Diet and exercise are the basis for achieving and maintaining a healthy weight; but for some people, all the exercise and salads in the world won’t remove that post-pregnancy tummy paunch or those stubborn saddlebags. That’s why ‘body sculpting,’ the ability redistribute, remove or add fat to specific areas, has become increasingly popular.

“Liposuction is still a very common procedure in the United States,” says Dr. Brock Ridenour of Ridenour Plastic Surgery. “It was the fourth most popular invasive procedure with about 200,000 cases done in 2013, while those numbers are down 1 percent over the previous year (and down 44 percent from the year 2000), the decline may be due to the increasing popularity of other procedures such as breast augmentation, but it may also be due to more emphasis on diet, nutrition and exercise, as well as the realization that liposuction carries certain risks, including injuries to the skin, pain, numbness, fat embolism and contour irregularities.”

Modern liposuction is usually power-, ultrasound- or laser-assisted, notes board-certified plastic surgeon Dr. Michele Koo. “Laser-assisted liposuction uses a combination of laser wavelengths and traditional liposuction fat-cell removal,” she explains. “Fat-cell freezing and fat-cell destruction by injections have not had randomized trials showing significant results. The FDA recently, however, did approve two devices for noninvasive fat reduction and body contouring.”

One of the FDA-approved devices is known as CoolSculpting, a form of cryolipolysis, freezing fat to destroy it, says Racquel Frisella, an aesthetic nurse at Nayak Plastic Surgery. She emphasizes that all patients should have a complete consultation to determine the best plan using CoolSculpting or other options. Zerona, which uses a laser to shrink fat cells, is the other FDA-approved body-sculpting treatment.

An array of other body-sculpting procedures is available. For instance, in addition to CoolSculpting, Ridenour offers BodyFx, which vacuums skin and fat into a treatment head while warming the skin to encourage collagen production and zapping fat with radio-frequency energy. He also offers ThermiTite, in which a small probe is inserted under the skin to deliver heat. “Fat is thermally destroyed and slowly resolves over the next few weeks,” he says. “The attachments between the fat and overlying skin are also tightened, which may improve some patients with cellulite.”

Despite the many options available, Koo still prefers the tried-and-true. “My personal preference for body sculpting is combination ultrasound with superficial liposuction for true fat removal and significant body contouring. If you only have very little subcutaneous fat, you are a candidate for one of the other noninvasive techniques,” she says.

Koo advises anyone interested in body sculpting to review before-and-after photos of patients with similar body shapes, and to speak with former patients to determine if that approach is the correct one for them. “Not all body contouring devices are the same,” she says. “It’s not the device that makes the difference in the results—it’s the operator that will make the difference.”

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