Noninvasive fat removal in plastic surgery

One of the hottest things in plastic surgery is noninvasive fat removal.

I’ve mentioned on Rachael Ray Showthat fat removal without any invasiveness is the ‘holy grail’ of plastic surgery, and I still stand by it.  I’ve gone over the Zerona a few times, but what about Zeltiq, a.k.a. Cryolipolysis?  Does this device actually remove fat without surgery or needles?

Well, let’s review the different fat removing technologies:

1. Diet and exercise. The best way to lose fat, period.  But everyone wants the quick fix nowadays.

2. Liposuction. The only proven way to remove fat cells permanently.  I do this surgery all the time.

3. Fat melting injections. Also goes by the names mesotherapy and Lipodissolve.  This involves injecting medications off-label in an attempt to destroy fat cells by the caustic nature of the medications injected.  Suffers from a lack of standardization and a bunch of yahoo plastic surgeon wanna-be’s doing it (but not everybody).

4. Zerona. These low-light laser treatments have been shown in multiple studies to take off an average of 3-4 inches after undergoing six treatments over two weeks, taking niacin and other supplements, performing regular exercise, and drinking a lot of water.  I believe this definitely works, and have seen some patients lose 8-9 inches total when measuring the thighs, waist, and hips.  The problems are two-fold: Patient Expectations (I found most patients to be ultimately unsatisfied even with major inch loss) and Lack of Control (Some patients who wanted to lose from the thighs lost from the hips instead, and vice versa).  That being said, I do believe it works.  I just couldn’t figure out how to get happy patients out of it, so I got rid of it!

5. Zeltiq – a.k.a. Cryolipolysis. This device acts by cooling the skin to such extremes that the fat underneath the skin becomes damaged and eventually cleared out by the bloodstream.  Because the skin is much more resistant to the effects of temperature and trauma, it remains undisturbed.  Initial studies have found approximately a 25% reduction in the thickness of fat after this treatment.  Sounds good, right?

Well, sort of.  Would you pay $2000 to lose only 25% of the thickness of your fat?  That doesn’t sound like a lot of change for 2 G’s.  I’m holding off on buying it until I see more impressive results.

Anthony Youn is a plastic surgeon who blogs at Celebrity Cosmetic Surgery.

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  • dave

    My question with cryolipolysis is “where does the fat go?” While with Zerona, its possible it is somehow metabolized (with the use of exercise/niacin/etc.) I don’t see how this is the case with Zerona. Is the extra fat being taken up by non-damaged visceral cells? If so does this have bad outcomes in terms of long-term health? I’ve never able to get a good answer (though I haven’t tried that hard).

  • Josh

    I would think the damaged cells are reabsorbed by the body in an effort to heal the damaged adipose. Sound right doc?

    • Anthony Youn, MD

      The science behind how the fat is removed by the body is still sketchy. Studies do show, however, that the impact of fat in the bloodstream (such as to raise the cholesterol or triglyceride content) is not significant. Most physicians believe the fat is cleared by the liver.

  • Mike

    “This device acts by cooling the skin to such extremes that the fat underneath the skin becomes damaged and eventually cleared out by the bloodstream.”

    One day last winter we dropped to -29° F (the north pole was a balmy -9° F that particular day). So, during December and January for the low price of $500, a mere 25% the price of this procedure, I will let you stand naked on my front lawn till you loose all the fat you want.

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