They say a clean diet, cardio and strength training, and a good night's sleep is the secret to a sculpted body. But the truth is, genetics often has the heaviest hand. Even if you do everything "right," you may still be struggling with areas of your body that leave you feeling less confident. Body sculpting can help to reduce fat (and increase muscle) in the areas that are leaving you feeling frustrated, like an unwanted belly bulge or love handles. There are a range of options that can help you design the type of curves that feel right for you.
Here is an overview of some of the most innovative body contouring procedures available today!
EMSCULPT is a patented high-intensity focused electromagnetic energy (HIFEM), which activates the musculature to powerfully and quickly contract the muscle. The broad-coverage of HIFEM energy also induces destruction of the fat collections surrounding the treated muscles. These combined sculpting effects facilitate, on average, a 16% increase in muscle mass and a 15% reduction in fat*.
The impressive body contouring results of EMSCULPT are further enhanced by the overall treatment experience. Each pain-free session requires approximately thirty minutes to complete, during which time your muscles will have undergone thousands of contractions that are roughly equivalent to 20,000 squats or crunches. Consequently, this gentle and effective device is capable of enhancing your curves while still leaving you enough time to grab a healthy meal during your lunch break.
*Results verified by manufacturer BTL
truSculpt iD is an innovative and non-invasive fat reduction treatment that harnesses monopolar radio-frequency energy to melt fat that is sandwiched between the skin and muscle layers. Using truSculpt iD’s proprietary technology, heat is evenly distributed to the entire fat layer being treated while simultaneously protecting your skin’s surface. A single 15-minute treatment, on average, destroys approximately 24% of your fat cells in the target area. This makes truSculpt iD one of the most efficacious non-invasive fat removal devices currently on market. However, this device is relatively new and only time will tell if the long term clinical efficacy will match the impressive data presented by the initial clinical trials.
Aside from its clinically-proven efficacy, truSculpt iD treatments are tailored to the needs of each patient. Six individual handpieces allow for treatment that is customized to the individual curves of your body and, if desired, targeting multiple areas simultaneously. Efficient targeting of the radiofrequency energy leads to treatments that are shorter in duration and more comfortable than other, older body sculpting devices like CoolSculpting or SculpSure. Patients can, therefore, treat their love handles, belly pooch or banana rolls all in one short, comfortable session with minimal to no downtime. Dr. Khorasani has experience working with both the CoolSculpting and Sculpsure devices and has come to the conclusion that truSculpt iD may be more effective and is reported to be more tolerable than these older competitors.
truSculpt iD is an excellent way to get rid of fat around your abdomen and flanks, outer and inner thighs, buttocks, and upper arms.
*Results reported by the manufacturer Cutera
SculpSure® is a non-invasive method of eliminating unwanted body fat and improving your body contours using 1064nm laser technology. Similar to truSculpt iD, there is no downtime and very few reported side effects. However, patients experience significantly more heat and discomfort with this device as compared to truSculpt ID. There are very few studies published on this modality. One manufacturer sponsored clinical study demonstrated an average fat thickness reduction of 14-18%. Maximum fat reduction was seen 6 months after the procedure (Decorato et al). The procedure uses laser technology to eliminate fat cells in stubborn areas that may not respond to diet and exercise alone. The laser targets fat cells without causing damage to your skin or nearby tissues. In fact, some practitioners believe that the laser heat stimulates collagen production, rejuvenating your skin while destroying fat. After the procedure, your body gradually and naturally processes and flushes out the fat cells over several weeks.
This procedure uses state-of-the-art cooling mechanisms to eliminate fat cells in stubborn areas that may not respond to diet and exercise alone. Fat cells are sensitive to both extremes of temperatures and will self-destruct when exposed to cold or hot environments. Coolsculpting has the longest track record of all the non-invasive fat removal devices on the market. It’s efficacy has been well established in the literature. So why are companies coming out with new devices if Coolsculpting works? The main reason is the increased reported side effect profile. Paradoxical adipose hyperplasia is an unfortunate real side effect. This means that on rare occasions, patients may actually report gaining fat in the area which was treated with Coolsculpting. Dr. Khorasani has helped many patients treat this condition with Liposuction after they were initially treated at a med spa with Coolsculpting. Another reported adverse outcome is the sensation of pain immediately after the procedure and on rare occasions, chronic pain for months after the procedure. It should be noted that Coolsculpting is one of the most commonly used non-invasive fat removal treatments and the nature of these adverse events could be multifactorial. One factor could be related to the vast volume of patients treated with this modality at many med spas without the proper supervision of a board certified dermatologist.
Liposuction, or lipoplasty, is one of the most popular cosmetic procedures, and it’s been around for decades. Dr. Klein, a Dermatologic surgeon from California is considered to be the father of modern day tumescent liposuction. Like other body contouring procedures, liposuction is not a weight loss strategy. To be a good candidate for liposuction, you should be at a healthy weight for your body type and have normal elasticity in your skin — you should be able to stretch it and have it return to its natural position right away.
Liposuction removes stubborn fat that you haven’t been able to shed through diet and exercise, but it does not remove sagging skin.
While liposuction is a popular way to remove fat from your abdomen, flanks, and thighs, it can also be performed on a number of other areas, such as:
There are many types of liposuction: tumescent PAL liposuction, ultrasound assisted liposuction, laser liposuction, radio-frequency liposuction, and helium plasma-liposuction.
During a tumescent liposuction procedure, Dr. Khorasani makes very small incisions (ports) and infiltrates a solution that helps break up the fat. The solution contains anesthesia to mitigate discomfort as well as ingredients to reduce bleeding and bruising. He then inserts a small tube, called a cannula, into the targeted area and suctions out the fat with a vacuum pump.This cannula oscillates at a set frequency in order to avoid injury to blood vessels and also facilitate fat removal. This procedure is also called power assisted liposuction (PAL). There is no knife or cutting involved, and depending on the volume removed, can often be performed with oral sedation in the office.
Recovery is relatively quick for smaller areas; many people return to work in a few days, and you can get back to your normal activities in a couple of weeks. For larger volume procedures, most patients like to take at least a week off from work. After the procedure, you’ll wear a compression garment for two weeks to help reduce bruising and swelling, and you should avoid heavy lifting and vigorous activity for about two weeks.
Both procedures were initially invented in order to help break up the fat and increase the efficacy of liposuction.
In ultrasound assisted liposuction, an ultrasound probe is passed under the skin in order to break up the fat before suction is started. Clinically, the areas that benefit most from this procedure are dense fibrous areas. Few examples include: male breast tissue or patients with scar tissue in the fat from previous procedures. It is also an excellent choice for patients undergoing fat removal from multiple body parts as it helps with operator fatigue. Although it makes the suction much easier for the surgeon, it often has to be done when the patient is under general anesthesia and not well tolerated for patients who are awake. Therefore, its utility for small volume cases and other areas beside breast and scar tissue is still debatable amongst many practitioners.
In laser assisted liposuction, a fiber optic probe is passed under the skin in order to break up the fat before suction is started.
Laser lipo uses laser heat to literally melt your fat, making it easier to suction out. It also has several other advantages. Laser lipo typically causes less bruising since it shrinks the blood vessels in the treated area. A decade ago when it first gained popularity, it was postulated that the laser stimulated the skin to produce more collagen and therefore contributed to some skin tightening. At the time, the most impressive study was done by Moy et al and others which showed a 16% skin tightening effect on the arms. The same efficacy was not seen in other body parts.
As a consequence, the efficacy of Laser lipo has been questioned in literature and among the leaders in the field. Although, in the hands of a selected few, it may still show impressive results. However, that is not the experience of the majority of the leaders in the field. Due to its lack of efficacy, unnecessary costs, and occasional reports of skin burns, its use has been abandoned by the majority of surgeons.
One of the most challenging aspects of liposuction in patients over 40 years old is the management of the skin post-lipo. We all have seen what happens to a birthday balloon after it gets deflated- it wrinkles up like a raisin. Similarly, we may remove fat from a large abdomen and the patient may look great with clothes on, but when bearing all, the patient may notice more loose skin around the abdomen that wasn’t noticed before. It’s because of this reason that subdermal skin tightening treatments have gained popularity in recent years.
The main purpose of these devices is to heat up the collagen from the inside as opposed to facilitating the fat removal. We know that when we raise the temperature of the dermis to 42 degrees Celsius, our body starts producing collagen. Unfortunately, this production is not immediate and the whole process may take up to 6 months to see the results, but it seems to offer a superior result in the long term.
The heating of the dermis happens after the suction of the fat is fully completed and the dermis has been released from the underlying fatty tissue. This heating can be done with a radio frequency probe called Radio-frequency liposuction (RFAL) or with a plasma probe called J-plasma liposuction. Both procedures accomplish the same end result of heating the dermis to 42 degrees Celsius and producing more collagen.
J-plasma has gained popularity in recent years among many top liposuction masters. Plasma is ionized gas and in the case of J-plasma this gas is helium. One of the main benefits of plasma is the narrow field of heat that it produces. Because of this narrow field, there is less chance of skin burns and no need to measure the skin’s surface temperature. The plasma is also in constant motion under the skin- constantly moving from one location to another, treating a larger area than the diameter of the probe.
The initial radio-frequency devices were a bit more cumbersome to use as compared to plasma probes as skin surface temperature had to be monitored closely with an IR camera. However, the newer generation radio-frequency devices have an internal temperature gauge and are therefore much safer to use. It remains to be seen which of these two modalities will be the champion in the war against loose skin.
Dr. Hooman Khorasani is quadruple board-certified in Dermatology, Cosmetic Surgery, Facial Cosmetic Surgery and Mohs micrographic surgery. Additionally he led the Division of Dermatologic and Cosmetic Surgery at Mount Sinai for 10 years. His dedication to clinical excellence and constant innovation led to numerous accolades, publications in premier medical journals, and authorship of a widely-used cosmetic surgery manual. He is considered an international expert in contouring procedures and has spent the majority of his career training the next generation of dermatologists and cosmetic surgeons.
Armed with this advanced clinical and academic competency, Dr. Khorasani carefully crafts an individualized liposuction surgical plan for each patient that adheres to the highest standards of medical care and is optimized to produce the greatest results possible. Personalization is infused into every aspect of our practice, from the treatment itself to our highly-skilled office personnel that are available 24/7 to answer any questions or concerns. Together as a team, we can maximize your lifestyle efforts to help you achieve your ideal body contour.
Dr. Khorasani and his highly-specialized team look forward to working with you to transform your medical or aesthetic goals into reality. To expedite a request for a consultation, message us securely or visit our contact page for more information.
We look forward to meeting you and offering the care and expertise you deserve. To expedite a request for a consultation, message us securely. You may also contact the office by phone at 212-230-3378, or fill out the information below.