Celebs and their plastic surgery

Articles about Mesotherapy

Noninvasive Fat Melting – Fact or a Myth?

Tuesday, November 2nd, 2010

One of the hottest things in plastic surgery is noninvasive fat removal.  I’ve mentioned on the Rachael Ray Show that fat removal without any invasiveness is the ‘holy grail’ of plastic surgery, and I still stand by it.  I’ve gone over the Zerona a few times on this blog, but what about Zeltiq, a.k.a. Cryolipolysis?  Does this device actually remove fat without surgery or needles?

Well, let’s review the different fat removing technologies:

1. Diet and exercise – The best way to lose fat, period.  But everyone wants the quick fix nowadays.

2. Liposuction – The only proven way to remove fat cells permanently.  I do this surgery all the time.

3. Fat melting injections – Also goes by the names mesotherapy and Lipodissolve.  This involves injecting medications off-label in an attempt to destroy fat cells by the caustic nature of the medications injected.  Suffers from a lack of standardization and a bunch of yahoo plastic surgeon wanna-be’s doing it (but not everybody).

4. Zerona – These low-light laser treatments have been shown in multiple studies to take off an average of 3-4 inches after undergoing six treatments over two weeks, taking niacin and other supplements, performing regular exercise, and drinking a lot of water.  I believe this definitely works, and have seen some patients lose 8-9 inches total when measuring the thighs, waist, and hips.  The problems are two-fold: Patient Expectations (I found most patients to be ultimately unsatisfied even with major inch loss) and Lack of Control (Some patients who wanted to lose from the thighs lost from the hips instead, and vice versa).  That being said, I do believe it works.  I just couldn’t figure out how to get happy patients out of it, so I got rid of it!

5. Zeltiq – a.k.a. Cryolipolysis - This device acts by cooling the skin to such extremes that the fat underneath the skin becomes damaged and eventually cleared out by the bloodstream.  Because the skin is much more resistant to the effects of temperature and trauma, it remains undisturbed.  Initial studies have found approximately a 25% reduction in the thickness of fat after this treatment.  Sounds good, right? 

Well, sorta.  Would you pay $2000 to lose only 25% of the thickness of your fat?  That doesn’t sound like a lot of change for 2 G’s.  I’m holding off on buying it until I see more impressive results.   

For my post on Zerona, click here

For my previous post on Zeltiq, click here

For my previous post on mesotherapy and lipodissolve, click here.


Noninvasive Liposuction in the U.S.???? Not yet…

Wednesday, June 18th, 2008

In plastic surgery news, Medicis, the company which produces Restylane and Perlane, has just announced that it is acquiring Liposonix, a Seattle-based company which specializes in nonsurgical fat removal. Liposonix is a pioneer in focused ultrasound technology as a noninvasive way to reduce fat. It’s being used in Europe, but is not available in the U.S. They are hoping that their machine will achieve FDA approval by 2011, if not sooner.

What’s the big deal? Well, we are always looking for ways to reduce fat without surgery(or exercise!). External ultrasound has been used in the past, but to my knowledge has never been proven to actually permanently reduce fat. It was a hot topic at one time, but has cooled over the past several years. With technology improving, however, it is possible that the Liposonix machine may produce results superior to the disappointing results of the past. In my office we utilize external ultrasound for cellulite reduction via the Dermosonic technique, but it is not proven to permanently remove fat cells. Yesterday our local Fox affiliate aired a segment on cellulite reduction where I described the cause of cellulite and how cellulite reduction works. Click here for streaming video of it.

Liposonix is a far cry from mesotherapy or Lipodissolve, however, which is by no means non-invasive. I saw a patient recently who had several treatments of Lipodissolve to the fat and loose skin of her tummy. To be honest, the fat did appear to have been significantly reduced. However, she was left with a bunch of leftover loose, hanging skin. She emphasized to me that the treatments were excruciatingly painful and cost several thousand dollars.

I am very interested in the possibilities of fat reduction with Liposonix. No matter what people may falsely advertise however, I know of no proven way to permanently remove fat here in the U.S. except via liposuction…. so far.

For the Medicis press release, click here.

Thanks for reading.

Michigan-based Plastic Surgeon

Anthony Youn, M.D.


Lipodissolve: Too Good To Be True?

Monday, April 14th, 2008

Good Morning America and 20/20 have recently broadcast investigations of Lipodissolve. Click here for their online story: ‘Lunchtime Lipo’ Draws Concern From Doctors. There is also a link to a streaming video of the GMA segment, where some patients are interviewed who developed disastrous results.

A few points:

  1. If it sounds too good to be true, it probably is.
  2. If you have a doctor perform a cosmetic procedure who is not a plastic surgeon certified by the American Board of Plastic Surgery, be very wary.
  3. I don’t perform Lipodissolve, but I am interested in learning how it may be done safely. If it is performed on patients, then patients must be informed first about potential risks, potential for little or no benefit, and that the injections are not FDA-approved for that purpose.
  4. Stay away from fake plastic surgeons.
  5. If you absolutely must lose fat in a nontraditional way, then click here.

For my other posts on mesotherapy and lipodissolve, click here.

Thanks for reading.

Michigan-based Plastic Surgeon

Anthony Youn, M.D.


Lipodissolve Chain Goes Belly-Up

Monday, December 17th, 2007

The lipodissolve chain, Fig, has filed for bankruptcy. This St. Louis-based company was probably the largest chain of fat-melting injectors in the country. According to their website:

The company is currently consulting with counsel and will likely seek legal relief under the bankruptcy code to ensure it preserves all options including the ability to reorganize and continue operations.

Current patients undergoing treatment will be contacted by the company regarding continued treatment options or making a refund claim. Please check this web site for the latest information.

Why did they go belly-up? Was it poor management? Overaggressive expansion? Or maybe poor clinical results? I would be interested to hear from their patients about whether they are actually getting taken care of, now that the company has shut down. Patient abandonment can, unfortunately, be a consequence of having procedures performed by a practice owned by business people, and not a physician.

There is currently an FDA-approved study being performed by ASERF which will hopefully shed some light on the safety and effectiveness of lipodissolve. I look forward to seeing these results.

Thanks for reading.

Michigan-based Plastic Surgeon

Anthony Youn, M.D.


The controversy of fat melting injections

Wednesday, November 7th, 2007

Allure Magazine has a fascinating article this month (November) written by Joan Kron on lipodissolve and other fat melting injections. The article, titled “Fat Chance,” is an in depth analysis of the risks, benefits, and even unethical marketing of this controversial treatment. I have touched on mesotherapy (the generic term for fat melting injections) in this blog in the past, and must admit that I do not perform these treatments. I am, however, very interested in their possible utility once they are proven safe and effective.

Some interesting points about fat melting injections:
1. The Kansas State Board of Healing Arts in August voted to outlaw lipodissolve treatments, except for approved drug trials. A court judge then blocked the ruling from taking effect in response to legal action from a lipodissolve chain. A trial is pending.
2. It is against the law to perform lipodissolve in Canada and Brazil.
3. England has prohibited advertising lipodissolve, and doctor’s insurance no longer covers these procedures.
4. There are some documented scientific papers which show nice improvement from fat melting injections without major side effects, but none of these have included an FDA-approved clinical trial to formally document its safety and efficacy.
5. According to an online Allure article, Realself.com has found that employees from two of these fat melting clinics have bombarded their message boards and comments areas with propaganda while posing as actual patients.
6. According to Allure: Essentially, lipodissolve clinics are practicing “human experimentation, due to the lack of significant data to support the claims to the consumer,” says Dr. Rod Rohrich, chief of plastic surgery at the University of Texas, Southwest Medical Center.

So what do I think of fat melting injections?

My take is that these controversial treatments are very intriguing and hopefully will live up to expectations. As a physician, however, my first priority is to the safety of my patients. A treatment like this needs to be proven to be safe and effective before I perform it on someone. Otherwise, it is considered human experimentation and should be explained to the patient in this way. There are too many doctors out there, however, who get blinded by greed and see this as their ticket to riches. Our patients deserve better than a non-proven treatment without proven safety, standardization of medication, or realistic expectations. Hopefully in the near future fat melting treatments will be proven safe and effective.

Photo credit: Allure.com

Thanks for reading.
Michigan-based Plastic Surgeon

Anthony Youn, M.D.


Mesotherapy articles

Friday, June 22nd, 2007

I get a lot of questions on mesotherapy, and its related techniques such as Lipodissolve. I do not perform this procedure but have been following it ever since I heard of it back during my year in Los Angeles (4 years ago). For those of you interested, here is a list of articles about mesotherapy, starting with the ones I recommend the most by the two main plastic surgery societies:

American Society of Plastic Surgeons article
American Society for Aesthetic Plastic Surgery article
My blog article
Wall Street Journal
U.S. News and World Report
New Beauty Magazine
Plastic Surgery 101 – Dr. Rob Oliver’s posts

Thanks for reading.
Michigan-based Plastic Surgeon

Anthony Youn, M.D.