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Noninvasive Body Contouring

Noninvasive Body contouring: Trusculpt, Cool sculpting, Venus Freeze, Velashape, Excilis, Vanquish, Vasershape, Apollo, Zerona

There are so many nonsurgical options for body contouring it will make your head spin. In fact, for all I know by the time I finish typing this blog another company will maybe bring a new device to market. Of course market is the key word here for unfortunately so much has to do with marketing, and less at times with science or results; it’s very tough for patients to sort out the differences between these technologies. Individual offices may choose one or two options to offer patients based on their belief in what works best in there hands, or what fits best for their market. As a plastic surgeon there is the genuine advantage of offering several noninvasive options, but also knowing when surgery or liposuction truly is in the patient’s best interest.

So what are these various technologies and how do they work. First of all every device listed in the title works to some degree or another, some are more aggressive, some less so. Remember all are noninvasive treatments that don’t have the control or power of liposculpting the body, but for many of our patients that is the point. Patients frequently want a non-surgical option with no down time that can greatly improve their body shape without recovery time; just be sure you remain realistic about what these noninvasive body contouring devices can and can’t do.

Trusculpt made by Cutera is a radio frequency (RF) energy source for tissue heating. Radio frequency(RF) is a type of energy generation that passes through tissue and the natural resistance of fatty tissue makes it heat up the fat causing it to “melt away” over time. “melt away fat” is a bit of a misnomer, but gives a good image. What really is happening is the focusing of the heat energy into the fat causes a little bit of damage to the fat cells from the radio frequency energy where the trusculpt is applied. The body slowly “cleans out” and removes the injured fat cells by a mechanism called apoptosis. The best way to explain apoptosis is to realize the body naturally is cleaning up damaged cells in our bodies all the time. There is significant turn over of cells in our liver, our skin, our bowels as examples and the body naturally cleans stuff up through inflammatory mechanisms. We don’t grow new fat cells (unlike the liver or skin) after puberty so once the injured fat calls are removed by apoptosis they are gone for good. So if you trusculpt your abdomen and flanks a couple times over the next few months the tissues will thin out as the body naturally removes the injured fat cells. Another advantage of the trusculpt and radio frequency energy is that it is well documented to help tighten lax skin. Radio frequency has been used for many years as an energy source for tightening facial skin; modifying how the energy is delivered by the trusculpt lets the device decrease fat and tighten the skin at the same time. The patient get two advantages at one time. Several devices listed in the title use radio frequency energy sources to help with body contouring. Each company will tweak the way the energy is delivered such as mono-polar, bi-polar, or tripolar energy delivery. I don’t wish to get into all of the energy physics of polarity in this blog, just think of radio frequency (RF) as a way to heat the fat to injure the cells to allow for apoptosis. Some devices like Velashape will add some vacuum and infrared, Excilis with RF and ultrasound, or Venus Freeze uses multipolar RF and magnetic field energy to do the job. Vanquish is another new device coming to market that drapes over your abdomen to try to treat that abdomen and flanks at one time, but the down side is it can’t be used in other body areas and doesn’t heat enough to tighten skin like the trusculpt might with it’s greater tissue heating.

As I mentioned all devices can work to some degree so why did we choose the options we have. The trusculpt is one of our options and we chose that for several reasons over some of the other RF devices. The trusculpt can get solid results with only  two or three treatments, where many of the other devices can require 6 or more treatments to accomplish the same thing. Many patients just can’t take time out to visit the office that often to see results. Also, patients in our experience like to se results progress more quickly, and if they have to do 6 or more treatments with some of the less aggressive devices they may be taking six months to see real results. We also love the fact that we can use the trusculpt on all areas of the body and aren’t limited to only the abdomen or flanks for example.

Cool sculpting is another body contouring device that’s been on the market for a number of years now. Cool sculpting works by chilling the tissues rather than heating them. The cold injury to the fat, like heating the fat, can cause damage to the cells that leads to apoptosis just like heat damage can. The same process makes the body clear the injured fat cells and the treated area gets thinner over the next few months. Like radio frequency, the cool sculpting definitely works, it’s down side is it requires special heads that suction your tissue into the head and than it freezes the area with cold. The heads only fit certain parts of the body well so it’s limited in how many body areas can be treated. Also up to 10% of patients can have a sudden neuralgia in deep nerves making it impossible to tolerate the freezing so they fail to get a full treatment.  The pain in the nerves doesn’t appear to be long acting, it’s just an intolerance to the treatment. Another aspect of cool sculpting that I feel makes it less useful than trusculpting is that RF is documented to assist with skin contracture and cold treatments don’t have the same documentation for that.

Some technologies use ultrasound energy to lead to cell injury and apoptosis. As long as energy can be focused in a specific direction to cause some degree of cell injury apoptosis can happen and cells removed. More energy may make more heat and give faster results with less treatments, less energy devices will not feel as hot, perhaps only mildly warm, but than may have a harder time getting the same degree of cell injury to lead to “melting the fat” away via apoptosis. Zerona is another device we have in the office for noninvasive body contouring and it is as non invasive as it gets.  Zerona doesn’t heat tissue or damage cells, it uses very low level laser energy to get cells to dump fat into the area around the fat cells which the body than clears out though lymphatic flow. While we have had patients get definite results from the Zerona we do find it less reliable in all patients however so we like to use it in concert with other treatments to further augment our results. I hope this gives a little back ground on non invasive body contouring, feel free to contact us via the internet or at 520 575-8400 if you want more information or to schedule an appointment.

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