Liposuction surgery remains the gold standard for fat removal for those looking to rid themselves of localised pockets of fat. However, as the demand for non-surgical treatments in all areas of cosmetic enhancement has grown, technology has kept pace and today there are a number of non-invasive body contouring systems designed to smooth contours with minimal downtime.
While liposuction surgery offers an effective and predictable method of removing fat deposits, non-surgical body contouring provides an option for those who are deterred by the thought of invasive surgery, its associated risks and recovery time.
Although non-surgical body contouring devices offer an effective means for achieving a more streamlined body shape – commonly targeting treatment areas such as the abdomen and thighs – it’s worth remembering that no non-surgical device can achieve the level of fat removal possible with liposuction.
Indeed, neither liposuction nor non-surgical body contouring techniques should ever be seen as an alternative for healthy weight loss, and neither is suitable for overweight and obese patients. Rather, the best candidates for liposuction surgery and non-surgical body contouring are in good health, with skin that has sufficient elasticity to allow for optimal results. Most patients will present with small to medium fat deposits in localised areas that are impervious to diet and exercise and many non-surgical devices call for a minimum depth of fat in order to achieve good results.
A key difference between liposuction and non-surgical body contouring devices is the number of procedures required. Most non-surgical devices require a minimum of three treatments in order to achieve optimal results, and often it can take longer before those results are seen, as the fat cells take time to be metabolised through the body’s usual processes.
It’s therefore important to have realistic expectations of what non-surgical body contouring can achieve, both in terms of the amount of fat that can be targeted, and the length of time it will take to see results.
Usually, anaesthesia isn’t required for non-surgical body contouring and treatments are performed in an in-office setting. There is normally no downtime, minimal patient discomfort, and complications are rare. In conjunction with a healthy diet and exercise regime, results should be long lasting because, just as with liposuction, when fat cells are permanently destroyed they will not return.
As developments in non-surgical body contouring continue, it’s easy to become confused by the wide range of devices and technologies on offer. Most devices harness some form of energy – be it radiofrequency, ultrasound, laser or freezing temperatures – to penetrate the skin and break down underlying fat. As with any technology, there are pros and cons for each method and it’s important to research which device best suits your needs before proceeding.
It’s also important to make the distinction between devices designed to break down fat, and those which result in skin tightening or cellulite improvement. Some devices will offer one of these elements, whereas others might offer a combination. Here, we summarise the main technologies that underpin the most popular non-surgical body contouring devices available in Australia.
Radiofrequency body contouring
This non-surgical treatment uses radiofrequency (RF) energy to reduce the look of cellulite and fat. The energy is emitted via an applicator through the skin without damaging the outer layers, only targeting the underlying fat and tissues.
Treatment typically takes about one hour and patients generally experience a warm to hot sensation around the target area during the procedure. The heat generated from the RF energy causes microscopic changes to tissues and collagen fibres, with further collagen remodelling occurring over the subsequent months following the procedure. The broken down fat cells are drained via the lymphatic system and then excreted as urine.
Localised fatty deposits such as on the abdomen, hips and thighs are most suited to RF body contouring treatments, with patients also noting a reduction in the appearance of cellulite. Temporary side effects may include temporary swelling, redness or bruising around the treated area, which normally disappear after a week or so. Depending on the device being used, results can be observed after a single treatment, although a series of treatments is usually recommended for significant results. The patient will gradually notice changes such as circumferential reduction of the treated area, a reduction in cellulite and a more streamlined body shape.
There is also a variety of machines that combine RF energy with other light-based technologies to more specifically target and treat a range of aesthetic needs – from skin tightening to cellulite reduction.
Ultrasonic body contouring
Ultrasonic body contouring treatments use targeted ultrasound frequencies to break down fat, particularly on the abdomen, hips, thighs and ‘love handles’. The best candidates are close to their ideal weight but have stubborn areas of localised fatty deposits that do not respond to changes in diet and exercise.
The focused ultrasound waves are delivered in short bursts of energy, or pulses, to destroy fat cells while leaving surrounding tissue, nerves and blood vessels unaffected. The ultrasound waves create a cavitation effect in the target fat cells – a process where the fat cell membranes are damaged with each pulse of energy so that the contents of the fat cells (triglycerides) are dispersed and processed by the body. The fat cell contents are then flushed out by the body’s lymphatic system.
Generally, a series of treatments per area achieves noticeable, measurable results, although some patients note a circumferential reduction in the area after the first treatment. It can take around four weeks for the final result to be visible as the body gradually eliminates the fatty debris.
Some devices use an applicator with suction to aid the lymphatic drainage system and directly deliver the ultrasound energy to the underlying fat layer, which draws the target area upward into the applicator. The treatment is generally considered to be pain-free, with some patients experiencing slight discomfort related to the suction action. Side effects are uncommon but may include some temporary redness or mild swelling. There is no recuperative period, although the patient should maintain a healthy lifestyle to preserve and optimise the results.
Laser body contouring
Low-level laser has recently been introduced to Australia as a convenient means of reducing circumferential body weight and, when combined with lymphatic massage, improving the appearance of cellulite.
Low levels of laser energy are thought to create a chemical signal in fat cells, breaking down the stored triglycerides into free fatty acids and glycerol and releasing them though channels in the cell membranes. The fatty acids and glycerol are then transported around the body to the tissues that will use them during metabolism to create energy. This process of fatty acid release is a natural response of the body when the body needs to use stored energy reserves, and essentially mimics the body’s natural response to exercise. The technology therefore doesn’t affect or damage any surrounding structures such as skin, blood vessels and peripheral nerves.
After treatment with low-level lasers, patients are recommended to complete a short period of exercise in order to eliminate the free fatty acids from the body.
A course of eight treatments over four weeks is typically recommended. The total time spent under the laser per treatment is around 20 minutes, and most patients can expect a reduction of around 5cm total circumferential reduction (measured across three points on the body) after a single treatment.
Adding vacuum massage enhances the removal of released fat cell contents and optimises the absorption of infrared laser in the dermis to promote collagen growth and enhance blood circulation in the area. The result is tighter skin with an improvement in the appearance of cellulite.
Cryolipolysis
Cryolipolysis uses almost-freezing temperatures to kill fat cells without traumatising the surrounding tissues or harming the skin. Known in Australia as CoolSculpting, the treatment is most suited to patients of average weight with pockets of fat which don’t respond to diet or exercise.
A gel drape is placed onto the target area to protect the skin before the applicator head is placed onto the fat pocket, where it remains for approximately one hour. The applicator acts like a vacuum to suck the area into position and direct the cold temperature to the target fat cells under the skin.
Patients experience a gradual cooling sensation, similar to placing the area in iced water, but this subsides as the body gets used to the change. The initial suction may be uncomfortable depending on the laxity of the skin, but any discomfort usually subsides about 10 minutes into treatment. Post treatment, the target area feels stiff and cold, appearing squarish as if still moulded to the inside of the applicator. This can look strange immediately after the treatment, but it subsides after about 30 minutes as the skin and underlying tissues soften back to room temperature. Generally, at least two to three treatments are recommended.
The results of cryolipolysis take at least a couple of months to appear, depending on the size of the area treated, so it is important that patients do not expect immediate results.
Injection lipolysis
Injection lipolysis is most frequently performed with injections of phosphatidy-choline (PPC) and sodium deoxycholate (DC), but a variety of other agents are also used. It involves a series of micro-injections directly into the target fat to break down the walls of the lipocytes, or fat cells. They are broken down into triglycerides (free fatty acids) which are then carried to the liver where they are converted to glucose and burned off during exercise.
The areas treated may be red initially and while the procedure does not require any sedation, topical anaesthetic cream can be applied to minimise any stinging sensation. Generally a series of treatments is required for optimal results.
While not a form of weight loss, injection lipolysis can achieve a noticeable circumferential reduction in the treated areas for some patients.
Endermologie
Originally developed as a rehabilitative treatment for damaged tissue, endermologie uses intense massage to loosen stiff, connective tissue for improved circulation and lymphatic drainage to the area.
During treatment, the patient wears a protective body stocking while the practitioner applies a device with a combination of rolling and suction to areas such as the thighs and stomach. The massage aims to deeply stretch the dense fibre complex attached to pockets to fat, which causes cellulite under the skin, releasing toxins and excess fluid.
