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Kybella and Other Fat Removal Options

5 Fat Loss Interventions That Don’t Require Diet, Exercise, or Major Surgery

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Fat. Ever since Charles Atlas and Johnny Weissmuller introduced American men to the idea of “body insecurity” a century ago, an industry of aestheticians has existed to get rid of it — promising to vibrate, massage, beat or suck it out of you, if diet and exercise alone aren’t cutting it.

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For decades, fat-removal technology fell into two camps: invasive surgery (liposuction, requiring general anesthesia and painful recovery time) or scams (remember those vibrating ab belts?). The great news: That has changed. In recent years, technology has advanced rapidly, bringing forth new procedures that make eliminating stubborn love handles or a bothersome belly easier than ever.

Modern times have brought another significant change: men are starting to take advantage of fat loss surgery at much higher rates. “In the past, there used to be about 90 percent female and 10 percent male in terms of the mix of patients in the office seeking these procedures,” says Dr. Raja Nalluri, M.D., the founder of the Nalluri Plastic Surgery and Laser Center in San Diego. “The demographics have shifted and the percentage of men is now closer to 20 to 25 percent seeking these procedures! “

Now, we’re not talking about major weight-loss surgery here — these minimally invasive and noninvasive treatments are best suited for a bit of extra pudge or fat reduction in stubborn areas that aren’t responding to regular workouts. But are they right for you, specifically? To help answer that question, we called in the experts to help us break down the different fat loss options and how to determine which one is best for your needs.


Are Surgical or Laser/Cooling Fat Loss Options Right for You?


Storing stubborn fat: Let’s begin by making a concession: diet and exercise work, and they’re most people’s best option for fat loss, most of the time. That having been said, there’s a good reason people might consider other alternatives. “Genetically, many people store stubborn fat in particular areas of their bodies that are very difficult or even impossible to get rid of without a procedure,” says Nalluri. “Part of what makes stubborn fat difficult to get rid of is that even with strict dieting and exercise, a person’s body holds on to these particular areas of fat, so much so that even if they look emaciated and skeletonized in other areas of the body, the stubborn areas of fat persist.”

Toxins blocking fat loss: Toxins also play a key role in storing stubborn fat cells, in such a way that regular diet and exercise can be ludicrously ineffective. “Our bodies are known to store certain toxins inside our fat cells. This is the body‘s way of keeping the toxin out of our circulation,” notes Nalluri. “However when the body tries to recruit and burn that fat the toxin can block the door to the fat cells so that the fat cannot come out of the fat cell.”

If either of the above examples applies to you, you might be a good candidate for fat loss intervention.


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Top Laser, Freezing and Surgical Fat Loss Interventions


Man getting minimally invasive liposuction procedure with ultrasoundGettyImages

Liposuction used to be major surgery, requiring a stay in a hospital or surgical facility and going under general anesthetic while fat was sucked out of your body with a tube the approximate size of a garden hose. The procedure has gotten considerably more sophisticated, evolving into minimally invasive liposuction. Fat is injected with a numbing solution, then melted with ultrasound waves.

“Once it’s melted, I can take something the size of a coffee stir stick to remove it,” says Dr. Ryan Neinstein, a New York City plastic surgeon who performs the procedure frequently. “What that means for the patient is smoother results, less downtime, and less trauma to the body.” The procedure takes about an hour; recovery involves just two days off work and a two-week break from working out.

Who’s a good candidate for minimally invasive liposuction? “This procedure can help people overcome barriers that they can’t at the gym,” says Neinstein, whose practice is about 40 percent men. “We work with doctors, lawyers, accountants — professionals who eat well and exercise but have some stubborn stuff. They’re not looking to overhaul their life; they’re just looking for a little bit of help. We’re really an extension of the wellness/fitness sphere,” he says. Most of his procedures run from $7,500 to $12,000.

Pros:

  • Simple and relatively painless procedure
  • Quick recovery time
  • Some ability to target fat cells in the body

Cons:

  • Expensive
  • Failure to make lifestyle adjustments will quickly reverse results
TruSculpt machine and TruSculpt text on blue boxTruSculpt

TruSculpt is a non-invasive radio-frequency machine that heats fat, causing selective apoptosis (or programmed cell death) of the fat cells so they can be naturally excreted by the body, says Dr. Marnie Nussbaum, a New York City dermatologist who offers the treatment. One 15-minute session can reduce fat in the treated area by an average of 24 percent.

“It feels like a hot stone massage,” says Nussbaum. “It delivers heat to the entire fat layer, while maintaining a comfortable skin temperature. You can do it on virtually any area, and the great thing is, you can do multiple areas at the same time.” The cost: about $3,000 a session. It takes about 12 weeks to see the full results, after which the procedure can be repeated if desired.

Dr. Nalluri adds that a major benefit of the procedure is its versatility: it works to treat “a wide range of patients who may not be a candidate for other contouring procedures due to treatment location, skin type, fat thickness, and presence of skin laxity.”

Pros:

  • Non-invasive procedure, meaning no incisions and minimal recovery time
  • Can be applied to small, localized spots

Cons:

  • Requires multiple sessions to get results
Man getting Kybella treatment in his chinGettyImages

A sharp jawline is one of the most desirable masculine attributes. But with age and weight fluctuations, things can soften up in the chin area. A relatively new, somewhat sci-fi-seeming treatment for “submental fullness” — a.k.a. the dreaded double chin — is Kybella. It’s an injection of deoxycholic acid, which melts fat cells so they’re naturally eliminated by the body. Nussbaum says a few treatments of Kybella are necessary: between three to five, spaced every six weeks. The results are permanent.

One factor to consider: a common side effect of a Kybella injection is bruising or swelling, which lasts about four to five days after each treatment. Although it’s temporary if you need several sessions, you could be looking at quite a bit of downtime. If that’s not doable, you might get more bang for your buck by doing liposuction instead. “The science on Kybella is real, and the results are real,” says Neinstein. “But to get results similar to surgery, it requires so many treatments that downtime quickly becomes much longer than a 25-minute surgical procedure that causes four days of bruising. So Kybella doesn’t make a lot of sense for a lot of patients.”

If your budget doesn’t cover surgery, or you want to stick to totally non-invasive procedures, there are options. In some cases where patients want to remove a significant amount of fat from under the chin, Nussbaum says she’ll do an initial debulking with Kybella, then follow up with TruSculpt.

Pros:

  • Results are quickly visible
  • Minimal recovery and after-care required

Cons:

  • Not as comprehensive a fat loss solution as others
  • Some people experience minor side effects like bruising, swelling, pain, and redness
EmSculpt device and EmSculpt text over blue boxEmSculpt

During an EmSculpt session, electromagnetic paddles are attached to your abs or butt, delivering energy that stimulates the muscles to contract. “Electromagnetic muscle stimulation of Type 2 muscle fibers is the next extension in body contouring,” says Neinstein. In 30 minutes, you’ll undergo the equivalent of 20,000 crunches or squats. It’s more of a muscle-sculpting than a purely fat-removal device, although MRI studies show that patients can lose about 20 percent of the pinchable fat above the muscle.

Nussbaum says she’ll often perform EmSculpt and TruSculpt together. “I love doing these in tandem, because they’re both noninvasive, you sculpt the muscle and reduce the fat, so you’re getting the best of both worlds,” she says. She recommends four 30-minute sessions over a two-week period for optimal results.

Pros:

  • Non-invasive procedure with minimal recovery time
  • Builds a small amount of muscle while targeting fat loss

Cons:

  • Multiple treatments are required
  • Results aren’t as extensive as with more invasive alternatives
Person having a plasma skin tightening procedure GettyImages

Some of Neinstein’s patients who see the best results will stack procedures as well, either following up minimally invasive liposuction with EmSculpt sessions — which can have the bonus of speeding up healing by breaking down scar tissue — or chasing lipo with a procedure called plasma skin tightening. It doesn’t remove fat by itself but makes liposuctioned areas look firmer and smoother after the procedure, which was previously only possible with surgery and a risk of scarring.

How plasma skin tightening works: A device that emits plasma energy heats the area under the skin, tightening the collagen from the inside. “It’s similar to tightening the knot on a loose shoelace,” says Neinstein. “I tell people, we’re going to turn back the clock, but the clock keeps ticking. We can put your skin in the dryer, but we’re not sending it to the tailor. Things will stretch out in time. But patients I find are happier. People are looking for these types of options versus major surgery with big scars and risks from downtime.”

Pros:

  • Immediate results
  • Also eliminates wrinkles and sagging skin
  • Painless, non-invasive procedure

Cons:

  • Doesn’t actually remove fat

So science marches on, giving us tighter jawlines and better abs. But, fortunately, or unfortunately, a cosmetic procedure doesn’t come with a get-out-of-the-gym-free card. It’s important to support your investment with a healthy lifestyle, including regular workouts and a sensible diet.


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