How do all these fat loss treatments compare?

Here are some key things to know about fat:

  1. By the time we are adults, the number of fat cells in our body stays about the same.   When we gain weight those fat cells fill up and stretch out, and when we lose weight they shrink again.
  2. We have fat inside us which is mostly in the space around our organs like our intestines, liver, spleen etc.  This type of fat is particularly bad for heart health and we can’t see it.  Sometimes referred to as a “beer belly.”  It is not “pinchable.”
  3. We have fat on the outside of us which is referred to as “pinchable fat.”   This is the kind of fat that can be removed and contoured with fat loss technology.
  4. If we gain weight later, then the remaining fat cells we have fill up and stretch out more.  The fat cells that are truly gone, are gone!

There are some systems that create permanent fat loss because the fat cells actually die and are carried off by your body slowly.  Other systems just rupture the fat cell membrane so that the fat leaks out.  This type of fat loss is temporary.  The cell membrane will reform over a period of about 6 months and the cell will fill up again.  These systems do not create permanent fat loss.

Here are the main systems that create permanent fat loss:

  • Coolsculpting.  The most tried, true and safe of systems that contour and treat localized fat areas and pockets.  Best for contouring, but you can do a lot of contouring.  Good for the abdomen, flanks, under the chin (Coolmini), underarms, back fat, knees, love handles, etc.  It can get expensive if you want to do a lot. Almost no downtime with it. (I don’t have any financial interest in CS.)
  • Kybella.  Really most useful for under the chin (FDA approved).  It’s permanent, but more painful than CS, and causes a lot of temporary swelling in most. Great for those who have small areas that just need a little contouring.
  • Liposuction.  Be careful of the word “sculpt.”  True lipo based systems use a cannula inserted under the skin to suck out fat.  The fat is gone!  Best for larger areas.  Some systems use heat, sound waves, cold and other tricks to help break up the fat, but still, the key thing is suctioning it out.  Some heat-generating systems particularly have caused burns and permanent scarring.  Downsides are it can be really uneven or bumpy afterward and temporary bruising can last 2-3 weeks.  Small scars at the site of cannula insertion generally heal well.  Choose your surgeon carefully. No Groupons please!!!

More good news is that most of the time, the skin will tighten somewhat after the fat removal in that area.  That may take 3-6 months.

Hope this helps,
Dr. Brandith Irwin
Founder, SkinTour
Director, Madison Skin & Laser Center
Follow my skin tips and travels on Instagram!



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