Unwanted local fat deposits negatively affect body shape and image. Diets, exercise, medications and/, liposuction, or gastric surgeries may effectively control obesity. Surgical or minimally invasive body shaping can dramatically improve the shape and proportion of your body, enhancing your appearance and boosting your self-confidence. For patients who require minor improvement or are unwilling or unable to undergo a surgical procedure, nonsurgical fat reduction is an alternative for surgical procedures. Nonsurgical and minimally invasive options for fat reduction use various modalities, including freezing, ultrasound, radiofrequency, infrared light, vacuum massage, and injectable medication. Realistic expectations on the part of patients and the appropriate application of technologies by surgeons are the key to achieving patients’ aesthetic goals.

There is increasing public, medical, and scientific awareness about the many hazards of obesity. Western culture and media often promote a slim body image. Excess body fat poses systemic health problems. Unwanted local fat deposits negatively affect body shape and image. Diets, exercise, medications, and/ liposuction, or gastric surgeries may effectively control obesity Body shaping can dramatically improve the shape and proportion of your body, enhancing your appearance and boosting your self-confidence. Improve your body’s shape and overall body shaping by non-surgical fat reduction and/or skin tightening. We make Bod shaping in one surgical session or stages depending on your overall health, the type and extent of procedures, along with the outcome from discussions and recommendations of Prof. Moawad during the consultation process.

Through liposuction, conventional fat removal has evolved as a minimally invasive alternative to remove fat through a cannula inserted through several small skin incisions. Liposuction is typically safe when highly skilled physicians perform, presented as an office procedure with tumescent anesthesia. It stays the standard gold treatment for fat reduction and body shaping. Areas treated by body shaping include the neck, upper arms, female and male breasts, abdomen, flanks, back, hips, buttocks, thighs, knees, and ankles. Body shaping surgery can help many people reshape body features that other measures cannot improve.

NNonsurgicaland minimally invasive options for fat reduction include technology that uses heat or cooling or an injected medication to reduce fat cells. While none of these treatments replace liposuction, they supply options for patients unwilling or unable to undergo surgery. NNonsurgicalfat reduction options use various modalities, including ultrasound, radiofrequency, infrared light, vacuum massage, and injectable medication. Among the procedures of non-surgical fat reduction; cryolipolysis (e.g., CoolSculpting), injection lipolysis (e.g., Kybella), radiofrequency lipolysis (e.g., Vanquish), and laser lipolysis (e.g., SculpSure). Patients who are pregnant or breastfeeding should not have any of the procedures. NNonsurgicaliposuction alternatives are big business. You have undergone one of these treatments, or you are thinking about it. There is a lot of hype around, so it is essential to know what each treatment can achieve before taking the plunge and paying out a considerable sum of money for a procedure.

What Should You Know About Fat Reduction?

For most of us, body fat has a bad reputation. From the dimply stuff that plagues women’s thighs to the beer bellies that can pop out in middle-aged men, fat is typically something we agonize over, scorn, and try to exercise away. But for scientists, fat is fascinating and becoming more so every day. “We are only now beginning to understand fat.” Fat has more functions in the body than we thought. Fat is known to have two primary purposes; fat stores excess calories in a safe way so you can mobilize the fat stores when you’re hungry, and fat releases hormones that control metabolism. However, that is the broad brushstroke picture. Brown fat has gotten a lot of buzz recently, with the discovery that it’s not the primarily worthless fat scientists had thought. In recent studies, scientists have found that lean people tend to have more brown fat than overweight or obese people and that when stimulated, it can burn calories.

Scientists are eyeing it as a potential obesity treatment to figure out how to increase a person’s brown fat or stimulate existing brown fat. It’s known that children have more brown fat than adults, which helps them keep warm. Brown fat stores decline in adults but still help with warmth. Brown fat is more like muscle than white fat. When activated, brown fat burns white fat. Although leaner adults have more brown fat than more massive people, their brown fat cells are outnumbered by fat white cells. White fat is much more plentiful than brown, experts agree. The job of white fat is to store energy and produce hormones secreted into the bloodstream. Small fat cells produce a “good guy” hormone called adiponectin, which makes the liver and muscles sensitive to insulin, making us less susceptible to diabetes and heart disease. When people become fat, adiponectin production slows down or shuts down, setting them up for disease.

Where Do You Store FAT?

Subcutaneous fat is found directly under the skin. It’s the fat that’s measured using skin-fold calipers to estimate your total body fat. In terms of overall health, subcutaneous fat in the thighs and buttocks, for instance, may not be as bad and may have some potential benefits. Prof. Moawad says, “It may not cause as many problems” as other types of fat, specifically the more in-depth, visceral fat, he says. But subcutaneous fat cells on the belly may be another story, says Prof Moawad. There’s emerging evidence that the danger of big bellies lies in the deep visceral fat and the subcutaneous fat. Visceral or “deep” fat wraps around the inner organs and spells trouble for your health. How do you know if you have it? If you have a large waist or belly, of course, you have visceral fat. Visceral fat drives up your risk for diabetes, heart disease, stroke, and even dementia. Visceral fat plays a more significant role in insulin resistance which boosts the risk of diabetes than other fat. It’s not clear why, but could it explain or partially explain why visceral fat is a health risk? Those with the most prominent bellies had a higher risk of dementia than those with smaller stomachs. The link was valid even for people with excess belly fat but overall average weight. We do not know why belly fat and dementia are linked, but we guess that substances such as leptin, a hormone released by the belly fat, may adversely affect the brain. Leptin plays a role in appetite regulation but also in learning and memory. Belly fat has gotten a mostly deserved reputation as an unhealthy fat. “Understand that belly fat is both visceral and subcutaneous,” “We don’t have a perfect way yet to decide which [of belly fat] is subcutaneous or visceral, except by CT scan, but that’s not cost-effective.” But if you’ve got an oversized belly, figuring out how visceral and subcutaneous isn’t as important as recognizing a big belly is unhealthy, Prof Moawad says.

How big is too big? Women with a waist circumference of more than 35 inches and men with more than 40 inches are at increased disease risk. Abdominal fat is a more significant health risk than hip or thigh fat, and that could mean having a worse effect on insulin resistance, boosting the risk of diabetes, and a worse effect on blood lipids, boosting heart and stroke risks. While men tend to accumulate fat in the belly, it’s no secret women, significantly if “pear-shaped,” accumulate it in their thighs and buttocks. Unsightliness aside, emerging evidence suggests that pear-shaped women are protected from metabolic disease than big-bellied people, says Prof Moawad. “Thigh fat and butt fat might be good,” he says, referring to that area’s stores of subcutaneous fat. However, the benefit of women being pear-shaped may stop at menopause, when women tend to deposit more fat in the abdomen.

Are You an Apple, Pear, or even Avocado?

Have you ever noticed how some people can have big bellies but lean legs? How do some people tend to store most of their fat in their thighs, hips, and butt? These are examples of fat distribution, which refers to where your body typically stores the fat, NO MATTER what your weight is! This is important because where you store fat can be a predictor of health risk. Overweight (BMI over 25) is only one health risk factor. Where fat is stored in your body is another. If you have fat stored around your waist instead of those with excess fat in your hips and thighs, you have a HIGHER RISK of health problems even if your BMI is healthy.

Do You Know the Waist and Hip Ratio Health Risks?

Many people worry about how heavy they are and the number they see on the scale. However, the number on the scale does not tell you everything because you don’t know what water is, fat nor muscle; sometimes, someone who might look thin can have a high visceral fat (non-visible to the naked eyes) and suffer from similar problems as someone with high BMI. Waist measurement may be the best way to decide your progress, and it can take the emphasis off the number you see on the scale. The waist-to-hip ratio is a standard measure of fat distribution. Your rate can help you track your weight loss progress while also serving as a warning about your estimated health risk for problems related to being overweight, such as diabetes, stroke, or heart disease.

Diet and Exercise Fat Reduction

Following a well-balanced diet to keep a healthy weight and exercising consistently to keep or meet a fit and healthy body are essential contributing factors to an individual’s body image. However, heredity, changes in the body over time such as weight gain or loss, pregnancy, and even aging can result in a difference in your body’s proportions and curves that may affect your body image and self-confidence. Reshaping disproportionate curves or reducing unwanted fat cannot always be achieved through weight loss and exercise alone. Fitness and skincare have little effect on uneven contours or bulges, as well as skin that lacks elasticity.

Ultrasonic Cavitation (Fat Cavitation) Fat Reduction

Ultrasonic Cavitation refers to the spontaneous formation, expansion, and contraction of tiny microbubbles within the liquid. In a medical setting where it is applied in a very controlled way, I can use it to destroy fatty tissue preferentially. The area is treated by massaging it with an ultrasound transducer. The ultrasound waves penetrate the selected areas and cause the fat cells to be destroyed through a series of microscopic implosions. Once the fat cell membrane (adipose tissue) is damaged, the fat is discharged between the cells, where they are turned into protein and then changed to free fatty acids and glycerol. Free fatty acids are moved to the liver, where they decay and are removed from the body. At the same time, water-soluble glycerol is transported to the circulatory system and used as energy. You will need around five to eight treatments to make good results. You would have no more than two areas treated at any one time. One session is done every week to ten days to properly dispose of the fatty tissue as metabolic waste. I can use it on any area of the body except the breasts. No post-treatment exercise is needed. Small results, typically 1 or 2 cm loss, can be measured at once after treatment with further reductions for up to a week as the body breaks the cells. As a rough generalization of currently marketed systems (for non-aesthetic applications), most non-invasive destructive or disruptive ultrasound devices use focused ultrasound since devices that warm the tissue are non-focused.

Facts about ultrasound fat reduction

• Treatments are intended for use on the abdomen and flanks
• Ultrasound is non-invasive, and no downtime is needed
• A typical patient needs 1 to 3 treatments spaced two weeks apart, depending on the treatment
• Results appear gradually and are typically last within 6 to 12 weeks
• Destroyed fat cells do not grow back; results can last with weight maintenance

Ultrasound Fat Reduction (Ultrashape and Liposonix)

Ultrasound fat reduction uses highly focused sonic waves to break down fat cell walls in the treatment area, thereby releasing the fat inside to be metabolized by the body and reducing the size of a fat deposit. The ultrasound energy transmits through the skin, creating rapid pressure changes that cause the fat cells to break down while leaving surrounding tissues unharmed. FDA cleared ultrasound fat reduction treatments to include UltraShape, which uses pulsed ultrasound technology, and Liposonix, which uses a high intensity focused ultrasound.

Cryolipolysis (CoolSculpting) Fat Reduction

Cryolipolysis is a non-invasive technology that uses extreme cold to dismantle fat cells and help reduce a fat pocket. A paneled or cupped device is placed on top of the skin in the treatment area, where it transmits temperatures that are just low enough to freeze fat cells, destroying them. Because skin, muscle, and nerve tissue freeze at a lower temperature than fat, these tissues stay unharmed. CoolSculpting is the brand name of cryolipolysis.

Fast facts about CoolSculpting

• Best for patients who wish to cut the size of a fat bulge with minor reshaping
• Treatments take 35 to 60 minutes; any discomfort is typically mild and includes an intense cold feeling.
• Cryolipolysis uses a powerful vacuüm which adds to the inflammatory response by drawing blood up to the skin’s surface layers.
• Patients can return to normal activities at once after nonsurgically shaping treatments as discomfort is minimal; a small percentage of patients may experience post-treatment pain, bruising, or numbness that requires a period of recovery.
• Common side effects include temporary, mild swelling, numbness, redness, and tingling. Profound or lasting side effects are infrequent
• The typical patient is satisfied after 1 to 2 treatments
• Results are noticeable within one month and last after 2-3 months
• it is not known how long the treatment effect will last or when and if later therapies would be necessary to keep the result
• Results last barring significant weight gain

Laser Treatment (SculpSure®) Fat Reduction

The treatment works by using a frequency of laser light that penetrates deep into the subcutaneous fatty layer and causes the fat cells to release their stored content, thus deflating them and therefore causing inch loss. SculpSure is the brand name of this non-invasive laser technology.

Fast facts about SculpSure

• The desired area is treated by applying paddles embedded with cold laser diodes. The light penetrates the skin down into the subcutaneous fatty layer, causing the fat cells to release their contents.
• With Laser Lipo, it is important to exercise after treatment to make sure the fat is burned off as the fat cells may re-absorb it.
• You will need eight to ten sessions to do good results. You would have no more than two areas treated at a time.
• Treatments can be done twice a week. I can use it on any area of the body except the breasts.
• Vigorous exercise is needed post-treatment for up to an hour to decrease the risk of the fat cells refilling.
• Small results, typically of 1 or 2 cm loss, can be measured at once after treatment.

Red Light Therapy (UltraSlim) Fat Reduction

One of the newest technologies to be FDA approved for non-surgical reduction uses red light therapy to cut the volume of subcutaneous fat cells. Instead of removing or destroying fat cells, photonic lipolysis, or “red light therapy,” delivers specific wavelengths of light through the skin using a specialized lamp. This light trigger selected fat cells to create small openings and release some of their contents, thus helping them shrink in size. FDA-approved treatments that use photonic lipolysis/red light therapy include UltraSlim.

Fast facts about red light therapy fat reduction

• Red light therapy is intended to treat the abdomen, hips, or thighs; your cosmetic surgeon may use it for more areas.
• Treatment is non-invasive -, and no downtime is needed
• Treatments take about 30 minutes to do
• Results begin to appear within a few hours after the session and improve as the body metabolizes the fat.
• Fat released by treatment is naturally eliminated as waste
• Patients typically choose to have three or more treatment sessions to do their goals
• Results can last if a patient keeps a healthy lifestyle and stable weight
• Red light therapy is a low-risk treatment with no determined side effects; however, pregnant patients or have reduced liver function should not undergo this procedure.

Injectable Deoxycholic Acid (Kybella) Fat Reduction

Deoxycholic acid is a naturally occurring substance in the body that helps break down fat for digestion. In injectable form, deoxycholic acid can break down fat cells on contact for isolated reduction of a fat pocket. Kybella (formerly ATX-101) is the only FDA-approved form of injectable deoxycholic acid to reduce a double chin.

Fast facts about Kybella

• FDA approved for reducing submental fullness (fat beneath the chin).
• Treatment involves multiple injections underneath the chin, using a skinny needle.
• Injections take about 20 minutes to do; a local anesthetic may be used to enhance comfort.
• Little to no downtime is needed; most patients return to total activity within two days.
• The typical patient needs 2 to 4 treatments, spaced one month apart, for optimal results.
• Common side effects include temporary, mild swelling, numbness, redness, and bruising at the treatment site. Serious side effects, such as facial weakness or prolonged numbness, are rare and usually resolve on their own
• Fat cells destroyed with Kybella do not return, and results should last, barring significant weight gain.

One of the newest fat reduction technologies is radiofrequency, which delivers energy to the areas of fat by driving controlled heat deep within the fat cells to destroy them. “Radiofrequency is a very versatile procedure that can be used on any area of the body – from large areas like the abdomen to tiny areas such as the chin – with the same degree of success,” said Prof Moawad. “For people who are not considered overweight but have stubborn pockets of unwanted fat that are not responding to diet and exercise, radiofrequency is a good option.” Another benefit of radiofrequency is reducing fat and tightening the skin by directing energy to target collagen. For example, a patient with flabby upper arms may have more loose skin than fat in this area. In this instance, Prof Moawad might use radiofrequency to tighten the skin first and then remove excess fat. However, if he determines that there is fat mainly in an area, she would remove the fat first and then tighten the skin afterward. RF technology offers unique advantages for non-invasive selective heating of large volumes of subcutaneous adipose tissue. The collagen-based fibrous septa are also preferentially heated, leading to further collagen denaturation and immediate contraction. Delayed fat cell Death leads to fat reduction, and new collagen deposition leads to skin tightening and lifting. A controlled internal electric field perpendicular to the skin–fat interface is selective in heating fat. It can induce lethal thermal damage to subcutaneous adipose tissues while sparing overlying and underlying tissues. In vitro adipocyte cells are heat sensitive to thermal exposures of 50 and 458C for about minutes, 1 and 3 minutes, respectively? In vivo, 15 minutes of thermal exposures to 43–45C result in a delayed adipocyte cellular death response.

What Should I Expect During a Consultation for Non-surgical Fat Reduction?

As with any cosmetic procedure, if you’re considering a non-surgical reduction, do your homework before scheduling surgery. Preparation is an investment in your outcome. Even though a non-cosmetic surgeon may offer treatments, he is the best to help to choose the best procedure to help you meet your goal, whether surgical or non-surgical fat reduction consultation. Be ready to discuss:

• Your goals
• Medical conditions, drug allergies, and medical treatments
• Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
• Earlier surgeries

Your cosmetic surgeon will also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Take photographs
• Discuss your non-surgical reduction options
• Recommend a course of treatment
• Discuss outcomes of non-surgical reduction and any risks or potential complications

It’s essential to understand all aspects of your non-surgical reduction procedure. It’s natural to feel some anxiety, whether excitement for your expected new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

Who Is a Candidate for Non-surgical Fat Reduction?

• A person who is in good health within 15 pounds of ideal body weight.
• A person who has fatty bulges is diet and exercise-resistant.
• A person who is not willing or able to have cosmetic surgery to cut fat stores.

Who Is Not a Candidate for Non-surgical Fat Reduction?

• A person with loose skin or poor tone.
• A person whose weight is unstable.
• A person who expects to see significant fat reduction immediately after the procedure.
• An individual who has a health condition that is contraindicated for chosen modality

Intended Results of Non-surgical Fat Reduction

• CoolSculpting – The treatment areas are found and marked. An appropriately-sized applicator is selected. A gel pad is placed against the skin. As it is applied, the fatty bulge is drawn into the hollow of the applicator with vacuüm power, where it is cooled and numbed. After one hour, the vacuüm turns off, and the treated area is massaged.
• Kybella – The treatment areas were found and marked. A temporary tattoo grid pattern is applied to the treatment area. Local anesthesia may be injected into the treatment area before injection. A precise amount of medicine is inserted into the treatment area. A stinging sensation is felt during injection that resolves shortly after injection.
• Vanquish – The treatment areas are identified and marked. The applicator is applied one centimeter from the surface of the skin for about 30 minutes. Warmth is felt during treatment.
• SculpSure – The treatment areas are found and marked. The applicator is applied for 25 minutes, during which the patient will initially feel a cooling sensation, followed by intermittent warming and/or tingling sensations.
• Ultrashape – The treatment areas are marked. A clinician moves the ultrasound transducer head over the treatment area. A thin layer of gel is applied to the skin. Warmth is felt during treatment.
• Liposonix – The treatment areas are identified and marked. A clinician holds the handpiece on your skin. Patients can feel cold, prickling, or warmth.

Healing and Recovery for Non-surgical Fat Reduction

• CoolSculpting – area appears flush and potentially bruised in the treatment area. Flushing dissipates shortly after treatment. Mild soreness in the area for a few days after the procedure, sometimes patients will experience moderate pain. Numbness is expected following treatment and can last up to several weeks.
• Kybella – Bruising from the injection is a possibility. The area injected is expected to have substantial swelling for the first few days that typically resolve over the next week. Firmness can last up to a few weeks after injection. Later treatments tend to have minor swelling than the first treatment.
• Vanquish – Area treated is warm to touch after treatment with potential mild swelling that resolves soon after complete treatment.
• Sculpsure – Mild tenderness and swelling in the treatment area after the procedure that may last up to a week
• Ultrashape – Mild tenderness, redness, and thirst can be experienced after treatment which typically resolves over a few hours.
• Liposonix – Redness in the treatment area, which usually resolves after a few hours. Swelling may also occur and settles in a few days.

Is Nonsurgical Fat Reduction the Right Choice for Me?

For patients at or near their ideal body weight who do not need significant reshaping in an area, non-surgical can be a great option to cut isolated pockets of diet and exercise-resistant fat without surgery and with little to no downtime. However, it is essential to have realistic expectations about what results from a non-surgical can do.

What are the Benefits of Non-surgical Fat Reduction?

• Little to no downtime is required
• No general anesthesia, incisions, or scars
• Side effects are minimal for most patients
• Gradual onset of results allows patients to be discreet about treatments
• Results can last if a patient keeps their weight

What are the Limitations of Non-surgical Fat Reduction?

• Reduces fat only (minimal sculpting ability compared to liposuction)
• We cannot choose precisely how much fat is lost, only estimate a percentage
• you may need multiple treatments to do desired results
• It May was not suitable for patients with significant amounts of fat to lose

What Does MSI Offer for Non-surgical Fat Reduction?

The biggest challenge with non-invasive body shaping is the patient choice with all before mentioned technologies. Results seem gradual, and “improvements can be subtle,” and there’s the need for repeat and maintenance treatments to consider as well.” added Prof. Moawad. Most importantly, we cannot, however, achieve the results of surgery. Prof Moawad added that radiofrequency, cryolipolysis and ultrasound are external devices that affect the fat layer’s surface. They need multiple treatment sessions (typically four courses) to produce the best results. These non-invasive- procedures are not meant to replace tumescent liposuction for fat removal. Tumescent liposuction is a controlled, precise procedure since the external devices must have a “wait-and-see” approach in which the dermatologist will check how the fat is responding.

Although these minimally-invasive techniques are being offered with increasing frequency across the United States, reliable data on their safety and efficacy is lacking. I must fully inform patients considering anybody shaping procedure about any unpredictability of non-surgical results, and their expectations must be realistic. As always, patients should seek treatment only from medical professionals qualified to carry out proper, clinically proven therapies. “There is a lot of controversy and confusion surrounding non-invasive body shaping treatment. As always, the more facts we have at our disposal, the more completely we can tell our patients to help make sure their safety and satisfaction,” Prof Moawad, President of the Egyptian Society of Cosmetic Surgery and Laser (ESCSL).

At MSI, we combine vacuüm, mono-polar radio Frequency, ultrasound cavitation, and red light to make sure the remaining adipose tissue (fat cell membrane) explode and forces the removal of triglycerides a tightening of the skin. The sub-dermis, where cellulite is found, is heated by the ultra-power mono-polar radiofrequency waves, which cause a tightening and slimming appearance on cellulite tissues. This combination ensures instantly shortens original collagen fibers, resulting in the presence of lifted and tightened skin, fragile adipocytes are stimulated to release fat into the bloodstream, and the formation of new collagen and elastin fibers are produced over few months(3-6months), increasing the tightening of the skin.

[foogallery id=”24474″]