Are There Alternatives to Liposuction?
05/19/2010
Are There Alternatives to Liposuction?
By Dr. Juris Bunkis
Q: I am a fit 54 year old, have had a face lift and look good
for my age, but I have a few fatty deposits over my hips and
cellulite that don’t go away with exercise and are driving me
crazy. I have heard of nonsurgical fat removal – is there any
way, shy of having liposuction, which will remove my cellulite
and fatty deposits?
A: First of all, congratulations on being fit at 54 and for
caring how you look! General health wise, there is nothing
better that you can do for your body than to keep fit and to
keep excess weight off!
In order to answer your question, I’d first like to give you
some background about fatty deposits and cellulite. We all have
fat within our bodies, some fat is necessary, but too many of us
have an excess of fat. Our body needs energy to survive, and
that energy comes from what we eat or drink. No matter whether
you are consuming protein, carbohydrates or fat, the body breaks
down the food you take in into tiny molecules. The body uses
what it needs to survive, and all of the excess, no matter
whether it started as protein, carbohydrates or fat, gets
converted by the liver into fat. This fat is transported by the
blood to fat cells throughout the body for storage. On days when
you do not consume as many calories as are needed for survival,
the stored fat gets returned to the liver where it is
re-manufactured into usable parts throughout the rest of the
body. We all know that fat is stored in different ways and
places in different people. Women tend to store their excess fat
over the hips, thighs and in the external layer, between the
skin and muscles, over the abdominal wall. Men tend to store
their excess abdominal fat internally, around the intestines, as
well as externally over love handles and the chest.
Cellulite refers to the surface irregularities seen over the
thighs, hips, and buttocks of almost all women, and is rarely
seen in men. Men and women store fat differently under the skin,
men more in horizontal layers with a smooth surface, while women
store the fat more in a perpendicular manner, which leads to the
objectionable surface lumpiness.
Now that we understand about excess fatty deposits and
cellulite, let’s discuss what can be done to improve cellulite
or remove unwanted fatty deposits. Let’s start with cellulite.
There have been many, many treatments varying from home
remedies, commercially available creams and ointments, wraps,
garments and machines that have been promoted as providing cures
for cellulite. It has also been claimed that caffeine, through
its ability to constrict blood vessels, can make your skin
appear tighter and improve cellulite.
I well remember when, about 20 years ago, Endermologie® was
introduced, received a lot of interest from the press and
doctors were lining up to purchase these $150,000 machines.
These machines basically used rollers that the company claimed,
sent a message to the cells, triggering actions such as fat
break down and collagen production. The company claimed that
cellulite was removed and inches would come off the treated
areas. Multiple treatments were required. After any one
treatment, the cellulite did seem to improve, probably from the
swelling caused by the localized trauma, but unfortunately, a
month later, when it was “time for another treatment”, all the
cellulite would be back in its full glory. What patients ended
up with was basically an expensive massage! This machine simply
did not live up to its claims or patient expectations.
Next came mesotherapy or Lipodissolve®, a “non-surgical
alternatives to liposuction”. Mesotherapy involves a series of
injections that may melt away unwanted small, localized areas of
fat. While the main ingredients used in these injections vary,
the chemical cocktail typically includes
phosphatidylcholine/deoxycholate (PCDC), multivitamins, alpha
lipid acid, enzymes and plant extracts. Phosphatidylcholine is
FDA-approved to break down blood fats that may increase risk for
heart disease, but it is not approved for injection or any other
purpose. Use of this substance to dissolve superficial fat is
performed in an off-label manner. During these treatments, your
doctor injects the chemical cocktail into the fat layers. The
injection is relatively painless, with no need for anesthesia.
The medication produces a chemical reaction which dissolves
localized areas of fat. Benefits can be seen within three weeks
of the treatment but proponents claim that several treatments,
four to six weeks apart, are required to produce the optimal
result. After a treatment, the patient can return to their usual
activities. Approximately 100,000 Lipodissolve® treatments have
been performed in the United States and Europe and some papers
have been written, showing post treatment improvement, but
problems remain, and because of these problems, Kansas and
Nebraska, are in the process of enacting legislation to ban
Lipodissolve®. ANVISA, the Brazilian version of the FDA, banned
the use of phosphatidylcholine-based products for injectable fat
removal, and Health Canada, the Canadian FDA, has ordered
physicians to stop marketing and administering the products. We
know that these injections can liquefy fat, but where the fat
goes is anyone's guess. Harmful deposits in the liver or blood
vessels could lead to serious medical problems including fatty
plaque and increase the risk of heart attack or stroke. The
American Society for Aesthetic Plastic Surgery (ASAPS) has
reported that infection, disfiguring masses of inflamed tissue
and tissue death can occur after Lipodissolve®. I have seen a
number of previously treated patients with indentations in the
treated sites. Ignoring the health issues, from a purely
aesthetic point of view, the main problem with Lipodissolve® is
that the results are unpredictable and that surface
irregularities are quite common. Lipodissolve® is still in the
experimental stage. Clinical studies in the United States that
look at the safety and efficacy of Lipodissolve® are underway.
This is a treatment that we would only recommend under special
circumstances at this time.
The latest nonsurgical technique which is being touted as a
magical cure for cellulite and fatty deposits is Cryolipolysis™,
using a machine built by Zeltiq, and promoting a “One hour fat
fighting treatment”. This is a new technology with very little
published information and their machine is not FDA approved yet.
From what I’ve read, probes are placed on the skin that cool the
fatty layer to about 5 degrees Celsius, about the temperature in
a refrigerator. This damages the fat cells and some will die
over the next four months. This procedure does not work on large
people, or those with a thick fatty layer because the cold
cannot penetrate more than a few cm. But for thin people with
very small fatty pockets, it might show some promise. The reason
it is not FDA approved yet is because there are questions as to
what this cold treatment does to nerves, blood vessels, skin,
muscle, etc. long term. I see similar question to those
discussed above with the Lipodissolve® - where does the fat go,
what are the health risks? I simply do not think that loosing an
inch off your hips is worth an earlier heart attack!
To summarize, simply put, nothing tops liposuction when it
comes to the removal of unwanted fatty deposits (as long as skin
laxity is not an issue – if it is, a skin resection may be
indicated).
Liposuction is the only scientifically proven method for safely
removing fat cells permanently and is the top overall surgical
cosmetic procedure performed in the United States. A variety of
different cannuals are now used for liposuction, but all are
inserted through tiny, hidden incisions and recovery after the
procedure is relatively quick and uncomplicated. If you have any
areas that are of concern to you, your best bet would be to come
in to discuss your concerns with a board certified plastic
surgeon.
About the Author: Dr. Bunkis MD, FACS of Orange County Plastic
Surgery is a Harvard trained, Board Certified Plastic Surgeon
and has 30 yrs of surgical expertise. Call OCPS at 949-888-9700,
email your questions to [email protected] or visit our website at
http://www.ocps.com for more information.
Source: http://www.isnare.com
Permanent Link:
http://www.isnare.com/?aid=532387&ca=Wellness%2C+Fitness+and+Diet
By Dr. Juris Bunkis
Q: I am a fit 54 year old, have had a face lift and look good
for my age, but I have a few fatty deposits over my hips and
cellulite that don’t go away with exercise and are driving me
crazy. I have heard of nonsurgical fat removal – is there any
way, shy of having liposuction, which will remove my cellulite
and fatty deposits?
A: First of all, congratulations on being fit at 54 and for
caring how you look! General health wise, there is nothing
better that you can do for your body than to keep fit and to
keep excess weight off!
In order to answer your question, I’d first like to give you
some background about fatty deposits and cellulite. We all have
fat within our bodies, some fat is necessary, but too many of us
have an excess of fat. Our body needs energy to survive, and
that energy comes from what we eat or drink. No matter whether
you are consuming protein, carbohydrates or fat, the body breaks
down the food you take in into tiny molecules. The body uses
what it needs to survive, and all of the excess, no matter
whether it started as protein, carbohydrates or fat, gets
converted by the liver into fat. This fat is transported by the
blood to fat cells throughout the body for storage. On days when
you do not consume as many calories as are needed for survival,
the stored fat gets returned to the liver where it is
re-manufactured into usable parts throughout the rest of the
body. We all know that fat is stored in different ways and
places in different people. Women tend to store their excess fat
over the hips, thighs and in the external layer, between the
skin and muscles, over the abdominal wall. Men tend to store
their excess abdominal fat internally, around the intestines, as
well as externally over love handles and the chest.
Cellulite refers to the surface irregularities seen over the
thighs, hips, and buttocks of almost all women, and is rarely
seen in men. Men and women store fat differently under the skin,
men more in horizontal layers with a smooth surface, while women
store the fat more in a perpendicular manner, which leads to the
objectionable surface lumpiness.
Now that we understand about excess fatty deposits and
cellulite, let’s discuss what can be done to improve cellulite
or remove unwanted fatty deposits. Let’s start with cellulite.
There have been many, many treatments varying from home
remedies, commercially available creams and ointments, wraps,
garments and machines that have been promoted as providing cures
for cellulite. It has also been claimed that caffeine, through
its ability to constrict blood vessels, can make your skin
appear tighter and improve cellulite.
I well remember when, about 20 years ago, Endermologie® was
introduced, received a lot of interest from the press and
doctors were lining up to purchase these $150,000 machines.
These machines basically used rollers that the company claimed,
sent a message to the cells, triggering actions such as fat
break down and collagen production. The company claimed that
cellulite was removed and inches would come off the treated
areas. Multiple treatments were required. After any one
treatment, the cellulite did seem to improve, probably from the
swelling caused by the localized trauma, but unfortunately, a
month later, when it was “time for another treatment”, all the
cellulite would be back in its full glory. What patients ended
up with was basically an expensive massage! This machine simply
did not live up to its claims or patient expectations.
Next came mesotherapy or Lipodissolve®, a “non-surgical
alternatives to liposuction”. Mesotherapy involves a series of
injections that may melt away unwanted small, localized areas of
fat. While the main ingredients used in these injections vary,
the chemical cocktail typically includes
phosphatidylcholine/deoxycholate (PCDC), multivitamins, alpha
lipid acid, enzymes and plant extracts. Phosphatidylcholine is
FDA-approved to break down blood fats that may increase risk for
heart disease, but it is not approved for injection or any other
purpose. Use of this substance to dissolve superficial fat is
performed in an off-label manner. During these treatments, your
doctor injects the chemical cocktail into the fat layers. The
injection is relatively painless, with no need for anesthesia.
The medication produces a chemical reaction which dissolves
localized areas of fat. Benefits can be seen within three weeks
of the treatment but proponents claim that several treatments,
four to six weeks apart, are required to produce the optimal
result. After a treatment, the patient can return to their usual
activities. Approximately 100,000 Lipodissolve® treatments have
been performed in the United States and Europe and some papers
have been written, showing post treatment improvement, but
problems remain, and because of these problems, Kansas and
Nebraska, are in the process of enacting legislation to ban
Lipodissolve®. ANVISA, the Brazilian version of the FDA, banned
the use of phosphatidylcholine-based products for injectable fat
removal, and Health Canada, the Canadian FDA, has ordered
physicians to stop marketing and administering the products. We
know that these injections can liquefy fat, but where the fat
goes is anyone's guess. Harmful deposits in the liver or blood
vessels could lead to serious medical problems including fatty
plaque and increase the risk of heart attack or stroke. The
American Society for Aesthetic Plastic Surgery (ASAPS) has
reported that infection, disfiguring masses of inflamed tissue
and tissue death can occur after Lipodissolve®. I have seen a
number of previously treated patients with indentations in the
treated sites. Ignoring the health issues, from a purely
aesthetic point of view, the main problem with Lipodissolve® is
that the results are unpredictable and that surface
irregularities are quite common. Lipodissolve® is still in the
experimental stage. Clinical studies in the United States that
look at the safety and efficacy of Lipodissolve® are underway.
This is a treatment that we would only recommend under special
circumstances at this time.
The latest nonsurgical technique which is being touted as a
magical cure for cellulite and fatty deposits is Cryolipolysis™,
using a machine built by Zeltiq, and promoting a “One hour fat
fighting treatment”. This is a new technology with very little
published information and their machine is not FDA approved yet.
From what I’ve read, probes are placed on the skin that cool the
fatty layer to about 5 degrees Celsius, about the temperature in
a refrigerator. This damages the fat cells and some will die
over the next four months. This procedure does not work on large
people, or those with a thick fatty layer because the cold
cannot penetrate more than a few cm. But for thin people with
very small fatty pockets, it might show some promise. The reason
it is not FDA approved yet is because there are questions as to
what this cold treatment does to nerves, blood vessels, skin,
muscle, etc. long term. I see similar question to those
discussed above with the Lipodissolve® - where does the fat go,
what are the health risks? I simply do not think that loosing an
inch off your hips is worth an earlier heart attack!
To summarize, simply put, nothing tops liposuction when it
comes to the removal of unwanted fatty deposits (as long as skin
laxity is not an issue – if it is, a skin resection may be
indicated).
Liposuction is the only scientifically proven method for safely
removing fat cells permanently and is the top overall surgical
cosmetic procedure performed in the United States. A variety of
different cannuals are now used for liposuction, but all are
inserted through tiny, hidden incisions and recovery after the
procedure is relatively quick and uncomplicated. If you have any
areas that are of concern to you, your best bet would be to come
in to discuss your concerns with a board certified plastic
surgeon.
About the Author: Dr. Bunkis MD, FACS of Orange County Plastic
Surgery is a Harvard trained, Board Certified Plastic Surgeon
and has 30 yrs of surgical expertise. Call OCPS at 949-888-9700,
email your questions to [email protected] or visit our website at
http://www.ocps.com for more information.
Source: http://www.isnare.com
Permanent Link:
http://www.isnare.com/?aid=532387&ca=Wellness%2C+Fitness+and+Diet
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