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   It seems like every time we turn around, we are presented with more choices for removing the fat cells that are taking up way too much room in our bodies. Constantly changing technology is also changing the terminology. We now have liposculpture, cryolipolysis, laser lipolysis, radiofrequency lipolysis, and so on. Each of those technologies has different trade names from different manufacturers, many of which are somewhat similar, so do we need a new dictionary, or what?

    Dr. Roque Ramos of Slim Image has performed many types of lipolysis. “External, or non-invasive, lipolysis is based on helping fat cells release their fat into the interstitial space between the fat cells, when it can drain into the lymphatic system and from there go to the liver for elimination. There are different kinds of lasers in use, which, depending on wavelength, reach a certain depth under the skin.” He says the LipoLaser penetrates to the depth of fat tissue and it is placed on the skin surface over the spot to be reduced. After 15 or 20 minutes of direct contact, the laser heats the fat cells, creating temporary pores in them to allow the fat to leak out and drain toward the lymphatics.

    Ramos says while companies claim you can lose a certain number of inches, it is very hard to achieve that goal, and all the systems require patients to be dieting at the same time. In his experience, any inches lost are somewhat temporary and more due to the diet than the laser, he says. “Fat cells may shrink temporarily with the external treatments, but if you stop dieting, they will come right back,” Ramos says. “The only way to permanently remove fat from an area is with invasive liposuction, either laser, radiofrequency or water jet.”

    Dr. Richard Moore of The Lifestyle Center explains several external devices that are on the market to reduce fat deposits. They are approved for different uses and have different benefits and drawbacks. The Zerona is a low-level laser FDA-approved for circumferential reduction. The person sits under it for 45 minutes and it opens the pores of fat cells, allowing the fat to leak out of cells and be eliminated by the body’s own mechanisms. The manufacturer guarantees 3 inches of girth loss or more over multiple measurements during six to 12 treatments, depending on the size of the treated area.

    The VaserShape is FDA-approved for cellulite and muscle pain, and uses ultrasound energy over a targeted area to have the same effect on fat cells with some possible destruction of cells over four to six treatments. VelaShape, also FDA-approved for circumferential reduction, uses radiofrequency waves and infrared light to create heat in the fat cells and increase metabolism of fat, causing them to shrink over a series of treatments. Another external approach, Zeltiq, uses suction and freezing to ‘frost-bite’ fat cells and make them break down, a process called cryolypolysis.

    Moore says that of all the invasive lipolysis options, the Vaser uses ultrasound energy to emulsify fat cells and break them up so they can be suctioned out. “This treatment has 80 to 90 percent less trauma and 50 percent more skin tightening than traditional liposuction,” he says. “Laser lipolysis (SmartLipo, ProLipo and SlimLipo) uses laser energy to emulsify and then suction out the fat. It’s good for small areas like the neck and upper arms, and also has less trauma and more tissue tightening than traditional liposuction.” He notes that all these treatments have to be combined with healthy lifestyle choices. They are not intended to replace a good diet and exercise, but they can help with motivation.