Some things in life we just can’t change, but thanks to the advent of noninvasive body-contouring procedures, treating areas with stubborn fat and cellulite is just not one of them. Long gone are the days of tirelessly spot-training one part of the body that refuses to get in proportion with the rest. Now, in just one, two or a series of visits to the doctor, we can finally say goodbye to those troublesome spots. “Noninvasive body contouring is perfect if you’re interested in losing a few pounds and inches and are committed to following doctor’s orders,” says Montclair, NJ dermatologist Jeanine Downie, MD.

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Fat Blasters to the Rescue

How They Work: All protocols—cold, heat, ultrasound, radio frequency (RF) and injections—work to disrupt fat cells and expel them from the body through its own metabolic system.

What to Expect: Immediate death of the fat cells doesn’t necessarily mean immediate results because the actual death cycle of the cell can sometimes take several months. In other words, “good things come to those who wait.”

Post-Treatment Care: Most noninvasive body-sculpting procedures are typically downtime-free with minimal recovery. “You can easily lose three to four inches, but you have to maintain a stable weight,” says Dr. Downie.

Longevity: “Once the fat cells are gone, they do not grow back, and therefore they can no longer shrink and expand with weight gain or loss,” says New York plastic surgeon David Rapaport, MD.

To reduce this 48-year-old patient’s upper arm fat, Greenwich, CT dermatologist Mitchell J. Ross, MD performed a CoolSculpting treatment on each arm. The “after” photo is shown three months post-treatment.

Energy Used: Controlled cooling

How It Works: Different-size applicators are used to target unwanted fat cells and freeze them, causing them to crystalize. Over a period of two months, the cells die, stimulating the immune system to remove them. “The crystallized fat cells are no longer viable. They undergo a death process called apoptosis and are slowly eliminated from the body through the natural metabolic process,” says Dr. Rapaport. “Of patients with visible fatty bulges, about 97 percent see an average fat reduction of 20–25 percent in treated areas.”

Treatment Areas: The abdomen, flanks, under the neck (double chin), back, bra area, thighs, arms, and under the buttocks (the banana roll)

Procedure Time: 35–60 minutes

Average Treatment Cost: $1,000–$2,000 per area

Energy Used: Light-based laser

How It Works: Applicators emit lasers through the skin (without affecting it) to heat up the fat cells and destroy them.

Treatment Areas: The abdomen, flanks, back, thighs, arms and under the neck (double chin)

Brand Names: Exilis Elite and Vanquish ME

Energy Used: Radio frequency

How It Works: Short, intense pulses deliver heat through the skin to break up fat and tighten and create new collagen.

Treatment Areas: The abdomen, flanks, back, bra area, thighs, arms and under the buttocks

Brand Names: Liposonix, Ultrashape and TruSculpt 3D

How It Works: Ultrasound waves break fat into small clusters so it is more easily removed.

Treatment Areas: The flanks, abdomen, waist, arms and thighs

Procedure Time: 30–60 minutes

Average Treatment Cost: $1,000–$2,000 per area

Bothered by what she called her “double chin,” this 26-year-old patient sought Windermere, FL oculoplastic surgeon Keshini C. Parbhu, MD for two treatments of Kybella, spaced one month apart.

How It Works: Injections of deoxycholic acid—a naturally occurring molecule in the body that aids in the breakdown and absorption of fat—are used for improving the appearance of a double chin. “It works almost immediately in that it literally digests the fat it comes in contact with,” says Vero Beach, FL plastic surgeon Alan Durkin, MD. “The cells are then cleared out naturally by the immune system.” Typically, 20–30 injections are done per session. There may be prolonged swelling and an inflammatory reaction, and multiple treatment sessions may be needed for optimal results.

Treatment Area: Under the neck; off-label uses include the inner thighs, above the knees and in the jowls

Procedure Time: 35–60 minutes

Longevity: Results are not totally predictable, but Dr. Durkin says, “there is strong evidence to suggest that the effect is permanent.”

Average Treatment Cost: $1,200–$1,500 per session

This 34-year-old patient visited New York dermatologist Bruce E. Katz, MD for four Emsculpt treatments completed over the course of two weeks. The result shows a tightened, toned tummy and an hourglass shape.

Energy Used High-intensity electromagnetic energy

How It Works During each session, an applicator is placed over the abdomen, love handles or butt, and electromagnetic energy induces tiny contractions to the nearby muscles. “We have medical devices that can freeze and melt away unwanted fat, but the muscle underneath is always left untouched,” says Delray Beach, FL dermatologist Dr. Janet Allenby. “Emsculpt is a game changer because it tones, tightens and strengthens the muscle underneath, which helps sculpt the area. I use it as an adjunct to the fat reduction treatments I do.”

Treatment Areas: The abdomen and buttocks

Procedure Time: Four 30-minute sessions scheduled two to three days apart

Longevity: “This treatment provides a jump-start to get you to a higher level of your own body goals than what you can achieve on your own, but I encourage my patients to maintain a healthy lifestyle to maintain maximal results,” says Dr. Allenby.

Average Treatment Cost: $1,000 per session, per treated area

All cellulite treatments have one goal in common: to minimize the appearance of dimpled skin for a smoother, firmer look. “Because women continue to develop cellulite as they age, I recommend, no matter which cellulite treatment you choose, a follow-up treatment at six to 12 months,” says West Palm Beach, FL dermatologist Kenneth R. Beer, MD. Average treatment cost, $2,400.

Paradise Valley, AZ dermatologist Susan Van Dyke, MD performed a Cellfina treatment on this 38-year-old patient who was concerned with dimples on her buttocks and thighs.

How It Works: The minimally invasive treatment uses a small, motor-driven surgical blade to break up attachments to the overlying skin, releasing the divots seen as cellulite.

What to Expect: Results have been clinically proven to last three years—with doctors predicting most dimples will never return.

How It Works: A laser is inserted to melt fat and break up the attachments to the skin while increasing collagen production.

What to Expect: Bruising, minor pain and the possibility of burns may occur. Results can be seen in the first few months, but will improve over one year.

How They Work: They target cellulite using a mix of radio frequency and suction massage.

What to Expect: Diminished cellulite in the treated areas and the look of firmer, tighter skin. Results may be temporary.

How They Work: These treatment breaks down fibrous fat and stimulates collagen production using radio-frequency energy.

What to Expect: A series of four to six treatments can noticeably improve the look of cellulite. Results may be temporary.

How It Works: A combination of modalities including RF, deep tissue heating, suction and negative pressure work synergistically to destroy fatty adipose tissue and tighten skin.

What to Expect: Results can be seen in four to six weeks, although three to four treatments may be needed. Las Vegas plastic surgeon Christopher Khorsandi, MD adds, “You can see temporary improvement with radio frequency alone, but for durable, lasting results, you need to target the cells and destroy the adipose tissue, which this treatment does.

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