Weight loss in the New Year
Article by Irvin M. Wiesman, MD
Chicago Plastic Surgeon
It’s the New Year in Chicago. It’s cold and snowy. We are all in layers and the holidays have just passed. Likely, most of us have eaten our way through the holidays. And now we’re making the same New Years resolutions that were made last year at this time: Eat better, work out more and lose weight (we all want to look good for swim suit season which is right around the corner).
The best way to shed those extra pounds is with diet and exercise. There is no magic bullet (or pill) for weight lose. Electronic belts will not create rock hard abs. The sad truth is that there are not any proven surgical, medical or spa treatment will take away pounds and keep them off without changing your eating habits and increasing your physical activity.
That being said, there are many treatments available for body contouring or treating specific areas of the body that are resistant to diet. Usually, this is the abdomen and flanks (love handles) in men and outer thighs or saddle bags in women. Other areas include: calf, neck, upper arms and bra strap area. There are many options available including invasive, minimally invasive and non-invasive treatments.
The fat melters:
External ultrasound (i.e. Accent) is a new technology that is totally non-invasive. The ultra-sound melts the fat transcutaneously, or through the skin, and the body excretes the damaged fat cells. It is a good treatment for smaller localized areas. There have been studies published that show almost a reduction of one inch around the abdomen or thighs with a single treatment. This procedure, like all procedures, is not without risks which includes skin burns. The permanency of these treatments is still to be determined. There is little clinical data to support the efficacy of this treatment.
Mesotherapy and Lipodissove:
Mesotherapy is a technique in which a mixture of medications is injected into the mesoderm or “the middle layer” of the skin. It has been used in France for over 50 years to treat a variety of ailments ranging from vascular disease, migraines and the common cold. It is commonly used in the U.S to dissolve fat and treat cellulite.
Lipodissolve is also a mixture of medication that is injected into the tissue underneath the skin to dissolve localized fat deposits. The main ingredient in lipodissolve is phosphatidyl choline and sodium deoxycholate which has been shown in studies to dissolve fat.
Both treatments require a series of multiple injections in the treatment areas.
One issue with these treatments are that the ingredients are not standardized or FDA approved. Side effects include redness, bruising, swelling, pain and possible skin loss.
these treatments are not endorsed by The American Society of Plastic Surgeons or the American Society of Aesthetic Plastic Surgery. Your on your own with injectible fat melters, don’t expect much and be pleasantly surprised if you achieve the result you were expecting.
Invasive removal of fat:
Liposuction is the best treatment for removing excess fat from those problem areas
Basically a small cannula, or hollow tube of varying sizes, is placed through 3 – 5 mm stab incisions and the fat is suctioned out. Once fat is removed it will never come back! This does not mean that you won’t ever gain weight in that area or anywhere else. Think of fat cells as a balloon. What ever is left (and there is always some fat cells remaining in an area that has been liposuctioned) can expand and store as many calories as you put in.
Fat cells also don’t jump into the blood stream and move to another area after liposuction. But, if you take away those stubborn fat cells that like to stick around and store calories and you don’t maintain your weight other parts of your body may now store those excess pounds and calories.
There are many different variations of the same theme ( and yet to be proven that anyone is better than the other):
- Traditional liposuction: just a cannula and a vacuum
- Tumescent liposuction: fluid is injected that has medication in it that helps cut down the pain and bleeding and facilitates removal of the fat
- Ultrasonic liposuction: tumescent fluid is injected and then an ultrasonic probe is placed into the areas to be suctioned and essentially burst the fat cells so they are removed more easily. Slight risk of skin burns.
- Power Assisted Liposuction: a machine caused the cannula to oscillate, move back and forth, which requires less effort from the surgeon during the procedure.
- SMART LIPO: the newest rave. A small laser is placed into the areas to be suctioned and melts the fat (sounds like U/S). Then the liquid is allowed to drain on its own or a suction cannula is placed to suck the fat out (sounds like liposuction). The laser may help facilitate skin tightening, but may also cause skin burns. This is still an invasive procedure!
Risks with any type of liposuction are bruising, infection, blood clots and contour irregularities.
Upside is this is guaranteed fat removal and improved contour as long as you keep up your end: DON’T GAIN WEIGHT.
Spring is around the corner, time to act on our resolutions (and hopefully not have to have the same one‘s next year). Remember, all these treatments are expensive and all come with risks. So get to the gym and start eating better.
The key to losing weight:
Burn off more calories than you take in, a simple math equation. Once your there and if there are still some stubborn areas consider one of the above treatment. Always, go to a reputable physician or medical spa.
If you do consider surgery, check for specialty training in plastic and reconstructive surgery or cosmetic surgery as well as completion of board certification in their specialty.