The Fine Print: Body Sculpting and Fat Removal

I think I can confidently say that almost all of us would like to have a more sculpted body. That is the upside. The downside of body sculpting is that sometimes things don't go like we want. Body sculpting with invasive treatments such as Liposuction; non-invasive FDA approved treatments such as Zeltiq Coolsculpting and Zerona; or treatments not yet approved by the FDA such as focused ultrasound (Ultrashape and others), or Mesotherapy (Lipodissolve) all have risks and the possibility of side effects. Risks are complications that sometimes happen, and that can be detrimental to your health, for instance a serious infection after a procedure. Side effects are things that can be expected based on the type of procedure that is performed and are aggravating but not dangerous, for instance, cutting into the skin may give bruising. And then there is "unpleasantness", which usually involves outcomes that are not what you wanted, or that are cosmetically a problem. That is the fine print. So let's go ahead and talk about them, even though it is not fun.

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I think I can confidently say that almost all of us would like to have a more sculpted body. That is the upside. The downside of body sculpting is that sometimes things don’t go like we want. Body sculpting with invasive treatments such as Liposuction; non-invasive FDA approved treatments such as Zeltiq Coolsculpting and Zerona; or treatments not yet approved by the FDA such as focused ultrasound (Ultrashape and others), or Mesotherapy (Lipodissolve) all have risks and the possibility of side effects. Risks are complications that sometimes happen, and that can be detrimental to your health, for instance a serious infection after a procedure. Side effects are things that can be expected based on the type of procedure that is performed and are aggravating but not dangerous, for instance, cutting into the skin may give bruising. And then there is “unpleasantness”, which usually involves outcomes that are not what you wanted, or that are cosmetically a problem. That is the fine print.

So let’s go ahead and talk about them, even though it is not fun.

Once again, my lawyer reminds me to remind you that this is not medical advice to you as an individual, just informational. If you are not my patient, don’t listen to me, listen to your doctor. If you are my patient, I would appreciate it if you would listen to me, but we will always talk about risks and benefits of treatments before your actual procedure, so this is not your informed consent.

Liposuction

  • Risks: The most significant risk of Liposuction is death from complications of fluid loss or anesthesia. If too much fat is removed the risk of serious side effects, including death, increase rapidly. This is because if too much fat is removed then too much fluid is either removed from the body or goes into the space created by the fat removal. This reduces the volume of fluid in the blood vessels, causing shock. That is why official guidelines have been set as to the amount of fat removed per session have been developed, and responsible physicians (the vast majority of those performing liposuction) follow them. The ones who don’t are often the ones who you read about in relation to liposuction related deaths, which are often also performed in inappropriate facilities without appropriately trained medical staff and equipment.
  • Other risks are hematoma (collection of blood in the fat removal pocket), infection, scarring, damage or death of skin over the treated area, and changes in sensation.
  • Fortunately, significant complications from liposuction surgery are infrequent.
  • Side Effects: Post treatment discomfort or pain, bruising for 7-10 days, swelling up to 3 months, drainage of a combination of fluid and blood coming out of the small incisions. The incisions heal with a small scar that are usually very faint.
  • Unpleasantness: Indentations, surface irregularities, rippling, worsening of cellulite appearance.

Zeltiq Coolsculpting

  • Risks: There has been one reported case of a small (less than an inch) second degree burn which is like a blistering sunburn. It healed without problem. A very small number of patients (1 in 2500 treatments) report significant pain after treatment, lasting 1-3 weeks after treatment, then resolving.
  • Side Effects: redness, minor bruising, tingling, or numbness after the procedure; all are temporary.
  • Unpleasantness: Less improvement than desired, improvement area restricted to area of applicator, possible need for additional treatments

Zerona

  • Risks: There have been no reported risks of Zerona that I can find. The supplements may have risks of their own depending on what is used.
  • Side Effects: There have been no reported side effects to Zerona that I can find.
  • Unpleasantness: The fact that there are no reported risks or side effects may be related to the lack of the laser really causing any effect on the tissue. My feeling, and the feeling of many physicians, is that there is no real effect from this treatment, and that any improvement is due to the diet and exercise program along with the “supplements.” We will talk about satisfaction rates next time, but, overall, it is low.

Mesotherapy (Lipodissolve)

  • Risks: Not approved by FDA, and you won’t know what is being injected into you. There are reports of significant pain, skin necrosis (death of skin), infection with abscess (pus pocket), allergic reactions
  • Side Effects: Bruising, redness, Hard knots, areas of firmness,
  • Unpleasantness: Lack of improvement, irregular contour, permanent discoloration and firmness at injection sites.

So much for the unpleasantness, we still want improved body contour and fat loss, so…...........

Next: Top 10 Aesthetic body sculpting tips—what works, what doesn’t