Newman, MD Plastic Surgery
870-425-6398
870-425-6398
CoolSculpting, Liposuction, Tummy Tuck and other "GUT" decisions...
CoolSculpting is the only FDA approved non-invasive device for PERMANENT fat removal. Newman, MD Plastic Surgery has been offering this exciting technology since April of 2011 with very impressive results. The reason that we have had impressive results is because we examine the patient and are able not only offer the full spectrum of body contouring options, but the knowledge to know the limits of each to help you decide which choice is best for you! Dr. Newman also remains current in examining the other new technologies and can help you weed through the confusion of marketing hype vs real results.
The three main options are from least invasive to most invasive: CoolSculpting, Liposuction, and Tummy Tuck (aka Abdominoplasty).
CoolSculpting's biggest benefit is by far the non-invasiveness, minimal downtime aspect. The procedure is done in the office with no pain medicine required. Though there is an initial intense pull from the suction of the device, the cooling quickly takes effect and the remainder of the procedure is quite comfortable. The procedure takes an hour per area. The middle of the abdomen, the love handles, muffin tops, flanks, and bra rolls have the best result if there is enough to grab but not so much it can't be pinched. We have also had success with the banana role (at the lower buttock), inner thighs, and male chest. There are two sizes of the device which can be used per area. The larger size costs $1500, the smaller costs $800. The correct size necessary depends on the examination.
The quoted results are 20-25% permanent reduction and we are certainly seeing that. Keep in mind this only includes the area that is treated. Also additional treatments would could also be expected. The best results are going to be patients within 10-20lbs of ideal body weight with good skin tone with localized fatty deposits. A healthy diet and regular exercise that are already a stable part of your life will allow you to continue to benefit, but are not part of how CoolSculpting works. This is literally spot treating fat, something sit-ups simply cannot do. It is an excellent option because the no down time, means you can have it done, then go workout, go back to work, whatever you like. As to be expected, the treatment is not a green light for excessive eating and sedentary living as what fat is not destroyed can infinitely hypertrophy and the long term benefits would then not be appreciated. Patients with large fatty deposits, spread out fatty deposits, large rotund bellies with internal abdominal fat, and those with extra skin do not benefit well from CoolSculpting.
The other non-invasive options do not even come close at this point, relying heavily on marketing hype and gimmicks to entice the consumer. This includes low level laser energy which does not even penetrate the skin, radio-frequency technologies, externally applied creams, etc. Many of these therapies rely heavily on diet restrictions and exercise which are essential to weight loss, but do not spot treat problem areas.
The next least invasive option would be Mesotherapy which includes a recently popular procedure with fat dissolving fluid placed by injecting chemicals such as sodium deoxycholate. This liver enzyme helps dissolve fat and the body excretes it. It was difficult to control, the injections were extremely painful, the tissue reacted sometimes quite violently, and lumps of scar tissue (granulomas) were left behind. Though the marketing hype was intense and many non plastic surgeons were financially scouring their communities, fortunately this treatment has fallen out of favor.
The next option for body contouring is Liposuction (aka suction assisted lipectomy). Liposuction is done by making small incisions and using a suction cannula removing the fat. The most benefit of fat removal can be done this way for the most different anatomical areas. This is not however considered a weight loss procedure and though it is done through small incisions IS definitely invasive. Current techniques are done to make the procedure more comfortable, more effective, and have less complications. Different technologies can be used to help make the removal of fat easier for the
the surgeon. This includes lasers, ultrasonic, radio-frequency, power assisted, power washed, etc. Each of these companies would like the patient to think that the technology is better, safer, lease invasive, etc. This has not ever been scientifically proven and simply is not true. (In fact studies have shown few plastic surgeons use the laser lipo devices and those that do, most only do it for the marketing angle.) The use of tumescent fluid and a "super wet" technique is done for comfort (because the fluid contains local anesthetic), for less bruising and bleeding (because the fluid contains epinephrine), and for safety of the tissues as it relates to the heating of the tissues using either a laser or ultrasonic probe. Small amounts of this can typically be tolerated without anesthesia, larger amounts benefit greatly from sedation and general anesthesia.
The benefits of liposuction include the greater ability to contour and remove larger areas of fat. In addition fat can be harvested and a certain amount can be reinserted in some areas to improve areas of fatty deficits. The drawbacks are the recovery time and the cost is more because of the operating room and anesthesia necessary. Safety is key, this procedure is not without complications and should only be done by properly trained physicians. A patient should strongly consider the physician and their credentials. Dr. Newman, specifically trained in the procedure with a residency in Plastic Surgery followed by board certification by the American Board of Plastic Surgery, the only American Board of Medical Specialties recognized board for Plastic Surgery of the entire body and face. A garment is typically worn for several weeks as well. Downtime varies per person and per area, but is not insignificant in even the smallest of areas treated. Return to full activities generally takes a couple of weeks. Liposuction remains a poor choice when extra skin is the problem. Excess skin and patients with poor skin tone do not benefit from fat removal without skin excision.
Finally abdominoplasty, aka abdominal lipectomy, aka tummy tuck, is the procedure of choice for skin redundancy of the abdomen. Frequently this will be used along with liposuction of the flanks for contouring of the trunk. The benefits are readily apparent with a tight abdominal wall and removal of excess skin and fat. The drawbacks are the downtime, the cost, the pain, the scarring, the potential for complications of either the anesthesia, the recovery, or the scarring. That being said frequently this is the best procedure for the patient's wishes and is well worth the risk. For the rotund abdomen with intra-abdominal fat (it can't be pinched on the outside with the abdominal muscles tight) can only be treated with weight loss. Again, a tummy tuck is also not a treatment for weight loss. However, in the right patient, It can be a great boost to someones overall appearance and self confidence. Recovery time is typically 4-6 weeks, though return to work and most activities is within a couple of weeks.
Finally, frequently I am asked about weight loss options, as any of the above results can certainly be improved or sometimes made possible by weight loss. I recommend starting with your primary care physician. General endocrine issues can certainly play a role as can other treatable medical and psychological conditions. There then remain many options for diets as well as physical conditioning. Your primary care can help determine if you are healthy enough for certain activities and the safety of dietary and medicinal therapies. Perhaps a referral should be made to a bariatric surgeon who specializes in stomach surgeries to decrease the ability to take in calories either by restriction or absorption.
I would certainly be very careful proceeding with the latest fad therapy administered by either a medical spa or a greedy physician who does not thoroughly examine, work-up, and monitor your progress.
I sure hope this helps educate and help with your decision making process!
Dr. Adam Newman
Newman, MD Plastic Surgery
Mountain Home, AR
870-425-6398 (NEWU)
