By Susan Neil, M.D.


People who are troubled by areas of unwanted body fat, that are resistant to diet and exercise now have several options for treatment, including traditional liposuction and nonsurgical procedures.

Liposuction may be most appropriate when there is a larger volume of fat that needs to be removed, however it has a longer recovery period. Removing fat with a cannula does cause bruises, swelling and soreness that lasts for several weeks, and a compression garment may be necessary. While results are seen after the swelling goes down, it takes 6 months to see the final results.  Negatives include greater risk for complications and generally greater cost, although more fat can be removed at one time.

If you are close to your ideal weight and want to target trouble areas, noninvasive treatments may be preferred.

The devices approved for permanent fat destruction include laser lipolysis (SculpSure), cryolypolysis (Coolsculpt), and high-intensity focused ultrasound (Liposonix.)  All of these methods take 12 weeks for full results, although some improvement, may be seen sooner, and usually require two treatments.  Non-invasive treatments average 20-25% reduction in subcutaneous fat per treatment.

Sculpsure is the newest of the non-invasive tools for permanent fat destruction. It takes about 25 minutes per area treated, and does not have bruising or swelling afterwards, and is generally less uncomfortable during and after treatment than some of the other methods.  Several areas can be treated during the same session or at different times, which could make it more affordable

Treatment for the submental area, (double chin) can be done with SculpSure on heavier people up to a BMI of 40, although for other treatments BMI of 30 or less is advised.  Kybella (TM) injections can also be used to dissolve fat in this area and also normally requires 2-3 treatments. There is usually some swelling, soreness and bruising for a few days after Kybella  which is not seen with SculpSure, full results are also seen in 12 weeks.

Thermage, a specialized radiofrequency treatment generally used for skin tightening is also indicated for improvement in the appearance of cellulite, but is not used as a treatment to reduce fat.