Thursday, November 17th, 2011
Currently one of the most talked-about procedures in plastic surgery is CoolSculpting by Zeltiq. I’ve mentioned it in previous blog posts here. A lot of patients are asking about this procedure, but truthfully my experience with it is relatively modest. I do not have the device in my office, but have demo’d it on myself and my staff.
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.
Friday, May 28th, 2010
One of the hottest things in plastic surgery today, and what I consider the Holy Grail of plastic surgery, is Noninvasive Fat Loss. One of the latest to claim this is Zeltiq. This is a device which is FDA approved in the U.S. for other purposes, but many physicians are using it ‘off-label’ to remove fat without needles or surgery. How does it work?
Zeltiq chills the surface temperature of the skin, causing the fat below it to become irreversibly damaged. The body’s natural clearing mechanisms then get rid of the fat over time, creating actual inch loss. According to an introductory study:
- Subjects were comfortable during the procedure and did not require pain medication.
- Cryolipolysis results in a visible contour change in a majority of subjects.
- 100% of a subset of ultrasound-evaluated subjects demonstrated a measurable reduction; the average for the group was 22.4% fat layer reduction 4 months post-procedure.
- Noticeable cosmetic efficacy was more consistently observed in properly selected subjects.
- 27 of 28 (96%) properly selected subjects (discrete fat bulges) had discernable efficacy.
Do I think this works?
Actually, yes. We’ve seen in certain types of reconstructive surgery (such as pressure sores) that the skin is much more resistant to damage than the underlying fat. Therefore, it makes sense that the chilling can destroy the fat but leave the skin viable. The before and after photos I’ve seen, however, have not been very impressive. 22.4% fat loss is pretty modest compared to what can be achieved with liposuction. For now, I consider it a modality with promise but limited effectiveness. It may be helpful for people who are not good candidates for liposuction.
For more on Zeltiq, click here for their website.
Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.: