Wouldn't it be great if someone could wave a wand and make pounds of fat disappear?
You know that's a dream. For most of us, weight loss is going to come down to the basics: Eat less and move more. There's no magic way to get out of a fat suit.
But for those areas that just don't respond — how do you exercise away that strip of flab on your back above your bra? Who's got the moves to make love handles disappear, or that poochy tummy that won't go away? — we've looked into a couple of medical treatments that offer hope without general anesthesia or the long downtime of more extensive plastic surgery.
These procedures — one new, one that's been around for a few years — don't remove a lot of weight. They are not cheap (insurance doesn't cover them), and they don't offer instant results. But they can be a finishing touch at the end of a weight-loss regimen, or an inspiration to keep you on track.
Cool fat away
A new machine called the Zeltiq cryolipolysis device (www.zeltiq.com) cools fat cells in small areas so they shrink and can be eliminated naturally from the body. Zeltiq Aesthetics introduced the device last year and has an application for approval pending before the Food and Drug Administration. Meanwhile, it's legal for doctors to use the device for fat reduction since it has been approved for skin cooling during dermatological treatments.
"This is not for the obese," says Dr. Elizabeth F. Callahan of SkinSmart Dermatology in Sarasota, one of 11 physicians in Florida and two in the greater Tampa Bay area who offer the cool sculpting procedure. "It's for someone who's got a little patch or bulge of fat they can't get rid of."
A cold gel pad is applied over the area in question and a vacuumlike device is placed over the pad, pulling the skin taught. The vacuum's cooling plates chill the fat for about an hour, during which the patient lies in a comfortable chair and can read, watch television, nap, check e-mail.
Harvard researchers discovered that "fat cells are uniquely sensitive to cold," Callahan said. The chilling permanently destroys the fat cells, which the body then disposes of through the liver just as it processes the fat you eat. The company claims the procedure can reduce the fat layer by 22.4 percent after one treatment. Once the fat cells are gone, they're gone. But keep overeating and new fat will deposit itself somewhere else.
Patients will feel the chill, but it's tolerable.
"It grabs hold real tight of your fat and pulls on it," said Laurie Solliday, 56, of Sarasota, who underwent the procedure recently to eliminate a roll of flesh above her navel. "It's not uncomfortable. It was maybe a 2 on a scale of 10, and that's pushing it."
When the device is removed the patient discovers what looks like "a cold red hunk of butter," as Solliday put it, under the skin in the treated area. The lump disappears quickly, and the mild redness and puffiness dissipate quickly, typically with no discomfort. But it's not a quick fix; results show within two to six months.
Solliday's tape measure showed she'd taken off about an inch and a half less than two months after the procedure. "I'd do it again in a heartbeat," she said.
Dr. Callahan estimated the cost at $500 to $900 per treatment; the number needed depends on the area being treated. It works well on love handles, back fat, inner thighs and the tummy, she said.
Lipo the 'smart' way
Another way to sculpt and reshape problem areas without major surgery is SmartLipo, a procedure that's been around for several years now. This form of liposuction is done under local anesthesia — the patient is awake and alert throughout — and the fat is suctioned out through very narrow tubes, perhaps as thin as a strand of angel-hair pasta. Under standard liposuction, the patient is fully anesthetized and the physician uses larger tubes to suction out the fat.
SmartLipo incisions are tiny and, its advocates say, there is less pain and virtually no downtime, unlike conventional liposuction, which may require a recovery period of days or weeks. It's also less expensive.
"Almost every area of the body is possible to do," says Dr. Thomas Su of Artistic Lipo Sculpting Center in New Port Richey. "The arms are pretty common, thighs, legs, waist, love handles, the fat pad on the back."
Su often has a patient stand up during the procedure so he can be sure that his suctioning, sculpting and shaping are creating the desired effect. "The goal is to get it smooth and even so it looks nice and there are no irregularities."
Su infuses the area to be worked on with a mixture of saline solution and lidocaine, an anesthetic. When the area is numb, he uses those narrow tubes, or cannulas, to break up and suction out the fat. The trademarked SmartLipo system uses a tiny laser to melt the fat, but Su doesn't. "I don't think it adds any benefit to the overall removal of fat," he said.
After the procedure patients wear an elastic compression garment for several weeks to help additional saline solution drain, to hold the skin firmly while it reattaches to underlying muscle, and to reduce swelling. A procedure may last from two hours to as much as five or six, depending on the area being treated. (You won't be doing this on your lunch hour.)
Ed Beaulieu, 60, of Spring Hill, always wore a baggy T-shirt at the beach or the pool. He had enlarged breasts (a condition called gynecomastia) and took more than his share of ribbing and cruel jokes. A few months ago he underwent SmartLipo treatment by Su to reduce his chest. "I'm not self-conscious anymore," he reports.
The procedure took about two hours, he said, during which he could feel the tubes pushing inside him. "Sometimes I'd feel a pinch, but it was tolerable," he said. He was able to drive himself home afterward and had one minor black-and-blue mark.
Pat Rodgers, 50, of Lutz, says she asked Su "to get rid of the areas I couldn't change by dieting." After undergoing the procedure on her stomach and hips, "I look like an hourglass," she said. "I have nice curves now." Inspired, she's dieting, exercising and working with a personal trainer to shed more weight.
SmartLipo won FDA approval in 2006; you can find doctors who offer it at www.smartlipo.com.
A "wrap" like Rodgers had costs between $6,000 and $7,000, Su said; smaller areas, in the vicinity of $3,500 to $4,000. Upper or inner thighs might cost $2,000 to $2,500; chin, $2,000 to $2,500.
Expectation management is a big part of the treatment, Su said. "Most people say, 'I'm not 25 anymore, I just want to look better in my clothes.' They don't expect to look 25 again."
Judy Stark is a freelance writer in St. Petersburg.