Q: Dr. Eppley, I have a consult scheduled with you in the next few weeks for a breast lift and removal/replacement implants. I was also wondering if you could answer some questions about the differences between Exilis, Vanquish, Venus Freeze, Cool Sculpting and I-lipo. A friend of mine has tried the I-lipo. I have read about all of them online. Hard to tell what the “best” option for a little targeted fat loss and skin tightening would be. Maybe they are all good options.
A: In today’s world of non-invasive/non-surgical body contouring, there are a number of devices that are currently available for some degree of fat loss and a little bit of skin tightening. (and I want to emphasize the phrase ‘a little’) All available devices are based on some form of penetrating energy from ultrasound, infrared, radiofrequency and thermal sources. They all claim effectiveness but whether one is better than the other can never be proven since there are no comparative clinical studies of them. I have used most of these devices and, in the properly selected patient, can offer some reasonable results. Currently we use Vanquish and Exilis for the best non-invadive body contouring results, They are best used in those patients who are never going to have surgery to those that want to give it a try with actual surgery as a final treatment if needed.
Dr. Barry Eppley
Q: Dr. Eppley, I am interested in a non-invasive procedure for fat reduction basically at thigh and abdomen. I would like to know what you recommend and what do you think about CoolSculpting. I have had 3 c-sections, no other medical conditions. Thanks.
A: Let me make some general comments about the differences between non-invasive vs. surgical treatments for body contouring. (fat reduction and skin tightening) First, when it comes to considering non-invasives (e.g., CoolSculpting, Exilis etc) the patient never has anything to lose…other than money. There are no medical risks or downtime. The only risk is in how well it will work. Thus if someone is dead set against surgery then go ahead and do the non-invasive approach. It will either produce a satisfying result or it will not. Second, understand that no non-invasive therapy will ever produce a surgical looking result. I don’t care what is said about it or how good some before and after pictures look. The role of noninvasive treatments for many patients is a bridging therapy…I don’t want surgery but I want some improvement. ..and I will accept that it will likely do less than I ideally want. Lastly, no patient wants to waste their money and effort on a treatment that never had a good chance to work for them. Thus it is important to get a qualified answer beforehand as to what your chances are for success with any non-invasive treatment.
While I have no idea what you look like, the fact that you have had three pregnancies/c-sections give me cause for concern about the success of any non-invasive treatment approach for your abdomen. Your abdominal skin is stretched out and probably has poor elasticity…that would be inevitable after three pregnancies. If you have any stretch marks at all, there is next to no elasticity. That skin has a very limited ability to shrink back down on its own no matter what energy treatment is applied to it. So even if you can shrink some fat what will happen to the skin? Without skin shrinkage with fat reduction the change in the abdominal contour will likely not be an aesthetically significant improvement. On your abdomen after three c-sections the real question is whether anything will really work short of a tummy tuck.
The thigh area is always different because the skin always has better quality. The issue here is the debate of something like CoolSculpting vs liposuction. I think that answer lies in how much reduction is needed and what does your abdomen really need. If a tummy tuck is the only answer to your abdominal concerns, then you might as well have liposuction done on the thighs at the same time.
I would be happy to review of any pictures of your abdomen and thighs to give you a more definitive answer.
Dr. Barry Eppley