But, don’t expect miracles, especially following the July 2017 public report indicating that more than 70 percent of adults in the United States are either overweight or obese.
Research generally concludes that nonsurgical cosmetic techniques to remove fat cells are mildly to moderately successful, but “they are not a substitute for healthy diet and exercise,” warns Dr. Morales, who is also an clinical instructor of dermatology at Mount Sinai in New York City.
“The ideal candidate for these procedures is a person who is at, or close to, his or her ideal weight, but cannot get rid of unsightly accumulations of fat in certain areas of the body, despite best efforts,” Dr. Morales explains. “Body toning is not intended to help one lose weight. For the person who is overweight or obese, science has yet to concoct a magical potion that can melt away the fat. Only lifestyle changes will do that.”
Next to skin-tightening, the demand for cosmetic body-sculpting has risen dramatically during the past several years. A review article published in October 2016 in the International Journal of Endocrinology & Metabolism indicated that noninvasive body-contouring techniques represent one of the fastest-growing areas of aesthetic medicine. And, the American Society for Aesthetic Plastic Surgery has presented data showing a more than 521 percent growth in nonsurgical body-contouring procedures during the past 20 years.
The popularity of these procedures is rooted in many people’s general insecurity about their body aesthetics, Dr. Morales says. Studies have indicated that improved body aesthetics enhance self-esteem, self-image and even social performance.
The basic premise underlying contouring techniques is to tone specific areas of the body by disrupting and destroying the fat cells there. The body then eliminates these dead cells naturally over time through the lymphatic system.
“Some people may have a genetic predisposition for developing fat pockets in certain areas -- like the thighs, the upper arms or the abdomen. No matter how active they are, no matter how healthy they eat, they just can’t seem to get rid of the bulges,” Dr. Morales says.
To accomplish fat-cell destruction, health practitioners now have at hand a variety of noninvasive tools – all approved by the federal Food and Drug Administration. These include cooling devices (like CoolSculpting®) to freeze the fat, radiofrequency energy (Vanquish®, for example), high-intensity ultrasound waves (Liposonix®), and lasers (such as SculpSure® and Zerona®).
Although multiple treatments are usually required to achieve desired toning goals, these fat-eliminating techniques can be performed in a short period of time, without anesthesia, with minimal side effects, but with visible results that can enhance self-image, Dr. Morales says.
So, what’s not to like?
First, few comparative investigations have been done to show clearly what technique will have the best results for which patient. Author of an Aesthetic Surgery Journal article opined in March 2015 that “not much in the way of high-level evidence [is available] to support the use of any of the noninvasive body contouring devices” and that few comparative trials have been performed “to demonstrate the effectiveness of one technology over the other.”
Secondly, “success does not always breed success,” Dr. Morales said. “Unless someone who has achieved a desirable result commits to a healthy lifestyle – good nutrition and exercise, the fat will return.”
That’s because only a small percentage of fat cells are removed from treated areas. Fat tissue remains throughout the body, including underneath the skin and at the tops of the kidneys. Fat is also stored in the liver and muscle. As people gain weight, fat cells simply grow larger, storing greater amounts of a person’s unspent energy.
For those considering nonsurgical body toning, Dr. Morales offers this advice:
- Consult with a physician before undergoing any procedure.
- Manage expectations. Know that nonsurgical approaches are intended to trim only an inch or two of unwanted fat from specific areas. They are not weight-loss tools.
- Understand that desired results are not immediate, and multiple treatments may be needed.
- Check your health insurance plan to determine what, if any coverage, is provided for these toning procedures
- Adopt a healthy lifestyle. Otherwise, the body improvements achieved will be temporary at best.
Romeo Morales, M.D., F.A.A.D., is a board-certified dermatologist and member of the American Academy of Dermatology and specializing in medical and surgical dermatology.
Advanced Dermatology, P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. www.advanceddermatologypc.com.