Which non invasive fat reduction machine?

With all of the non-invasive fat reduction machines (e.g. Sculpsure, CoolSculpting, Zerona, ThermiRF, etc) on the market, how do doctors decide which ones to use in their practice? As a patient, many of them seem like similar machines with comparable results. How do I decide which one to go with?


F, 42, Texas

For many patients who have lost weight and who simply want help shifting small localized deposits of body fat, non-invasive fat reduction technologies are an extremely appealing alternative to surgical procedures like tummy tucks. There has been a vast increase in the number of fat reduction or fat removal machines available on the market, with some fading into obsolescence and others growing in popularity.

Nowadays, non-surgical fat reduction treatments that promise to permanently eliminate fat cells are preferred over those that shrink fat cells. Technologies such as Zerona can only perforate fat cell membranes and cause them to leak, giving the appearance of shrinking. Treatments such as CoolSculpting, Kybella, truSculpt, Vanquish, and SculpSure use laser treatment, thermal manipulation and radiofrequency to target fat molecules, permanently remove them, and ultimately improve the body contour. So long as you maintain your weight, you will enjoy permanent results.

Surgeons take into consideration a range of factors when they select new non-invasive fat reduction machines for their clinics. Most critically, they research clinical studies for evidence of the efficacy of the treatment and also verify its safety by ensuring it has been FDA-approved. Some surgeons also like to try out the technologies on themselves so they can better understand its effects and any issues that may arise.

The most popular technologies among surgeons tend to be those that are most effective, like SculpSure and CoolSculpting. Both are very safe and can deliver excellent results; however, SculpSure has a lower risk of side effects, shorter treatment sessions,  and requires only one session.

It is impossible to give you a direct answer regarding which technique is most effective or which will guarantee you the best results. Each fat reduction treatment has its own unique strengths and weaknesses. The treatment or combination of treatments that is right for you will depend on your body type, the extent of the surface area you wish to treat, the area you wish to target, and how much you are willing to invest to achieve your body contouring goals.

CoolSculpting costs up to $850 per session per area but, generally, only requires two sessions. Kybella, on the other hand, may require between four and six treatments for optimal results, with a session costing $1500 per area. I suggest you schedule a consultation with a board-certified plastic surgeon or experienced technician to help you determine the most effective fat reduction technology for you.

Dr. Robert N. Young has 1 CoolSculpting before & after:

CoolSculpting before image performed by Dr. Robert N. YoungCoolSculpting after image performed by Dr. Robert N. Young

» View Dr. Robert N. Young's full profile

Non-invasive fat reduction treatments are very appealing to many patients because they virtually require no recovery time. Most surgeons offer at least one, if not more, fat loss technologies in their clinics because of this popularity. However, as you point out, from a patient's perspective, many of the machines seem to deliver similar treatments with comparable results.

Surgeons select the latest technologies for their clinics based on their experience with the product, knowledge of their success rates in peer-reviewed studies, clinical data, and whether they have received FDA approval.

While there is an extensive range of fat reduction machines, four are very popular and approved by the FDA as fat reduction technologies: CoolSculpting, SculpSure, Kybella, and Vanquish. These machines use different technologies to achieve slightly different results: for example, Kybella is ideal for addressing excess fat under the chin, SculpSure can cover a large surface area around the abdomen and love handles, and CoolSculpting can effectively treat the stubborn fat layer around the inner thighs, outer thighs, stomach, and upper arms.

CoolSculpting works on the principle of cryolipolysis, where targeted fat cells are frozen and crystallized, leaving surrounding blood vessels, nerves, and tissue unharmed. The fat cells are destroyed as a result of this process and are then naturally excreted from the body. However, because the applicator uses suction, some patients notice a demarcation between the area that has been treated and the surrounding tissue. Some patients experience mild discomfort or numbness following treatment.

SculpSure uses laser light technology to permanently eliminate unwanted fat cells in the body. The laser heats up fat cells leaving the surrounding tissue and nerves untouched. The increased heat destroys the fat cells. In addition, the treatment works deeper than the targeted area to give more natural results, so there is subtle blending between the treated area and non-treated area.

Vanquish is a radio frequency fat removal treatment. The machine creates heat which effectively causes the fat cells to rupture and die. It can also work on a larger surface than other non-invasive fat reduction treatments to address greater problem areas.

Kybella is a synthetic version of deoxycholic acid, a molecule found naturally in the body that works to destroy fat and facilitates skin tightening. It is injected into the skin and as subcutaneous fat cells are eliminated, neocollagenesis (the process of new collagen production) begins, helping to tighten loose skin and give a more youthful appearance.

Schedule an appointment with a board-certified dermatologist or surgeon so you can explain your goals. They will be able to help you determine the most suitable treatment type for your body.

This is an excellent question. Because of the increasing popularity of non-invasive treatments with minimal downtime and little to no pain, the non-surgical fat reduction market has burgeoned in recent years and has changed the face of plastic surgery. As a result, there is a large range of body-shaping devices and technologies available, meaning it can be confusing when it comes to choosing the right one.

While many of them appear to be similar, there are in fact both subtle and explicit differences between many of the machines: for example, some more than others are better equipped to target certain areas of the body, some shrink fat cells, some permanently remove fat cells through different methods such as freezing or radiofrequency, some are more painless than others, and some take longer than others to be effective or can require more sessions.

If you schedule an appointment with a board-certified plastic surgeon experienced in non-invasive fat reduction, they will be able to discuss these differences with you in detail and help you determine which treatment will be most suitable for you given your specific goals.

In truth, there are several factors that doctors and surgeons weigh when they select fat-reducing technologies for their aesthetic clinics or surgeries. One factor is their experience and understanding of the technology. A new product may come to a surgeon's attention as a result of a conference. If they’re interested, they’ll review the clinical literature or peer-reviewed data to determine its efficacy and make their choice based on that information.

If the surgeon is satisfied that patients can gain clinical benefits from the treatment, they may then either rent or purchase a machine and undergo any necessary training to gain authorization to operate it safely. For example, Allergan, the company which manufactures CoolSculpting equipment, stipulates that technicians administering the treatment must first be certified in its use to meet FDA requirements. These technicians are highly trained and experienced to ensure that the patient receives optimal results from the treatment and is safe during the procedure.

Thank you for your question. You have hit on a very hot topic. There are a number of different so called "non invasive" or "afternoon" fat elimination body contouring devices on the market. Some espouse to freeze the fat while you wait, others use laser energy to melt fat and rely in the body to absorb and eliminate the melted fat cells. For instance SculpSure uses a laser that penetrates the skin to the level of the fat, melts the fat without burning the skin, and the body eliminates the fat. Depending upon whom you ask, they work great or not much at all. As you can imagine, marketing has a lot to do with the popularity of the devices. Family practice physicians, gynecologists, dermatologists, plastic surgeons are bombarded by marketers of these devices as the next greatest thing finding the holy grail of fat loss and body contouring without work, workout, diet or any contribution on the persons part. This is particularly marketed to non surgeon physicians who are not credentialed to perform liposuction procedures in a hospital or surgery center, but can implement these devices in their own offices.

Also, keep in mind, these devices are not cheap. If a physician purchases or leases one, he or she then has to pay for it. The old adage, " If all you have is a hammer, the whole world is a nail" comes to mind.

Reviewing the medical literature, there really is not a lot of good data on these devices. Most of the studies are published by the device developers on patients that were compensated for their participation in the study, all very sketchy to the skeptical scientist.

Bottom line is, I'm not convinced. I await more stringent studies (randomized, blinded studies), that carefully look at the effectiveness of these devices.

Liposuction, on the other hand, is tried and true. You can see the fat removed and you can see the effects. Safely done in an accredited facility by a Board Certifed Plastic Surgeon, you are more likely to be pleased with the results than disappointed. Buyer Beware!!