Some fat is a necessary component of a healthy body. But when it clumps and clings to the waistline and other areas in unsightly, stubborn bulges, clients will do just about anything to get rid of it. Medical spas armed with FDA-approved innovations in noninvasive and micro-invasive devices are ready to battle the bulge for clients who want results without the risks of surgery. With what seems like the wave of a magic wand, the new slim science encompassing lasers, ultrasound, radiofrequency, and more whittles middles, reduces jiggle, and boosts your bottom line. “If you can successfully treat fat and cellulite, you will have clients for life,” says Jame Heskett, M.D., founder of The WellPath (New York City). Here, medical spa professionals reveal their favorite equipment to help clients achieve the bodies they crave.
Chromogenex i-LipoXcell
Jame Heskett, M.D., founder of The WellPath (New York City)
How it Works: The i-LipoXcell features low-level laser technology that mimics the body’s natural fat-shrinking processes, vacuum massage to smooth cellulite, and high-power radiofrequency to spot reduce fat and slim the body. The laser emits a cold light that interacts with the surface of the fat cell, causing it to release its contents and shrink.
FDA Approval: It is approved for circumferential reduction and improvement in cellulite and pending approval for radiofrequency skin tightening.
Ideal Candidates: Nonsmokers and those who have not undergone liposuction fare best. “It is hard to shrink fat from areas where there has been liposuction, because the circulation is so bad,” says Heskett. “I look at underlying cause, lifestyle, and budget and then help patients make a decision based on my experience.”
Course of Treatment: FDA-approved protocols generally include six to 10 treatments, with each session lasting about 30 minutes.
Homecare: “I am a big fan of dry brushing and inverted yoga poses to improve circulation,” says Heskett. “Also, decreasing sedentary behavior is key. The more people sit on their behinds, the more cellulite they will have.” She also recommends patients stay hydrated and avoid wearing clothing or undergarments that pinch fat, because it cuts off circulation, making it harder to get the fat out of those areas.
Expected Results: Clinical studies show an average of one inch lost immediately after each 30-minute treatment. “Fat reduction is permanent,” says Heskett. “The only way to plump the fat cell back up is to store extra calories as fat.”
Zeltiq CoolSculpting
Jody Levine, M.D., New York City dermatologist and national medical director at AOB Med Spa (multiple locations in Colorado and Texas)
How it Works: A specialized applicator with cooling plates suctions in a flabby area and chills it to induce cryolipolysis, the process by which fat cells are frozen until they are destroyed. Each applicator is designed to treat a different trouble spot.
FDA Approval: It is cleared for reducing fat in the flanks, abdomen, and thighs.
Ideal Candidates: Ideal patients are those with unwanted fat and noticeable bulges who are looking for non-surgical options to treat targeted areas.
Course of Treatment: "Each patient has an individual treatment plan, which varies based on the patient's specific needs, body type, and on the number of areas being treated," says Levine. Plans may include one or multiple treatments, and sessions can be as short as one hour each.
Homecare: Levine does not recommend any additional at-home regimens, but many patients are motivated to adopt a new diet and exercise habits, which can enhance results.
Expected Results: It takes a few weeks to begin to see fat reduction in treated areas, with full results visible in two to four months, after the body completely processes the destroyed fat cells. "CoolSculpting eliminates fat cells and reduces unwanted bulges to achieve natural-looking body contouring," says Levine. "It offers long-term results, because once fat cells are frozen, they are processed by the body and then eliminated."
Syneron Medical VelaShape III
Rivka Veder, licensed esthetician at White Tea Med Spa (New York City)
How it Works: Infrared light energy, bi-polar radiofrequency, and vacuum work in tandem to precisely heat and manipulate tissue—including fat cells, underlying dermal collagen fibers, and connective tissue—up to 15mm deep.
FDA Approval: It is cleared as safe and effective for all skin types for circumferential reduction.
Ideal Candidates: Normal to overweight patients seeking cellulite reduction or circumference reduction in a variety of problem areas and those committed to a healthy diet and lifestyle can be treated with good results.
Course of Treatment: The 30-minute treatment can be done once every two weeks. “A series of three to six is a good place to start,” says Veder. “Three treatments often show results, but many people have a specific goal in mind, and it usually takes a few extra treatments to get to the place they want to be. Cellulite does come back, so they will need a few maintenance sessions.”
Homecare: “Water is important to help the body metabolize the fat and flush out toxins,” says Veder. “Without the proper hydration, the body will become stagnant, making it harder to recuperate post treatment and making it harder to see good results. Lifestyle, diet, and exercise play a big part.”
Expected Results: Clients see a reduction in cellulite with a gradual smoothing of the skin’s surface plus inch loss and reshaping of the treated area. Though Veder says, “results are client specific, and there are many factors at play, including diet, exercise, water intake, lifestyle, and consistency with treatments.”
Syneron-Candela UltraShape
Bruce Katz, M.D., director of Juva Skin & Laser Center (New York City)
How it Works: The UltraShape System relies on pulsed, focused ultrasound to shake up and selectively destroy the fat cells at a controlled depth so as not to harm neighboring tissue. It is a mechanical process, so there is no uncomfortable heat. Destroyed fat cells are processed naturally through the body.
FDA Approval: It is approved for abdominal circumference reduction by mechanical disruption of fat cells.
Ideal Candidates: People who are at a healthy weight and are able to pinch at least one inch of belly fat can safely undergo the treatment. “It’s not a weight-reduction treatment,” says Katz. “It’s a way to contour the body.”
Course of Treatment: Each session is about 40 to 45 minutes. “We recommend two or three sessions, with two weeks between each treatment,” says Katz. “Most people see results after two weeks.”
Homecare: Between treatments and after, Katz tells patients to maintain normal activities and a balanced diet and warns them against becoming couch potatoes, because they will gain the fat back, just in different areas.
Expected Results: “We tell people to expect to lose one or two pant sizes and a couple of inches, though it depends on how they wear their clothing,” says Katz.
Fit BodyWrap
Aaron Flickstein, M.D., clinical director at Fit Bodywrap
How it Works: The wrap produces far infrared heat in the same 5-15 micron wavelength as the sun and penetrates one to two inches below the skin where fat and toxins are stored. The fat and toxins are soluble at just more than 100 degrees and can be dissolved and excreted through sweat or processed by the kidneys.
FDA Approval: Clinical research supports claims of effectiveness, but FDA approval is not required for this device.
Ideal Candidates: “For those who can’t, won’t, or shouldn’t exercise, this approach is ideal,” says Flickstein. “Anyone who will take the time and make the investment will enjoy the weight loss and, if needed, cellulite reduction, too.”
Course of Treatment: Each session is 50 minutes, and programs are customized for each client. Flickstein recommends three sessions each week until clients achieve desired results followed by a maintenance program of weekly visits.
Homecare: “Balance is extremely important,” says Flickstein. “So I recommend meditation or relaxation sessions for 15 minutes, twice a day, incorporating resistance training three times a week for 10 minutes with their normal exercise routines, and a well-balanced diet.”
Expected Results: “There are quite a few factors that correlate with success,” says Flickstein. “However, a loss of 1.5 to 5 pounds of fat is possible.” He adds that results last as long as the client stays motivated to maintain them with a healthier lifestyle, including diet and exercise.
ThermiAesthetics ThermiTight
Karen Harkaway, M.D., dermatologist at The Harkaway Center for Skin Refinement (Delran, NJ)
How it Works: A tiny SmartTip probe inserted under the skin enables direct transfer of radiofrequency, or thermal energy, to subdermal tissues to heat them to a specific temperature range, which melts fat cells and tightens skin.
FDA Approval: ThermiRF is FDA cleared to be safe and effective for dermatological and general surgical applications in soft tissue and nerves.
Ideal Candidates: “The ideal patient is not extremely overweight, and younger patients tend to respond better than older patients,” says Harkaway. “However, with appropriate patient expectations, almost any patient can achieve good results.” This treatment is a good option for those looking for more extensive results than noninvasive procedures can deliver but who don’t want to undergo liposuction.
Course of Treatment: One minimally invasive procedure lasting about one hour is needed to target cellulite. Use of a local anesthetic eliminates discomfort.
Homecare: No specific treatments or regimen is needed at home.
Expected Results: Results begin to appear one month after the procedure, and the areas treated continue to show improvement throughout the following year. Skin will appear tighter, as cellulite is diminished, and fat will be reduced in the area. “All patients treated with ThermiTight have seen improvement, with the majority of patients achieving 60 percent reduction or greater,” says Harkaway. She notes that a more than two-to three-inch reduction is common, and results have been shown to last several years.
Banish inches of your clients’ unwanted flab with the latest equipment from the following companies.—Jessica Morrobel
BTL Industries www.btlaesthetics.com
Chromogenex www.chromogenex.com
Fit Bodywrap www.fitbodywrap.com
Onyx Medical www.onyxmedical.net
Pollogen www.pollogen.com
Satin Smooth www.satinsmooth.com
Silhouet-Tone www.silhouettone.com
Syneron-Candela www.syneron-candela.com
ThermiAesthetics www.thermi.com
Zeltiq www.coolsculpting.com