Bulges in All the Wrong Places

by

Lois W. Stern

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?

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.

Endermologie: Sometimes referred to as lipomassage, endermologie is a mechanical system that uses 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, endermologie is not a permanent form of cellulite reduction, as maintenance sessions are required.

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. 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.

Ultrashape - On the Horizon: There may soon be a non-invasive system for body contouring. Ultrasound body contouring is based on a mechanical vibration emitted from specialized ultrasound equipment and 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.

Although not yet in popular use, to date over 40,000 ultrasound body contouring treatments have been performed with clinical results published in the prestigious journal, Plastic and Reconstructive Surgery.

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.

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.

Mesotherapy: Despite the hype about injection fat-loss treatments such as mesotherapy, a relatively new fat-dissolving technique also known as injection lipolysis, liposuction is the only proven method for safe, effective, permanent fat removal to date. According to the ASAPS, the treatment claims to reduce or eliminate local fat deposits when "various compounds" are injected into the subcutaneous fat are as yet scientifically unproven, lacking any objective data on safety and efficacy. In addition, none of these procedures has received FDA approval, with the ingredients poorly defined. The procedures also may be offered by persons without sufficient medical training, thereby putting patients at risk of harm.

A clinical trial investigating the safety and efficacy of one type of injection lipolysis treatment will begin soon. The study, which was designed and funded by the Aesthetic Surgery Education and Research Foundation, will be conducted under FDA supervision. The clinical trial will follow patients for 46 weeks to evaluate the efficacy and safety of one form of injection lipolysis and collect data on adverse reactions and any long-term complications. Now that a clinical trial is about to get underway, time will tell if mesotherapy will eventually be proven as safe and effective as liposuction is said to be. At present, no form of injection lipoplasty has been FDA approved.

Cautions: The Physicians Coalition for Injectable Safety issued the following consumer warning: “There is much more unknown and unproven about these injections than there is proven. This is not a beauty treatment. This is a medical treatment that involves hundreds of injections into the body of a compounded mixture of drugs. This mixture is not FDA approved nor has it been formally tested for predictable results or safety. That alone should steer consumers away from the marketing hype.”

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.
  
  
  To read one woman's a personal liposuction account, click here.
  
  For an excellent additional resource for those interested in liposuction procedures, click here.
  
  You have my permission to reprint this article in part or full providing it contains the following: attribution:
  Lois W. Stern is the author of the award winning book, Sex, Lies and Cosmetic Surgery, (Infinity, 2006), soon to be republished in a revised edition with a CD enclosure. Lois invites prospective cosmetic surgery patients, physicians, and media to visit her website to read other articles and/or sign up for her monthly newsletter at: http://www.sexliesandcosmeticsurgery.com
  
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