What’s a way to help patients reduce unwanted fat? Noninvasive body treatments, which are sometimes referred to as “body contouring,” can include fat-reduction procedures. How can these treatments work to potentially help patients address their full-body aesthetic concerns? Several experienced Medical Aesthetics providers share their observations about some of these procedures as well as their experiences with real patients.

An overview of cryolipolysis.

But first, what are some of the specific forms of body contouring used in Medical Aesthetics? Cryolipolysis is a process that uses freezing temperatures to target and destroy fat cells within a specific fatty bulge on a patient’s body. An applicator is applied to the fat bulge for approximately one hour while the patient remains awake.¹

This treatment is effective because fat cells are particularly vulnerable to freezing temperatures; when the treatment is administered correctly, non-fat cells remain unharmed while the fat cells shrink in volume. In her Manhattan-based practice, Denisse Serrano, PA-C, MS, has noticed that “once you’re in your 50s and above, you can think about doing more noninvasive body contouring treatments to the back of the arms and the abdomen.”

The basics of radiofrequency lipolysis, aka an “energy-based” device.

Radiofrequency lipolysis, which is sometimes described as an “energy-based” device, works without making direct physical contact with the patient’s skin. Instead, a radio frequency is projected from an applicator approximately 1 cm away from the skin.² Similar to cryolipolysis, except using heat instead of cold, the frequency heats fat cells without harming adjacent non-fat cells.

Denisse is careful to explain to patients that different parts of the body require different treatments and/or devices. “How I incorporate energy-based devices into treatments is very simple. I tell patients, ‘let’s talk about all the different concerns’ so I can recommend the appropriate treatment method.”

Popular uses of liposuction.

Liposuction can be a minimally invasive procedure,³ but it’s still classified as the surgical removal of fat with a cannula. Liposuction can treat numerous parts of the body, including the abdomen, buttocks, arms, ankles, hips, knees, neck, waist, thighs, and upper arms. In many cases, liposuction is performed in tandem with other plastic surgery procedures, such as a facelift, tummy tuck, or other procedure.⁴

In his North Carolina practice, Dr. Gaurav Bharti frequently performs liposuction as part of a “Mommy Makeover,” which often involves a series of procedures performed on women who aim to augment their bodies similar to their pre-childbirth condition. “I very much like combination surgery, and I also like the idea of addressing multiple areas of concern,” Dr. Bharti explains.

Meanwhile, Denisse notes that as patients age, they begin to experience bony degeneration, fat atrophy, and skin laxity. “Patients might want to start thinking about a noninvasive, deep plane neck lift, as well as facelifts and things of that nature,” she says.

Understanding risks of body contouring procedures.

While there is a risk of surface irregularities and asymmetry, for the most part cryolipolysis has a low complication rate. In less than 1% of patients, paradoxical fat hyperplasia, or an unexpected increase in the number of fat cells, may present.¹

Some patients who undergo radiofrequency lipolysis may experience mild erythema.² Liposuction has potential complications that may include but are not limited to swelling, infection, bruising, deep vein thrombosis, thermal burn, poor wound healing, anesthesia risks, fluid accumulation, damage to abdominal organs, and need for revision surgery.⁵

Determining what certifications are required for each procedure.

Although many of these procedures are noninvasive, many states require that the treatments can only be given by a licensed physician, board-certified plastic surgeon,⁶ or a registered nurse working with a licensed physician or board-certified plastic surgeon.

Aesthetic healthcare providers should first check the requirements of the state(s) in which they wish to practice to determine what certification is required.

Discussing body contouring with patients.

Because body contouring is a personalized treatment plan, Medical Aesthetics providers will benefit from developing positive consultation relationships with their patients to understand their goals to achieve desired results. Preparing patient expectations and treatment visits needed is also helpful.

“I say to them, it’s a journey, not a race. We don’t have to do all of this. And we’re probably not going to do all of this in one appointment,” Denisse says. “But I promise you if you look at yourself today versus how you’re going to look in a year to 2 years from now, while you’re with me as a patient, you’re going to see a remarkable difference.”