THE BATTLE OF THE BULGE by Lois W. Stern


bulges

As spring approaches, our thoughts are likely to turn toward refreshing our summer wardrobes. We all want figure enhancing clothes, but if you have fat deposits in unwelcome places, it’s sometimes hard to find clothes designed to conceal those bulges. Despite good health and a reasonable level of fitness, some people may still have a body with disproportionate contours due to localized fat deposits. These areas may be due to family traits rather than a lack of weight control or fitness. What do you do?

What do you do? From least invasive to surgical options, here are some answers.

Diet and Exercise: The first line of defense should always be diet and exercise. It takes some work, but when effective, is so rewarding. However, when an overall slim body is marred by the appearance of selective fat deposits that just won’t disappear, there are several other solutions.

Cellulite treatments as Endermologie and Velosmooth: mechanical systems that use motorized rollers to break down cellulite, slim the body, and firm the skin over areas of stubborn fatty deposits. These treatments, which are said to feel like deep tissue massage, work best for those who are physically fit and only moderately oveweight. A series of treatments is required to obtain results. Candidates are advised to exercise regularly and drink plenty of water to help eliminate fat through their perspiration and urine. Although effective and non-invasive, these are generally not permanent forms of cellulite reduction, as maintenance sessions normally are required. Most recent annual statistics gathered by the American Society of Plastic Surgeons indicate that 37,916 such procedures were performed in the US last year.

Cooling devices: Some of the newer non-invasive systems for body contouring include:
Ultrasound body contouring: based on a mechanical vibration emitted from specialized ultrasound equipment, Ultrasound is designed to permanently destroy fat cells. The objective is to deliver ultrasound energy precisely focused to destroy fat cells, while leaving neighboring tissue unharmed. Treatment is said to be painless for most patients with no downtime or post-treatment restrictions.

CoolSculpting (AKA Zeltiq): based on a cooling process that kills the fat cells underneath the skin, literally freezing them to the point of elimination. Only fat cells are frozen. Healthy skin cells remain intact. Once crystallized, the fat cells die and are naturally eliminated from your body. To learn more about these fat cooling devices,Click here.

Injection Lipolysis: Initial studies by the ASPS concluded as follows: “All patients showed remarkable reductions of fat deposits treated with injection lipolysis. Using the correct technique, injection lipolysis is a safe and efficacious alternative to lipoplasty on smaller areas for patients objecting to, or unable to undergo, surgery. It is not a replacement for a necessary change of lifestyle, nor is it a method of weight reduction or a treatment for obesity. The ideal patient is one with small to medium fat deposits that cannot be reduced by exercise and diet.” Personally, I would like to see studies comparing fat reduction results obtained through cooling devises as opposed to injection methods.

Smart Lipo, approved by the U.S. Food and Drug Administration in November 2006, is a less invasive form of lipoplasty that uses laser technology to sculpt the body. During the Smart Lipo procedure, a tiny tube (a cannula,) about the size of pencil lead is inserted through the skin and into the fat layer. A laser fiber sits inside the cannula, which the doctor moves back and forth in a fanning motion. When inserted under the skin, this laser fiber dissolves fat cells with heat. The melted fat is removed through the cannula, just like during traditional liposuction, but because of the heat, there is less fat to remove and the skin is tighter. Although the laser fiber isn’t hot enough to burn gauze held against it, its heat is sufficient to melt little tunnels through the fat, which can then be drained away. This form of body contouring, best suited to patients within 10 to 15 pounds of their ideal body weight, is ideally used on areas for spot reduction, such as under a chin, upper arms, abdomen, thighs, or knees. Results show loss of inches, though not necessarily a loss of a lot of weight.

Liposuction: Spring is high season for liposuction, a cosmetic procedure described by some as a surgical magic wand. But this magic wand is not recommended for weight loss. It is intended solely to remove excess fat deposits on localized areas of the body, to reshape and to improve body contours and proportion. This surgical procedure removes fat from under the skin with the use of either a cannula, to suctions out the fat, or an ultrasonic probe, to break up the fat into small pieces before removing it.

Advantages of Smart Lipo include its slightly lower cost compared to traditional liposuction and the fact that only a local anesthetic is used and the patient remains awake the entire time. Because Smart Lipo causes less trauma to the body, with less bruising, blood loss, or swelling than in traditional liposuction, there is an overall quicker healing time. However, it is is still a surgical procedure that should be performed only by a surgeon trained and experienced in this technique.

The tumescent or super-wet technique requires an infusion of saline solution with adrenaline and anesthetic prior to removal of excess fat. Ultrasound-assisted lipoplasty uses ultrasonic energy to liquefy excess fat prior to surgical suctioning. According to the American Society for Aesthetic Plastic Surgery (ASAPS), more than 400,000 liposuction procedures were performed on patients in the U.S. in 2007.

For an excellent additional resource for those interested in liposuction procedures, click here.

Reminders:

  • Do not be taken in by media hype.
  • Do not undergo any procedure that has not been FDA approved.
  • Be aware that any licensed physician, regardless of training, legally may perform liposuction.
  • While some physicians’ professional societies may recommend training before performing liposuction surgery, there is no standardized training for physicians performing liposuction.

 

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5 thoughts on “THE BATTLE OF THE BULGE by Lois W. Stern

  1. I think if I were going to try any of these options (besides diet and exercise) it would be the cooling one. The rest kind of scare me. I have a friend who works in a dermatologist’s office that says they do this sort of treatment and it works very well.

    • Yes, I’ve had several conversations with Dr. Lawrence Bass about Zeltiq while writing a magazine article about this cooling device. (Dr. Bass is a board certified plastic surgeon who heads the laser department at Cornell Hospital, NYC, so he is a great resource). Here is a fun piece of information. The technique of cooling fat to melt it away came about from an interesting observation. Children who habitually sucked on popsicles were developing dimples in their cheeks because the extreme cold was melting away fat! From that simple observation, Zeltiq and other cool sculpting technologies began to develop.

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