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What’s the buzz – fat reduction

“What’s the buzz; tell me what’s a happenin’?”

Non-invasive and less- invasive techniques are being considered by patients for weight loss. As our desires to look trim and lose weight soar, manufacturers are finding newer ways to help feed our hunger to look thinner and empty our pocketbooks.
Well folks, caveat emptor, buyer beware…. these newer techniques promise a lot and don’t necessarily deliver!
Devices such as external ultrasound, radio frequency, heat, laser, light and freezing devices or internal ultrasound, radio frequency and lasers have no greater performance and provide less value than traditional lipo contouring for the cost transferred to the consumer for the added cost of the machines.
I will say that I have found that with well informed expectations and the proper selection of patients, some devices can help contour limited areas at a time.
Despite FDA approval* and unbelievable promises, ALL fat reducing options require the individual to participate in the weight loss, weight maintenance and body contouring process.
Let’s review these devices one at a time:
N     Non-Invasive Treatments
Accent XL is a non-surgical radiofrequency skin treatment for contouring the body. It uses radiofrequency energy to break down adipose tissue (fat) to a depth of about 20 millimeters (¾ inch). Once dissolved, the fat joins other bodily waste fluids that are eventually eliminated through urination.
Endermlogie resembles a deep tissue massage. The pressure of the rollers on your skin will be progressively adjusted to massage deeper levels of your adipose (fat) tissue. You can expect to feel sore after each treatment. The crushing and sucking activity of the rollers can injure the fat and create inflammation and therefore a sense of tightness, loss of interstitial water and possibly a little fat.  Because Endermologie’s effects are temporary, you’ll need follow-up treatments once a month or so to retain its effects.
LipoSonix uses a High-Intensity Focused Ultrasound (HIFU) to cause the death of fat. Focusing the ultrasound energy to 1-2 cm below the surface of the skin reduces the risk of any burns or trauma to the skin during the 1 hour session. The disrupted fat cells attract the body’s inflammatory and healing responses. Special cells called macrophages engulf the fat and cellular debris. The macrophages then transport the fat through the lymphatic and venous system eventually to the liver. This process takes 2-4 weeks. The liver treats the fat just like fat you have eaten. The fat is carried away in your stool.
SmoothShapes uses a combination of laser and light energy and aggressive mechanical vacuum massage. The two kinds of energies liquefy excess fat cells, and the massage rollers push the resultant fluid toward the lymphatic system. It takes about half an hour per area treated. Any skin warmth or reddening will disappear within a few hours, so you can return to your normal activities right away. 8 treatments are recommended during a one-month period. The final effects of the treatment may not become noticeable for several additional weeks.
Thermage uses radiofrequency energy to heat, contract and tighten collagen fibers within the skin. Thermage has not been approved for body contouring by the Food and Drug Administration. It has been approved, however, for the treatment of wrinkles and for the temporary reduction of cellulite. A Thermage procedure may take from 30 minutes to 2 hours to complete, depending on the size of the area to be treated. You may be given an oral analgesic medication before the treatment begins to prevent any pain or discomfort. The Thermage device will emit a cool spray to protect your skin’s surface. You may experience mild redness and swelling after the procedure; these symptoms typically disappear within a few days. A small percentage of patients (less than 0.5 percent) develop external injury and scarring. Although you’ll likely notice some immediate tightening of your skin, the plumping up and smoothing of your skin will occur gradually over several months as new collagen forms. Not everyone experiences improvements.
The Titan Procedure™ uses an infrared light source to tighten the skin. The Titan™ heats the deep layer of the skin to cause collagen contraction while preserving the epidermis through continuous cooling. Like all other skin tightening and fat reducing techniques, it can stimulate long-term collagen rebuilding and remodeling but is temporary in improvement.
The TriActive procedure is a therapeutic-like massage with laser for collagen stimulation. Each session takes about 45 minutes. For best results, 10-20 treatment sessions are recommended. Maintenance sessions are also recommended to keep the treated areas toned.
UltraShape uses pulses of ultrasound waves to melt away selected fat cells The UltraShape procedure can be completed in less than an hour. Results are usually visible after three treatments, which are usually staggered at two-week intervals.
VelaShape and its earlier version, VelaSmooth, both radiofrequency energy and light to heat the 0.5 inches of fat located right under the skin. The heat is delivered with the aid of a gentle vacuuming device and specially designed rollers that manipulate the skin. A treatment feels like having a warm, deep-tissue body massage. Treatment sessions generally last 20 to 45 minutes. Afterward, your skin will feel warm for a few hours. You may also experience some mild redness and bruising. The recommended treatment protocol for most people is 4 to 6 weekly treatments. You may notice some tightening of the skin after the first treatment, but significant improvement usually occurs only after four or more treatments. The effects are temporary.
Zeltiq Coolsculpting uses a gel patch attached to a machine that freezes unwanted fat cells, causing them to self-destruct and get re-absorbed into the body over several months.
Zerona: a low energy laser aimed at troublesome fat areas forcing them to empty. The oil get reabsorbed and pooh-poohed away over weeks.
Invasive Procedures:
Mesotherapy uses a technique known as injection lipolysis. Injection lipolysis breaks down fat by injecting chemical solutions directly into the subcutaneous tissue. The ingredients used for mesotherapy vary according to the practitioner, but usually contain a combination of drugs, plant extracts, vitamins and other substances. Although mesotherapy has used for many years in Europe, no credible scientific evidence exists to support its effectiveness. It has not received approval by the Food and Drug Administration, and several medical organizations have issued warnings about its use. One major concern is the lack of control over the ingredients used in the formulations. They are not regulated.
LipoDissolve is a treatment that uses tiny injections of naturally occurring chemicals to dissolve small, limited areas of fat. While this procedure goes by many names (e.g., Lipostabil®, Lipodissolve, Lipo-zap, Flab-Jab, Mesotherapy, Lipotherapy, Injection Lipolysis), the technique typically involves patients receiving dozens of small ‘fat burning’ injections of compounded phosphatidylcholine/deoxycholate (PCDC) into fat and connective tissue over several sessions.  Like mesotherapy, LipoDissolve has not undergone any rigorous clinical trials to determine whether it is either safe or effective. As a result, the Food and Drug Administration (FDA) has not approved its use
SmartLipo, also known as “Laser Lipo” is a minimally-invasive using a 1 mm laser procedure that helps remove unwanted fat with less down time and fewer side effects than traditional liposuction surgery. SmartLipo is a perfect alternative for areas like the “turkey gobble”, the back of the arms or legs, and upper abdomen. In many cases with Smart Lipo, no stitches are required to close the incision. There is significantly less volume contoured and fat destroyed with this technique. It remains dependent on the redraping and collagen producing inflammatory repair to tighten the surrounding tissues. In many cases, traditional liposuction is performed to remove the injured fat cells and released oils.
Ulthera is the first aesthetics device to combine ultrasound imaging with focused ultrasound energy for non-invasive skin tightening. This enables deeper skin tightening while leaving the top layers including the epidermis unaffected. Thermage and Titan, the two older generation skin tightening procedures, dumped heat into the entire thickness of the skin, resulting in greater.You may expect some mild redness for 30 minutes and a tightening sensation.
In general, each technique will remove, injure or shift fat from the body. Any source of energy will create inflammation. Inflammation is a process that in itself causes collagen (i.e. scar) formation and tightening.  Don’t get overwhelmed with a manufactures promise! It is up to the patient to maintain and continue their individual body contouring!
*FDA “approval” is the government’s seal of approval that a drug or device meets the definition of safety and efficacy within the parameters requested by the manufacturer.  This does not mean that the drug or device work effectively, nor does it guaranty the amount of help it will provide. For a fuller understanding of this process, link to http://en.wikipedia.org/wiki/Food_and_Drug_Administration .
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