There are currently two FDA-approved devices for non-surgical body contouring. One uses a cooling technology (cryolipolysis, Cool Sculpting™) that reduces the superficial layer of fat thickness by approximately 25%. The second one uses high-intensity focused ultrasonic energy (HIFU, Liposonix™) to destroy fat and tighten the collagen within the mid-level fatty tissue. Both of the devices take approximately 12 weeks to produce an outcome following a treatment.
First, the ideal patient for this type of treatment is an individual with a normal weight, who has good skin tone and realistic expectations for this type of treatment. Patients must understand that their outcome from a non-surgical procedure will be more subtle than surgical lipoplasty, but without the need for a surgical procedure, anesthesia, and the downtime for recovery.
While both devices can produce improvements in body contour of the flanks and abdomen, there are differences in the technologies and the time required for treatment. Each device targets different layers of fat and it’s important to know what level is being treated. “The differences between the two technologies is substantive”, says Dr. Jewell, who was the Principal Investigator for the pivotal study that led to the FDA approval of the Liposonix device in 2011. Dr. Jewell has authored approximately 5 other peer-reviewed scientific publications on the use of HIFU. While cryolipolysis will improve body contour, this is produced by diminishing the superficial fat layer by 25% and does not tighten collagen layers. Additionally, cryolipolysis affects sensory nerves and noxious sensory nerve irritations have been reported following cryolipolysis treatments.
The Liposonix device targets the mid-level fat and collagen layer with HIFU energy to destroy fat and to tighten collagen in order to produce an “internal shrink wrap effect” to improve contour. This procedure uses lower energy levels of HIFU than used in the research studies to improve patient comfort and produce a good outcome. A diagnostic ultrasound examination gives the best determination of fat layer thickness and what technology will work best, versus relying on imprecise “pinch an inch” approaches to determine the best way to improve body contour.
Dr. Jewell has done much to advance the “science of fat” with regards to having specific scientific approaches to improve body contour with the non-surgical Liposonix, Vaser ultrasonic liposuction, or the lipoabdominoplasty. He has developed both Liposonix and Vaser devices, and has been one of the first to introduce the lipoabdominoplasty to US plastic surgeon. Dr. Jewell believes that each patient seeking body contour improvements needs an individualized approach, based on objective data that will produce the best outcome. To this extent, he utilizes diagnostic ultrasound to measure fat layers in order to determine which of these technologies will be selected.
With regards to the Liposonix device, a comfortable 1 hour treatment generally will result in the loss of 1-2 inches of waistline circumference. Surgical liposuction allows the option of greater and more rapid improvements in body contour, but with the need to a surgical procedure, anesthesia, and recovery time afterwards. The lipoabdominoplasty combines both liposuction of the abdomen and flanks with a surgical procedure, tighten the looseness in the abdominal wall and remove excess skin. This is the most invasive of the body contouring procedures, but will address excess skin, abdominal wall laxness after pregnancy, and reduction of fat all at the same time.