No scalpel, needle or scars. Helen Garston compares three of the most common non-surgical fat busting techniques. 

No matter how much we exercise or diet, we are often left with areas of fat, which simply won’t budge. Previously the only option to get  rid of those bulges was liposuction – a surgical procedure that meant down time. Now, technology has presented us with a myriad of choices of non-surgical interventions – but how do they work and are they any better than their surgical counterpart?

So, what’s on offer?

1.Fat freezing (Cryoliopolysis)

What is it?

Cryoliopolysis or fat freezing – or CoolSculpting as it is marketed –  isn;t that new – it’s been around for about 15 years and was developed in America. Doctors realised that when people got frostbite their fat cells were damaged before the other cells in their skin – mainly because of the high amount of water stored in fats cells. They applied the same idea to Cryolipolysis; a procedure which freezes the fat cells near the surface of the skin. The water in them expands as it freezes and the cells basically pop and the contents are then adsorbed by the body and excreted in the urine. The rest of the skin is left  intact.

How does it work?

Up to two sections of flesh can be inserted into the freezing device where they are treated for up to an hour.  Most machines use a vacuum system which draws up the area to be treated into an applicator cup and that area is then cooled. Everyone’s pain threshold is different and it may be a little uncomfortable as it cools and you may also feel some pulling, tugging, or mild pinching.

The number of sessions needed to destroy the fat cells depends on the size of the area of fat. It takes up to six weeks for the results to be seen and more than one session may be required. Afterwards, the patient is almost always able to resume normal activities.

Who is it best for?

Good candidates are people who exercise and watch their diet but still struggle with stubborn areas of fat on their body.

Are there any side effects?

Because the techniques destroys fat cells permanently, any weight regain will not return to that part of the body but will instead go to areas that have not been treated. It therefore, important to keep up a healthy diet and exercise regularly. The skin may be red and bruise after the treatment.

In rare circumstances, (one in 1,000 people) the fat you are trying to destroy can actually increase. Doctors are not sure why this happens but if it does the situation can be reversed with liposuction.

What’s the cost?

Prices start from £700 per area, per session. Patients typically need between one and three sessions. Results will not show immediately but will take a few weeks or even months to develop.

 2.Ultrasound

What is it?

Ultrasound is sound waves that are most often used to scan the human body, as in pregnancy, or to detect disease or injury. But non-surgical ultrasonic liposuction is now being used to reduce fat from stubborn areas.

How does it work?

As the ultrasound machine passes over the area to be treated, the waves pass through the fat cells inside your body and cause them to vibrate. This causes the fat inside the cells to change from a semi-solid state to a liquid one.

Once liquefied, the fat will drain from the cell and pass through the lymphatic system, and are ultimately excreted from the body. Again, results take a few weeks to become visible.

Who is it best for?

Ultrasound is best for people who have stubborn fat on the stomach, thighs and love handles.

Are there any side effects?

In rare circumstances there can be temporary blistering or redness which tends to fade within days. More common are headaches due to dehydration if the patient doesn’t drink enough water immediately afterwards.

What’s the cost?

Costs from £150 per session. The number of sessions needed depends on the size of the area to be treated.

3.Radiofrequency

 What is it?

Radiofrequency – as the name suggested, passes energy from electromagnetic radio waves through the skin, heating the tissue layer where collagen fibres are found. The localised heating causes a contraction of these fibres which in turn causes the fat cells to shrink. The effect of this is tighter, smoother, younger looking skin with a visible ‘lift’. Fat cells are reduced and stubborn cellulite looks a lot less noticeable.

Who is it best for?

Again, this is best for patients who do not have a vast amount of weight to lose. It’s good for people who want a smoother look and to reduce the appearance of cellulite. Patients who have a pacemaker or metal implant are not suitable for this treatment.

Are there any side effects?

Radiofrequency can produce swelling, redness or bruising around the treated area, which usually disappears in a few days or weeks. Some people may notice a slight increase in urine output following treatment because any excessive fluid build up in between cells in the area treated is drained through the lymphatic system – this then gets excreted in the urine.

In very rare circumstances, it is possible to suffer from a skin burn.

What’s the cost?

Prices range from £80 – £100 per 60 minute session and how many sessions required again depends on the size of the area to be treated. You may see results after each session but up to ten sessions may be required to achieve the desired result and they are usually spaced about two weeks apart.

What’s the verdict?

In 2015 Dr Reza Nassab, of the British Association of Aesthetic Surgeons, published a study called The Evidence Behind Non-invasive Body Conturing Devices which concluded that the evidence supporting these procedures is weak. He wrote that the studies are usually small and with no long term follow up, and done by or supported by the manufacturers of the devices, however some showed short term positive results.

When it comes to ultrasound the results are very subtle and not enough long-term research has been carried out, he claims.

“Quite often I have noticed that the results are short-lived and have disappeared just a few weeks after treatment.”

Dr Nassab says that radiofrequency is still the most popular non-surgical fat reduction method in general. However, out of all three procedures, he finds CoolSculpting the most reliable and effective.

“Most of the research that has been carried out on non-invasive techniques only involve small numbers of patients over a short period of time. There have been more studies into CoolSculpting than the other two so I’d favour than one,” he said.

This may however be a function of the fact that it is the oldest of the three methods so there has been more time for studies to be done on CoolSculpting.

It’s always advisable to do your homework. Ask to see your practitioners before and after pictures and ask how many of his or her patients have come back unhappy with the results and what they have done about it. Always make sure your practitioner is qualified, has experience and has discussed realistic results with you.