Nonsurgical Fat Reduction
Also known as noninvasive body contouring or CoolSculpting
Nonsurgical fat reduction is a procedure that uses specialized equipment to create a controlled injury to small volumes of fat. Currently, there are two types of devices used for nonsurgical fat removal: ultrasound and cold energy or cryolipolysis. Both allow outpatient treatment resulting in efficient and consistent fat reduction as well as enhanced body contour.
When to Consider Nonsurgical Fat Reduction
- If you are struggling with pockets of fat that are resistant to diet and exercise programs.
- If you have undesirable but limited fat deposits on your abdomen, flanks, back or thighs.
- If you wish to achieve a trimmer appearance without having to undergo surgery.
- Effective in diminishing stubborn areas of unwanted body fat.
- Outpatient treatment with little to no downtime and minimal discomfort.
- No incision required.
- Multiple treatment sessions may be needed to produce satisfactory results.
- Small burns are extremely rare but have been noted with ultrasound devices.
- Temporary redness and numbness may occur.
These are the top three pros and cons to weigh when considering nonsurgical fat reduction. If you want to focus on those specifically unique to you, please consult with your aesthetic plastic surgeon.
Am I a good candidate for nonsurgical fat reduction?
Following are some common reasons why you may want to consider nonsurgical fat reduction:
- You are in relatively good shape but have modest bulges of fat on your abdomen, flanks, back or thighs that you’d like removed.
- You have pockets of fat that are resistant to diet and exercise .
- You wish to achieve a trimmer look without having to undergo an invasive surgical procedure.
It is important to note that nonsurgical fat reduction is not a weight loss treatment. This procedure is best suited for treating very limited volumes of fat of the abdomen, flanks, back and thighs. Because larger volumes of fat require multiple nonsurgical treatments, liposuction is probably a better option for larger fat accumulations.
If you are in good general health and have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.
About Your Procedure
How is a nonsurgical fat reduction procedure performed?
Depending upon your needs, your surgeon may recommend one of the following treatment modalities:
- Premedication is usually not needed.
- Your treatment areas are marked by your surgeon.
- A technician applies a thin layer of gel to your skin.
- The ultrasound transducer head is then moved over the treatment area. The same area may be treated more than once.
- Your session may last anywhere from a half hour to several hours.
- The fatty area is sucked up into a handpiece between two metal plates and the area is slowly cooled.
- Current treatment guidelines are one hour per site.
Though clinical studies show cryolipolysis works, this is an “off-label” treatment according to FDA guidelines. The FDA acknowledges that “off-label” treatments may represent the state-of-the-art treatment.
What are my options?
There are currently two types of devices used for nonsurgical fat removal: ultrasound and cold energy or cryolipolysis. Your board-certified plastic surgeon will determine what is best for you based on his or her experience, your body type and your cosmetic goals.
Think about ultrasound energy like sunlight. A magnifying glass can focus sunlight to ignite paper. Above and below the point of focus, paper does not burn. In a similar manner, by focusing ultrasound energy, only fat near the focus point is injured. Your skin (above the focus point) and tissue (below the focus point) are protected. Your body then slowly absorbs the damaged fat. One or more treatments may be needed.
This treatment disrupts fat using a form of controlled frostbite. Research has shown that during frostbite fat cells freeze before skin freezes. Cryolipolysis works in the same way, freezing fat but not your skin. The “frozen fat” dies and is absorbed by your body over time. One or more treatments may be needed depending upon the amount of fat to be eliminated.
Patient alert: Injection Lipolysis (also known as mesotherapy)
Currently the American Society for Aesthetic Plastic Surgery does not endorse these injections as practiced in mesotherapy/lipodissolve treatments because there is not yet sufficient proof of their safety and efficacy. Do not to seek treatment from individuals who are unlicensed and unqualified. Fortunately, there are now a number of other nonsurgical treatments that have met the standards for safety and effectiveness.
Always consult with a board-certified plastic surgeon if you are considering a nonsurgical fat reduction procedure.
What are the brand names for nonsurgical fat reduction?
Your surgeon may use one or a combination of the following devices, depending on your skin type, the amount of fat being treated, the size and location of the area being treated and the treatment timing:
What will my nonsurgical fat reduction incisions and scars be like?
Is nonsurgical fat reduction safe?
Selecting Your Surgeon
Select a surgeon you can trust
It's important to choose your surgeon based on:
- Education, training and certification
- Experience with nonsurgical fat reduction surgery
- Your comfort level with him or her
Members of the American Society for Aesthetic Plastic Surgery are experienced and qualified to perform your aesthetic procedure. Learn how to select a surgeon.
After finding a board-certified plastic surgeon in your area who is experienced in performing nonsurgical fat reduction, you will need to make an office appointment to set up your consultation. Generally, because of the in-depth nature of the consultation, there is a cost associated with the initial visit.
Your initial consultation appointment
During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your surgeon will evaluate you as a candidate for nonsurgical fat reduction and clarify what nonsurgical fat reduction can do for you. Understanding your goals and medical condition, both alternative and additional treatments may be considered (see related procedures).
You should come to the consultation prepared to discuss your complete medical history. This will include information about:
- Previous surgeries
- Past and present medical conditions
- Allergies and current medications
Your treatment plan
Based on your goals, physical characteristics and the surgeon’s training and experience, your surgeon will share recommendations and information with you, including:
- An approach to your treatment, including the type of procedure or combination of procedures.
- The outcomes that you can anticipate.
- Your financial investment in the procedure.
- Associated risks and complications.
- Treatment location options.
- What you need to prepare for your treatment.
- What you can expect to experience after treatment.
- Show before-and-after photos of cases similar to yours and answer any questions.
Questions to ask your aesthetic plastic surgeon
For a general list of questions to ask your surgeon about his or her background, to find out about plastic surgery safety and to plan your procedure, visit the Planning Toolkit.
We developed these questions to help you:
- Make the most informed and intelligent decisions about your procedure.
- Confirm that you have the right surgeon for your procedure.
- Make your initial consultation as rewarding as possible.
- Understand your options, potential outcomes and risks.
It is important for you to take an active role in your treatment, so please use this list of questions as a starting point for your initial consultation.
- Am I a good candidate for nonsurgical fat reduction?
- Are the results I am seeking reasonable and realistic?
- Do you have before-and-after photos I can look at for the procedure I am undergoing?
- Will there be scarring?
- What will be the costs associated with my treatment?
- What will you expect of me to get the best results?
- What kind of recovery period can I expect and when can I resume normal activities?
- What are the risks and complications associated with my procedure?
- How are complications handled?
- What are my options if the cosmetic outcome of my treatment does not meet the goals we agreed on?
Preparing For Your Procedure
How do I prepare for a nonsurgical fat reduction procedure?
Your surgeon will provide you with pretreatment instructions and answer any questions that you may have.
In advance of your procedure, your surgeon will ask you to:
- Stop smoking before undergoing treatment to promote better healing.
- Avoid taking aspirin, certain anti-inflammatory drugs and some herbal medications that can cause increased bleeding.
- Regardless of the type of procedure to be performed, hydration is very important before and after treatment for safe recovery.
Nonsurgical fat reduction is usually performed on an outpatient basis. Be sure to arrange for someone to drive you home after treatment and stay with you at least the first night following treatment.
What can I expect on the day of nonsurgical fat reduction treatment?
Nonsurgical fat reduction is performed on an outpatient basis. Most nonsurgical fat reduction sessions take less than an hour to complete but may take up to several hours.
- Medications may be administered for your comfort during the procedure.
- Your surgeon will follow the treatment plan discussed with you.
- After your procedure is completed, you will be able to return home and resume your normal activities.
Aftercare And Recovery
Nonsurgical fat reduction usually requires little, if any, recovery. For most patients, full activity may be resumed immediately. After the procedure, you and your caregiver will receive detailed instructions about your post-treatment care, including information about:
- Skin care
- Normal symptoms you will experience
- Potential signs of complication
See options for short-term recovery locations in Aftercare and Recovery (Planning Toolkit).
Immediately after your nonsurgical fat reduction
You may notice temporary skin redness, swelling of the treated area and numbness of the area, but these side-effects usually resolve quickly. Some patients (especially those with larger treatment areas) may benefit from oral pain medication. It is important that you follow all patient care instructions provided by your surgeon.
Recovery time frame after nonsurgical fat reduction
You will be able to return to work and resume normal activity right away. You'll see noticeable fat reduction in the treated areas within one to two months following the procedure.
How Long Will My Results Last?
The results are permanent, because the adult body does not produce new fat cells. When you gain weight, your existing fat cells expand. Once fat cells are destroyed and removed from the body, you will not gain weight in the treated areas.
Maintain a relationship with your aesthetic plastic surgeon
For safety, as well as the most beautiful and healthy outcome, it’s important to return to your plastic surgeon's office for follow-up evaluation at prescribed times and whenever you notice any changes in the treatment areas. Do not hesitate to contact your surgeon when you have any questions or concerns.
The cost of nonsurgical fat reduction varies from doctor to doctor and from one geographic area to another. Like any new treatment, the total treatment cost may be higher than traditional liposuction. Because nonsurgical fat reduction is an elective procedure, insurance does not cover the costs. Many surgeons offer patient financing plans to make the procedure more affordable.
These numbers only reflect the physician/surgeon fees last year and do not include fees for the treatment facility, anesthesia, medical tests, prescriptions, compression garments or other miscellaneous costs related to treatment.
Choose your surgeon based on quality, training and experience—not cost.
See why ASAPS members are widely recognized for upholding the highest standards in the area of aesthetic plastic surgery by viewing their basic credentials, training and certifications.
Limitations And Risks
Fortunately, significant complications from nonsurgical fat reduction are infrequent. Your specific risks for nonsurgical fat reduction will be discussed during your consultation.
All procedures have some degree of risk. Some of the potential complications include:
- Infection and bleeding
- Allergic reactions
- Damage to underlying structures
- Unsatisfactory results that may necessitate additional procedures
Other risks specific to nonsurgical fat reduction are outlined below:
- Temporary redness, bruising, tingling and tenderness.
- Temporary dulling of sensation or cramping.
- Small burns are extremely rare but have been noted with the ultrasound devices.
You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your nonsurgical fat reduction treatment.
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