Whenever I tell people what I do, one of the first questions is invariably “What can I do that’s painless, inexpensive, has no down time and will give me great results?”….at this point I have to chose my words carefully because that’s a tall order to fill. There aren’t many procedures that fit these criteria but one that shows promise may be just what these patients are looking for: External ultrasound for fat disruption.

Now a few disclaimers first. The technology isn’t commercially available yet. The cost to the patient hasn’t been determined because no one knows what the units will sell for. And finally, it won’t replace liposuction for troublesome fatty areas. What it will do (hopefully) is make a difference in problem areas for those patients who don’t need a lot of improvement and don’t want the discomfort, recovery time and expense of more traditional procedures.

External liposuction isn’t a particularly new concept. For many years, surgeons have known that fat cells are more susceptible to injury from ultrasonic energy than are skin or muscle cells. For this reason, injury to fat can take place with minimal effects to these surrounding tissues. By being very careful in the depth of fat and amount of fat “injured” body contour can be selectively effected in problem areas. Once the fat is injured, the body has ways to spot injured cells and to break them down. Fewer fat cells means less overall fat – and better still less of a tendency to gain weight in those areas treated.

The problem has been how do you deliver that ultrasonic energy without causing burns to skin or irregularity. Two companies are working hard to bring new devices to market that do just that. Ultrashape is an Israeli company that was able to demonstrate significant decreases with just one treatment. The changes were on the order of a couple centimeters (an inch) decrease, and more treatments would likely result in even greater benefit but this is still substantially less than the result following traditional tumescent liposuction. The second company, Liposonix, is a US based company which is also actively trying to deliver the ultrasonic energy to fat while minimizing injury to surrounding structures. At this point, both companies are awaiting direction from the FDA.

Treatment with either unit will likely be done in a doctors office with little or no anesthesia. The treatment is carried out by running a large ultrasound handpiece over the area to be treated similar to a fetal ultrasound. Patients will likely need some type of compressive garment after the treatment but will likely need it for less time that the one month of compression I recommend following tumescent liposuction. Keep your ears open for ultrasonic liposuction…something new in plastic surgery.