[5 min read] How to treat patients with unwanted fat pockets on the face and body

Pockets of stubborn fat on the face or body are a common aesthetic issue, especially for non-overweight individuals. Since the excess fat tissue does not respond well to diet and exercise, many people consider a more radical solution. Until recently, only surgical options were available. But now, several effective non-surgical techniques are available at the primary care level.

For further information on this topic, you may be interested to learn more about the HealthCert Professional Diploma program in Aesthetic Medicine.

Persistent pockets of fat can exist in various areas of the body. These include:

  • Submental fat (double chin),
  • Panniculus (bell bulge, belly pooch, or beer belly),
  • Bilateral fat overhangs (love handles),
  • Upper thighs fat pockets (saddlebags), and
  • Cellulite

These are all purely aesthetic issues. There are rarely any medical indications for their treatment. However, fat pockets can affect the patient’s mental health and social well-being, causing low self-confidence, body image issues, anxiety, and depression, among other things.

Offering a safe and effective solution at the primary care level increases overall patient satisfaction, generates additional income, and potentially expands the patient base.

What are the non-surgical treatment options?

Modern aesthetic medicine offers a variety of treatments for unwanted fat pockets. Most physicians require only some additional training before including these in their portfolio.

The most popular treatment options are:

  • Cryolipolysis,
  • Laser fat reduction,
  • Fat-dissolving injections,
  • Ultrasound fat reduction, and
  • Red light therapy

Cryolipolysis is a non-invasive body sculpting and fat-dissolving technique. It uses low temperatures to kill fat cells. A physician places the cup-shaped device on top of the fat pocket to transmit cold onto fat cells. Skin, muscles, and nerves do not suffer damage because they freeze at lower temperatures.

Laser fat reduction uses heat to disintegrate subcutaneous fat cells. The laser device setting’s at a specific wavelength that enables the transfer of heat energy to the fat cells without damaging the overlaying tissue (there is also a cooling mechanism). The fat cells receive heat to the point where they begin to break down. Laser fat reduction works well all over the body, but using the laser on the face and around the eyes requires special precautions.

Fat-dissolving injections are gaining popularity lately. They use various substances, such as Phosphatidylcholine (PC) and Deoxycholate (DC), to initiate lipolysis inside fat pockets. After the injection, fat cells come in contact with these substances and break down. The effect is local, affecting a small area around the injection site. Fat-dissolving injections are usually the first-choice solution for submental fat (double chin).

Ultrasound fat reduction technique uses the energy of highly-focused sonic waves to disintegrate fat cells. The sonic waves travel through the skin applying pressure on the fat cells without damaging other tissues. Broken-down cells are metabolized by the body, resulting in local fat reduction. The treatment is suitable for the flanks and abdomen.

Photonic lipolysis or red light therapy does not destroy fat cells. It uses light at specific wavelengths to force the cells to “open,” release some of their content, and shrink. The device looks like a  lamp. Physicians can use it to improve the appearance of fat pockets in the hips, thighs, and abdomen.

References:

  1. Ingargiola MJ, Motakef S, Chung MT, Vasconez HC, Sasaki GH. Cryolipolysis for fat reduction and body contouring: safety and efficacy of current treatment paradigms. Plast Reconstr Surg. 2015 Jun;135(6):1581-1590. doi: 10.1097/PRS.0000000000001236. PMID: 26017594; PMCID: PMC4444424.
  2. Caruso-Davis MK, Guillot TS, Podichetty VK, et al. Efficacy of low-level laser therapy for body contouring and spot fat reduction. Obes Surg. 2011;21(6):722-729. doi:10.1007/s11695-010-0126-y
  3. Thomas MK, D’Silva JA, Borole AJ. Injection Lipolysis: A Systematic Review of Literature and Our Experience with a Combination of Phosphatidylcholine and Deoxycholate over a Period of 14 Years in 1269 Patients of Indian and South East Asian Origin. J Cutan Aesthet Surg. 2018 Oct-Dec;11(4):222-228. DOI: 10.4103/JCAS.JCAS_117_18. PMID: 30886477; PMCID: PMC6371720.
  4. Zhou B, Leung BYK, Sun L. The Effects of Low-Intensity Ultrasound on Fat Reduction of Rat Model. Biomed Res Int. 2017;2017:4701481. DOI: 10.1155/2017/4701481. Epub 2017 Aug 23. PMID: 28913353; PMCID: PMC5587957.

 

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