As soon as warmer weather comes knocking, we all become more concerned about our body’s shape. Whether we worry about extra weight, toning, excessive and sagging skin, stretch marks or cellulite, our focus seems to turn on attaining that impeccable look.
Whether non-invasive procedures are more accessible and affordable, or people simply care more about how they look these days, it is clear that people of all ages and genders are turning to improve their body image. It may come as no surprise that the Body Contouring market had an annual increase of 20% in 2017 compared to the previous year and according to GlobalData is expecting to achieve even more growth in years to come.
However, patients’ expectations towards these procedures have also changed over the years and many of them are expecting nothing less than a miracle. In order to meet these expectations, it is vital that patients undergo a detailed educational consultation, examination and medical history in order to tailor the procedures to their individual constitutions.
Causes of body aging, such as skin sagging and physical “imperfections” such as abdominal fat, saddlebags, love handles, stretch marks, bra-bulge, and cellulite, are far more complicated than one might think. So it makes sense that offering a single treatment modality to address all these problems wouldn’t be successful. Therefore, a combination treatment approach allows physicians to meet patient expectations and achieve greater satisfaction and superior results in the body contouring process.
Understanding the cause
There has been an important paradigm shift in treating aesthetic body concerns which focuses on understanding the real underlying cause of the problem. Localized adiposities, i.e. fat, in areas such as the abdomen, inner thighs, outer thighs, flanks, and arms are usually caused by some underlying medical issue. This can mean having insulin resistance, estrogen dominance, androgen excess or insufficient detoxification, among other things.
Today there are many non-invasive procedures such as cavitation, cryolipolysis, radio-frequency, laser, ultrasound, and injectables that remove fat as effectively as invasive procedures such as liposuction. Under the supervision of an experienced physician, they usually deliver very similar results. The difference is in recognizing and treating the underlying cause of these body issues in order to obtain sustainable results. This is what needs to be clearly explained to patients so that they can participate in achieving their desired body shape in the long-term.
Let’s take an example of a patient considering cryolipolisis or cavitation of abdominal fat. Patients considering these procedures may think that removing the fat also removes their risk of obesity-related problems such as high blood pressure or cholesterol and that the fat will never come back. These procedures do offer a number of benefits which help to improve the “look” of the body by removing stubborn pockets of fat that are visible on the waist. However, it is the “invisible” fat (between the organs) that is responsible for health issues related to abdominal fat. Without dealing with these underlying health issues, patients will find that the fat will keep coming back, much to their disappointment and dissatisfaction.
Combination approaches for non-invasive body contouring often include procedures that target sagging skin as well.
Localized fat is often accompanied by increased skin laxity (sagging) especially in older patients and individuals that have lost a lot of weight, post-pregnancy patients, have premature aging or insulin resistance. Treating excessive fat with sagging skin is quite a challenge, particularly in aging individuals as their collagen is continuously diminishing. Therefore, the results from fat removal procedures just don’t give the full effect. That is why fat removal techniques need to be combined with a skin tightening procedures such as mono, bi or tripolar radiofrequency (RF) and pulsed electromagnetic field (PEMF), tailored infrared light and ultrasound. Things like LED, mesotherapy, and PRP can also enhance collagen production.
We’ll often find that rapid removal of fat in older patients through procedures such as liposuction and laser fat removal will cause increased laxity. Therefore, the physician needs to be ready to offer a tightening device immediately afterward or inform the patient to start it elsewhere.
Together with skin tightening procedures, one of the most important combinations to be made is to address the underlying cause of increased collagen loss such as sex hormonal deficiencies, high cortisol, high insulin, high sugar intake, and high free radical formation.
Some patients need medical integrative interventions before starting non-invasive body procedures. For instance, it does not make any sense to sculpt the body of patients with androgen excess (PCOS, Insulin Resistance ), who often have a masculine body shape with wide shoulders, increased fat on upper arms and high waist to hip ratio, when the underlying cause of androgen excess will simply perpetuate the problem. Similarly, women with estrogen dominance often have an exaggerated pear shape with excessive cellulite. Although their cellulite can be successfully treated with ongoing treatments, the circumferential reduction will be limited as the excessive estrogen will keep gynoid fat (which deposits on the lower part of women’s bodies) to keep growing. Identifying these treatable causes is very much part of the comprehensive approach for sustainable results in body re-shaping.
The best candidates for combination non-invasive body contouring are patients with minor skin laxity and small localized adiposities that are mostly related to a temporary “junk-food” lifestyle. These problems are often treatable with proper lifestyle interventions in addition to contouring procedures.
So if one suffers from excessive body weight, obesity, stubborn fat, increased laxity, and hormonally-caused fat deposits, the way forward will be to use combined aesthetic procedures and a comprehensive approach with integrative medical interventions. Moreover, to achieve the greatest level of success we as physicians need to take the time to understand the patient’s goals and manage their expectations realistically.