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Nonsurgical and 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 are a replacement for liposuction, they provide options for patients unwilling or unable to undergo surgery. Nonsurgical fat reduction options use a variety of modalities, including ultrasound, radio frequency, infrared light, vacuum massage and injectable medication.

Among the procedures that comprise nonsurgical fat reduction are cryolipolysis (e.g., CoolSculpting), injection lipolysis (e.g., Kybella), radiofrequency lipolysis (e.g., Vanquish) and laser lipolysis (e.g., SculpSure).

Non-surgical fat reduction includes minimally invasive treatments that selectively break down fat cells in specific areas to reduce the size of subcutaneous fat pockets (fat deposits that sit beneath the skin, but above the muscle). A number of FDA cleared treatments are available, each achieving gradual, modest fat loss without surgery or downtime.

Nonsurgical fat reduction is also known as non-invasive body contouringNonsurgical fat reduction is a procedure that uses specialized equipment to create a controlled injury to small volumes of fat. Currently, there are two types of devices used for nonsurgical fat removal: ultrasound and cold energy or cryolipolysis. Both allow outpatient treatment resulting in efficient and consistent fat reduction as well as enhanced body contour.

Pros
• Effective in diminishing stubborn areas of unwanted body fat.
• Outpatient treatment with little to no downtime and minimal discomfort.
• Non-invasive procedure with no incision required.
• 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 as long as a patient maintains his or her weight

Cons
• Multiple treatment sessions may be needed to produce satisfactory results.
• Small burns are extremely rare but have been noted with ultrasound devices.
• Contour fullness may rarely occur in the abdomen after cryolipolysis.
• Temporary redness and numbness may occur.

Are you a good candidate for nonsurgical fat reduction?

Following are some common reasons why you may want to consider nonsurgical fat reduction:
• You are in relatively good shape but have modest bulges of fat on your abdomen, flanks, back or thighs that you’d like removed.
• You have pockets of stubborn fat that are resistant to diet and exercise .
• You wish to achieve a trimmer look and contour your body without having to undergo an invasive surgical procedure.

It is important to note that nonsurgical fat reduction is not a weight loss treatment. This non-invasive procedure is best suited for treating very limited volumes of fat of the abdomen, flanks, back and thighs. Because larger volumes of fat require multiple nonsurgical treatments, liposuction is probably a better option for larger fat accumulations.
If you are in good general health and have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

How is a nonsurgical fat reduction procedure performed?

Depending upon your needs, your surgeon may recommend one of the following body contouring procedures:
Ultrasound
• Premedication is usually not needed.
• Your treatment areas are marked by your surgeon.
• A technician applies a thin layer of gel to your skin.
• The ultrasound transducer head is then moved over the treatment area. The same area may be treated more than once.
• Your session may last anywhere from a half hour to several hours.
Cryolipolysis (also known as “fat freezing”)
• The fatty area is sucked up into a handpiece between two metal plates and the area is slowly cooled.
• Current treatment guidelines are one hour per site.

What are my options?

There are currently two types of devices used for nonsurgical fat removal: ultrasound and cold energy or cryolipolysis. Your board-certified plastic surgeon will determine what is best for you based on his or her experience, your body type and your cosmetic goals.

Ultrasound
Think about ultrasound energy like sunlight. A magnifying glass can focus sunlight to ignite paper. Above and below the point of focus, paper does not burn. In a similar manner, by focusing ultrasound energy, only fat near the focus point is injured. Your skin (above the focus point) and tissue (below the focus point) are protected. Your body then slowly absorbs the damaged fat. One or more treatments may be needed.

Cryolipolysis

This treatment disrupts fat using a form of controlled frostbite. Research has shown that during frostbite fat cells freeze before skin freezes. Cryolipolysis works in the same way, freezing fat but not your skin. The “frozen fat” dies and is absorbed by your body over time. One or more treatments may be needed depending upon the amount of fat to be eliminated.

Patient alert:Injection Lipolysis (also known as mesotherapy)

Currently the American Society for Aesthetic Plastic Surgery does not endorse these injections as practiced in mesotherapy/lipodissolve treatments because there is not yet sufficient proof of their safety and efficacy. Do not to seek treatment from individuals who are unlicensed and unqualified. Fortunately, there are now a number of other non-invasive treatments that have met the standards for safety and effectiveness.
Always consult with a board-certified plastic surgeon if you are considering a nonsurgical fat reduction procedure.

What are the brand names for nonsurgical fat reduction?

Your surgeon may use one or a combination of the following devices, depending on your skin type, the amount of fat being treated, the size and location of the area being treated and the treatment timing:
Ultrasound
• Ultrashape
• Liposonix
Cryolipolysis
• CoolSculpting

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