Should I do Vaser lipo, Vanquish me, Emsculpt Neo to remove fat from waist? (Photo)

Question

Hi doctor, would like to have your professional advise that which way should I do to remove fat from waist (not love handle, pink area in the picture)? I’m not too fat in that area so CoolSculpting can’t work on me since it’s not able to suction (vacuum) for treatment. I’d like to remove like 1-2 inch of my waist. Based on your experience, should I do Vaser lipo, vanquish me, EMSCULPT? Or what treatment can I do to get a rather permanent result? Thank you very much!

Jason Emer, MD · Answer

sculpting liposuction would be best.

my whole practice is doing lipoabdominoplasty, or at least liposuction with internal heating (which is not the gold standard for skin tightening with body contouring).

the smaller you are before liposuction the more contouring you can get from the procedure. most of my liposuction patients get pre and post surgical optimization with hormonal therapy (see link to help boost their weight loss before surgery and help them heal after).

You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Traditional liposuction awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radio-frequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a Brazilian butt lift when you inject the fat to the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face.  Cellulite should also be treated with cellfina, sculptra, subcision and/or fillers such as bellafill, renuva synthetic fat, or sculptra.  If skin is very loose before surgery then it will need to be removed such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  Overall you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting.  Dr. Emer.

Arian Mowlavi, MD, FACS (license on probation) · Answer

High definition VASER liposuction is the best liposuction technology available right now. The Gold Standard for superior liposuction results requires use of the advanced technology of ultrasound assisted VASER liposuction. As an official trainer of VASER liposuction, I perform full body liposuction cases every week. VASER liposuction has been the only modality that has consistently resulted in outstanding liposuction outcomes. VASER liposuction ensures a smooth contour regardless of degree of excess fat by virtue of being able to remove any and all remaining fat comprehensively and uniformly. If skin redundancy is observed, Renuvion technology can be simultaneously applied to tighten your skin to optimize your overall contour outcome. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.

Respectfully,
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Mats Hagstrom, MD (license on probation) · Answer

Liposuction regardless of what the name of the devices is the gold standard for the removal of undesirable subcutaneous fat.

It is by far more effective than any of the other modalities you mentioned.

I do not recommend spot treating the torso in a single area. It leads to an unnatural fat distribution.

I recommend having in person consultations with highly experienced board-certified plastic surgeons who have many years of experience in a proven track record for Liposuction.

And experience the plastic surgeon should have no difficulty showing you well over 50 sets of abdominal before and after pictures of quality Liposuction results.  A highly experienced provider should have several hundred.

Cool sculpting it’s unpredictable and may create enough results to be slightly noticeable.

Radio frequency treatments are not going to give a noticeable difference for the great majority of patients who are use that modality.

Best,

Mats Hagstrom

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