Surgical and non-surgical fat removal


Liposuction has been the tried and true method for fat removal since it was first introduced in the early 1970's. Troublesome fat deposits, such as the hips, thighs, and abdomen, are treated by completely removing the fat cells via negative pressure through a hollow metal tube. It's sort of like sucking up a milkshake through a straw. Once those fat cells are removed, they are gone forever. Unless the patient gains a large amount of weight, new fat cells should not develop in the treated area.

Liposuction has undergone improvements over the years including the use of the Microaire reciprocating cannulas which move backwards and forwards to help shear off the fat cells. Internal ultrasound was also used with some success, however, there is a greater risk of damage to surrounding non-fat tissues (skin, muscle). Newer technologies employ the use of lasers (SmartLipo, SlimLipo) to melt fat cells, essentially turning them into fat soup which is easier to remove. In addition, lasers can help tighten up skin by heating the under surface of the skin causing the elastic fibers in the skin to contract more.

For years, doctors have been trying to develop a non-invasive way to get rid of fat. Treatment modalities such as Endermologie, VelaShape, external ultrasound, and now CoolSculpting have been developed to help minimize fat pockets. The problem faced was how to destroy fat cells without damaging surrounding skin and muscle cells as well. Also, since the fat cells are not physically removed with CoolSculpting or other modalities, fat can re-grow in these areas.

The advantage of liposuction is that it usually requires only a single procedure and recovery period. Liposuction may also be combined with other surgical procedures. The results are more immediate and predictable. Research has shown that selective freezing of fat cells may only result in a 20-25% reduction in volume so, while there is no real recovery period for CoolSculpting, it does require multiple one-hour sessions to treat the involved areas. This amounts to a lot of time and expense devoted to a non-surgical approach with limited predictability.

Article by
Atlanta Plastic Surgeon