What may work for the thin skin under the eyes won’t necessarily work elsewhere on the body, where the skin is much thicker and less permeable, says Anolik.
5. Reduce, Reuse, Recycle
If you’ve ever dreamed your extra pounds would do the polite thing and migrate from your hips to your breasts, well, you’re in luck. Fat transplants can make that particular dream come true. Early attempts by unskilled practitioners earned the practice a complicated reputation, but in recent years, a more measured approach has made playing Mother Nature with your figure more popular. “The techniques for fat preparation have really evolved,” says Jarrah-Nejad.
“We wash the fat, take out the grease, take out the debris, and make sure it’s the quality we know will survive. That way we will get a much more predictable result.” Another breakthrough in the process: doctors’ understanding that sometimes the less fat that is injected, the greater the chance that the surrounding network of blood vessels will accept it.
That’s why doctors like Justin Yovino, a cosmetic surgeon in Beverly Hills, use as little as 10 milliliters of fat to smooth the back of a hand or 20 milliliters to lift cheekbones. (As a point of reference, a cough- syrup cup is about 15 milliliters.) Yovino also uses fat to round breast contours or to render a derriere just ever so slightly perkier.
The idea is to make tweaks, not dramatic transformations. And though the fat must be procured via liposuction (often from the inner knees, though any area the patient wants slimmed down will work), the transplant doesn’t require general anesthesia.
“I give my patients a little Xanax or laughing gas before the procedure,” Yovino says. “They’ll just feel a tiny prick when I inject the anesthetic and after that light pressure and vibrations where I’m removing the fat. Then I’ll inject it back in.” But couldn’t a synthetic filler (like, say, Restylane) achieve similar results without invasive liposuction? Not necessarily. Because it’s living tissue, fat won’t wear off and won’t need refilling every six months.
And since it came from you in the first place, your body can’t have a reaction to it (though it’s rare, some people are allergic to other fillers). As with any procedure, researching a reputable cosmetic surgeon (and you will need a surgeon, since the process involves liposuction) is critical: If fat transfer is done incorrectly, the body can reject the fat and create a cyst or calcification that requires surgical removal.
Bring all ingredients to a boil in an 8-quart stockpot. Reduce heat and simmer, skimming foam occasionally, 2 hours. Strain stock through a fine-mesh sieve into a bowl, pressing on and then discarding solids. If you have more than 6 cups, boil to reduce; if less, add water. If using stock right away, skim off and discard fat. If not, chill stock (covered once cool) and discard fat after it solidifies.
Notes: In place of roast-chicken carcasses, you can use 3 and 1/2 to 4 pounds wings, necks, and backs from uncooked chickens. Stock can be chilled up to 3 days or frozen up to 3 months.
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