In-Person Botox Training: Your Key to a Successful Aesthetic Practice
Whether you are new to Botox injections or an experienced injector, read these Botox best practices.
When you turn on the television, whether it is a reality show, talk show or just an advertisement, you are bombarded with “lose fat without surgery,” “freeze your fat today,” and “now you can lose fat without dieting!”
The common source of all these claims is typically body contouring or fat reduction procedures.
After all, who doesn’t want all their fat removed without surgery or dieting!
The chances are you will have patients coming in and asking what is available, and if it will work for them.
You are already most likely familiar with the surgical options, like liposuction or laser-assisted liposuction, but what about all these newly FDA-approved fat reduction and skin tightening devices?
This primer is meant to educate you on all the players in the American market.
Hopefully, by the end of this article, you will be in a better position to make a decision on whether to offer these procedures to your patients, and understand the financial investment for your practice.
When you turn on the television, whether it is a reality show, talk show or just an advertisement, you are bombarded with “lose fat without surgery,” “freeze your fat today,” and “now you can lose fat without dieting!”
The common source of all these claims is typically body contouring or fat reduction procedures.
After all, who doesn’t want all their fat removed without surgery or dieting!
The chances are you will have patients coming in and asking what is available, and if it will work for them.
You are already most likely familiar with the surgical options, like liposuction or laser-assisted liposuction, but what about all these newly FDA-approved fat reduction and skin tightening devices?
This primer is meant to educate you on all the players in the American market.
Hopefully, by the end of this article, you will be in a better position to make a decision on whether to offer these procedures to your patients, and understand the financial investment for your practice.
Learn how to start a profitable medical weight management program that really works!
>> Request Your Free Guide
It is a fact that most people have some insecurity regarding their bodies. For some it is their love handles and for others it may be the shape of their buttocks.
Fat deposits in any body-zone can significantly spoil a figure, and for aesthetically conscious people – it is a nightmare.
With the advent of a new generation of non-invasive body contouring and fat elimination equipment, we can effortlessly get rid of these stubborn fat bulges. The question is, are they effective? Absolutely!
Non-invasive fat elimination is the treatment of choice for people who have failed to eliminate stubborn areas of body fat, despite strict dieting and training in gyms for hours and even for people who have not achieved their desired results from surgical procedures.
Genetics does play a role where different people retain their unwelcome “fat pockets” and often they may find that their parents and grandparents also retained these “fat pockets” in the same areas.
The ASAPS (American Society for Aesthetic Plastic Surgery) data on emerging aesthetics trends clearly reflects the recent hype of non-invasive fat elimination and body sculpting. Some important items to take note of are:
A recent market study revealed that the emerging market for energy-based devices and body shaping / skin tightening segments would experience solid annual gains of 6.2% and 13.8%.
After reviewing these recent statistics, it can be concluded that every physician should have a basic understanding of these techniques and my goal is to give you an insight into the non-invasive body sculpting industry.
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Non-invasive fat reduction, as its name signifies, melts away your body fat without making an incision in your skin.
For people experiencing a dreaded plateau in their battle with weight loss or aggressive exercise plans, these procedures can act as a life turner.
Here is a birds-eye view of the extensive list of benefits which non-surgical body-sculpting (fat reduction) technologies offer:
Through these procedures, one can accomplish similar results without the risks of surgery.
One can avoid:
Remember these procedures are not an alternative for a healthy lifestyle, it just gives one the push to jumpstart the motivation to maintain healthy habits.
These procedures are not for anyone who wants to lose weight, in fact these procedures rarely result in any weight loss.
If weight loss is their goal, they should first participate in a physician-directed medically supervised weight loss program.
As well, none of these devices rival the results of surgical intervention.
It is important to understand what this equipment can and cannot do.
For most people, they will have better results with a tummy tuck / liposuction combination then with any of these devices.
However, most patients also don’t want the downtime, surgical scars, and having to wait months to see their final results which are associated with these surgeries.
Non-invasive fat elimination procedures are really meant for patients who don’t want to go under the knife, and are happy with a one-inch reduction of the circumference of their abdomen.
What is surprising is the number of patients who don’t hesitate to shell out $2,000-4,000 on these procedures for that 1 to 2-inch reduction.
Often your patients just want their clothes to fit better, and dropping a size or two is all they want.
Many are of a healthy weight, and no amount of exercise is ridding them of their problem area.
Help your patients and grow your practice. Request your guide to starting a profitable medical weight management program that really works!
>> Request Your Free Guide
Wide ranges of non-surgical, non-invasive equipment options are now available for body contouring, and depending on what was highlighted on today’s episode of Dr. Oz, The Doctors, The View or another talk show, will most likely determine what equipment patients will be calling about.
You will find there are five main technologies used in the equipment described below: Cyrolipolysis (freezing fat), Ultrasound, Radiofrequency, Pulsed Electro Magnetic Fields and Lasers (and sometimes a combination).
Here is a listing of the current FDA approved devices (more arriving each month!):
| TECHNIQUE | TECHNOLOGY | PROVIDER | AVERAGE PATIENT COST* | DURATION OF SESSION |
| CoolSculpting® | Cryolipolysis | ZELTIQ | $2000-2,250 average cost | 1 hour/ area |
| BTL Vanquish® | Radiofrequency | BTLaesthetics | $500-750/ session | 45 mins/ area |
| BTL Exilis Ultra™ | Focused RF + ultrasound waves | BTLaesthetics | $1,375 average cost | 20-30 mins/ session |
| SculpSure® | 1060nm laser | Cynosure | $300-350/ treatment applicator | 25 mins/ area |
| UltraShape® | Ultrasound waves | Syneron candela | $800-1,000/ session | 45 mins -1 hour/ area |
| Liposonix® | High- intensify focuses ultrasound | Solta medical | $150-300/ square | 1 hour / session |
| TruSculpt® | Radiofrequency | Cutera | $1,700 average price | 30 mins-1 hour/ session |
| Venus Freeze™ | Radiofrequency and magnetic pulses | Venus treatments | $1,225 average price | 15-40 mins/ session |
| i-Lipo™ | Low level laser (600- 650 nm laser) | i-Lipo | $3,650 average cost | 20-30 mins |
| Invasix BodyFX™ | Vaccum, Radiofrequency | Invasix | $2,000-2,250 average cost | 30 mins-1 hour/ session |
| Verju™ | 532 nm laser diodes | Erchonia | $60-280 average cost | 20-40 mins |
| vShape Ultra | Ultrasound, Focused Radiofrequency | Alma Lasers | $600-1,100 per area average cost | 30-60 mins/ session |
| Strawberry Laser Lipo | Low Level Laser | Laser Lipo Ltd | $1,600 per area average cost | 10 mins/ area |
*varies with number of areas treated, clinic location.
The most popular, and one that you must understand is the CoolSculpting® “Freeze your fat” technology, which utilizes Cryolipolysis®. ZELTIQ is a science-based medical device company located in the San Francisco Bay Area, and has licensed the commercial rights to Cryolipolysis®, from Massachusetts General Hospital (MGH).
FDA Approval: “affect the appearance of visible fat bulges in the submental area, thigh, abdomen and flank”
The mechanism behind the technique:
When patients receive CoolSculpting® treatments for non-invasive fat removal, a specially designed cooling applicator is applied to the desired area of fat reduction to extract energy from (or cool) the underlying fat tissue without damage to other tissues.
Most of the CoolSculpting® applicators use vacuum pressure to draw the tissue between the cooling panels. The CoolSculpting® procedure safely delivers precisely controlled cooling to gently and effectively target the fat cells underneath the skin.
Exposure to cooling via energy extraction results in apoptosis – a natural, controlled cell death – which leads to the release of cytokines and other inflammatory mediators that gradually eliminate the fat cells in the ensuing months.
Untreated areas will have no change in fat cell distribution, leaving a more sculpted body.
There have been over 3 million CoolSculpting® procedures and the procedure offers 95% proven results and a high patient satisfaction rate (75% to 95%).
A CoolSculpting® treatment lasts between 35 minutes to one hour. Depending on the patient’s desires, several treatments may be required (one for each area of concern), typically 3-6 treatments are required per patient.
A huge negative to CoolSculpting® is that it requires pricey consumables each time you do a treatment (currently between $125-175 per application).
For further detailed information regarding the consumable costs associated with offering CoolSculpting® to your patients, please refer to our article on “The Cold Hard Truth About CoolSculpting®.”
BTL Vanquish ME® is a non-invasive, contactless Radiofrequency fat removal procedure. One of the procedure’s selling points is that it has the largest treatment area, allowing you to treat the upper and lower abdomen, and both flanks at the same time.
It allows physicians to reduce circumference of the entire abdominal area or tone the legs. It is FDA approved for the “Non-Surgical Circumferential Reduction of the Abdomen”.
Treatment sessions are short (30-45 minutes depending on the area) and are very comfortable. This is great equipment for extenders to use since it offers little risk of side effects, no pain, no downtime and proven lasting results.
FDA Approval: “temporary reduction of the circumference of the abdomen”
The mechanism behind the technique:
The system’s patented technology creates a high-frequency energy field that targets the thermal effects into the fat layer while protecting the surrounding skin tissue.
Being an affordable treatment without pain or downtime and also an operator independent procedure, Vanquish® yields higher patient retention and conversion rates.
One of the best things about the Vanquish® is that is doesn’t require any consumables, so its one of the most profitable fat-elimination equipment options of the list.
BTL Exilis Ultra™ is unique in that it is the first non-invasive aesthetic device that simultaneously transmits radio frequency and ultrasound energy.
By combining energies, the delivered therapy is safer and more comfortable, with consistent results for a wide variety of patients of various age, body mass index, and skin type.
BTL Exilis™ has a simultaneous adjustable cooling system. The device improves skin laxity and has anti-aging effects.
Other important features are operator ease-of-use and a convenient user interface.
The benefits also extend to a practice’s return on investment (ROI) and the fact that the system requires only the minimal, inexpensive disposables (approximately $8-12/treatment).
In a 2014 study published in the Journal of Drugs in Dermatology, an evaluation of the Exilis™ technology demonstrated a 35% reduction in skin laxity, a 42% reduction in fine lines and wrinkles and a 33% decrease in the appearance of photodamage.
FDA Approval: “treatment of facial wrinkles and rhytides”
The mechanism behind the technique:
The Exilis™ uses a layering technique. Layering simply means that energy is delivered to the various depths in the tissue.
Changing the cooling during treatment allows you to treat deep tissue all the way up to the superficial layer.
New on the market, SculpSure® is the world’s first FDA-cleared laser treatment for non-invasive lipolysis of the flanks and abdomen.
It is a state-of-the-art, controlled light-based technology, targeted to patients looking to get rid of stubborn fat.
One of its primary benefits is time. Cynosure’s one 25 minute SculpSure® session will melt up to 24% of unwanted fat in your desired area (which with the CoolSculpting® new 35 minute applicator, this is not that big of a benefit).
Similar to the Exilis™, the SculpSure® has the added benefit of skin tightening (which with all of these devices is not that amazing).
FDA Approval: “affect the appearance of visible fat bulges in the abdomen and flanks”
The mechanism behind the technique:
The equipment is powered by a 1060 nm wavelength controlled hyperthermic fat reduction technique which has specific affinity for adipose tissue, coupled with minimal absorption in the dermis.
It elevates adipose tissue temperature between 42°C and 47°C, inducing apoptosis of the fat cells. Its special proprietary algorithm of Contact Cooling TM for patient comfort, prevents any damage to the skin and surrounding tissue.
SculpSure® is comfortable and well-tolerated, used on all skin types and offers over 90% patient satisfaction rates (this is a pretty high satisfaction rate for the newest entry in the market, I’m sure we will see that go down as more procedures are completed).
As well, SculpSure® has pricey consumables required for each treatment.
UltraShape’s® pulsed delivery of focused ultrasound energy causes immediate fat tissue destruction, enabling noticeable and long-lasting results.
FDA Approval: “non-invasive reduction in abdominal circumference”
The mechanism behind the technique:
UltraShape® is a FDA-cleared, non-invasive body-shaping procedure that uses focused pulsed ultrasound for selective fat-cell destruction.
UltraShape® ultrasound energy destroys the walls of fat cells, releasing the fat in the form of triglycerides.
The triglycerides are then processed through the liver and eliminated from the body naturally. The surrounding tissues, nerves, and muscles are left unharmed.
UltraShape® is virtually painless and leaves no visible signs of treatment.
Liposonix® uses high-intensity focused ultrasound to treat and eliminate stubborn fat. Like everyone else, they say its “perfect for people close to their ideal size and shape but need help where diet and exercise just won’t work”.
FDA Approval: “non-invasive waist circumference reduction”
The mechanism behind the technique:
Liposonix® is a high-intensity ultrasound energy that focuses on the targeted fat, destroying fat cells beneath the surface layers of the skin.
A continuous lesion is created in the targeted fat and the skin layer is not harmed. The treated fat tissue is removed through the body’s natural healing and elimination process, leaving you with a thinner, more contoured waistline.
TruSculpt® a product of Cutera, is high-powered radiofrequency technology. TruSculpt® features a large, ergonomic, 40 cm2 hand piece to conveniently treat larger zones of the body.
FDA Approval: “relief of pain” and “temporary reduction in the appearance of cellulite”
The mechanism behind the technique:
TruSculpt® has fast, intelligent and efficient operator control.
This latest non-invasive technology addresses a wide set of concerns on the body. TruSculpt® is clinically proven to deliver deep, uniform heating to all body areas with comfort and ease.
Its unique electrode design delivers deep, uniform, temperature distribution, while the proprietary coating on the electrode surface eliminates potential hot spots or edge effects—ensuring optimal patient comfort and safety.
The TruSculpt® system features a built-in temperature monitoring and feedback system, providing real-time readings of skin temperature to ensure that required therapeutic parameters are achieved and sustained for a period of 3 minutes.
You would think that Venus Freeze™ also uses cyrolipolysis but it doesn’t, it uses a combination of Radio Frequency (RF) and Pulsed Electro Magnetic Fields.
Venus says this combination provides the added benefits of increased oxygen, nutrients, and blood to the skin, giving it an immediate, long-lasting glow.
They say it not only reduces a patient’s circumference, but also improves the appearance of cellulite, tightens skin, and reduces the appearance of wrinkles.
FDA Approval: Oddly, the Venus Freeze™ is not approved for any body treatments, but is only authorized for “facial wrinkles and rhytides”.
The mechanism behind the technique:
Venus Freeze™ combines Multi-Polar Radio Frequency and Pulsed Electro Magnetic Fields, which produce a soothing and therapeutic heat matrix over the skin.
Skin tightening, wrinkle reduction, and cellulite reduction occur because the radio frequency causes a thermal reaction in the tissue, which stimulates the body’s natural healing response.
This restoring response causes new collagen to form, along with the increased production of fibroblasts and new elastin fibers.
The active collagen in the skin contracts, achieving a tighter appearance, along with softening of wrinkles and reduced cellulite.
i-Lipo™ uses a low-level laser device for smoothing cellulite, laser fat reduction & laser body contouring. The i-Lipo™ uses photobiomodulation to stimulate the body’s natural process for releasing stored content in the adipose cells.
The procedure is non-invasive with no pain, no needles, and no downtime.
FDA Approval: for the “temporary reduction in the circumference of the waist”
The mechanism behind the technique:
The i-Lipo™ emits low levels of laser energy, which creates a chemical signal in the fat cells, breaking down the stored triglycerides into free fatty acids and glycerol and releasing them though channels in the cell membranes.
The fatty acids and glycerol are then transported around the body to the tissues that will use them during metabolism to create energy.
A period of exercise post treatment will ensure the complete metabolism and thus elimination from the body of the freed fatty acids.
The BodyFX™ (formerly known as TiteFX) body contouring procedure provides improved circumferential reduction through a combination of vacuum and RF energy.
FDA Approval: “reduce the appearance of cellulite”
The mechanism behind the technique:
BodyFX™ uses a vacuum applicator that draws the skin and fat into the applicator, where radiofrequency (RF) energy targets the fat.
One of the selling points is that the fat is pre-heated, giving you better results. RF has been demonstrated to provide tightening results on the skin.
Erchonia, the maker of the Zerona, now offers the Verjú which uses 532 nm laser diodes, that painlessly reduce inches and remove stubborn body fat.
The Verjú delivers a non-invasive treatment for body contouring and a treatment for the appearance of cellulite.
FDA Approval: is not for actual fat reductions but as “an adjunct for individuals intending to undergo liposuction for the reduction of circumference of hips, waist and thighs”
The mechanism behind the technique:
As with the other treatments, Verjú causes the release of fatty lipids from within fat cells causing the fat cells to collapse and shrink to a smaller size, which reduces the circumference and the appearance of cellulite.
The fatty lipids then enter the lymphatic system where they are broken into free fatty acids and used as energy in the cardiovascular system.
The Verjú laser system penetrates the skin to treat hypertrophic adipocytes while increasing dermal collagen and stabilizing the fibrotic septae collagen.
The vShape Ultra (from Alma Lasers), with its JuVaShape technology, has the highest frequency and power in the market. vShape focuses thermo energy to address fat reduction and loose skin in the neck and face and address unwanted fat in the neck and chin area.
The radiofrequency technology destroys the fat cells out of the body, the body will flush the fat cells naturally.
vShape Ultra is ideal for people with stubborn fat or problem areas like the lower belly, outer or inner thighs, fat around the bra line area and the jawline.
FDA Approval: vShape Ultra is FDA approved for selective fat cell destruction using its patented shear wave ultrasound technology.
It is also FDA approved for skin tightening and cellulite reduction using its patented radiofrequency technology, that is the most powerful in the market.
The procedure targets and instantly destroys stubborn fat and tightens and tones the skin, without pain or downtime.
The mechanism behind the technique:
The vShape device is very powerful, and its advanced Radiofrequency (RF) technology helps target fat, tighten skin, reduce stretch marks, and treat cellulite all in one treatment.
vShape Ultra delivers selective cold shear wave ultrasound technology directly into the problem areas below your skin’s surface with controlled depth settings for maximum results in all the layers.
The ultrasound energy causes the fats cells to rupture – all while leaving the surrounding areas (nerves, blood vessels, skin, ect.) unharmed.
The radiofrequency technology supercharges water molecules in your skin, which in turn cause a heat reaction to tighten and tone the skin, even within the first treatment.
The Strawberry Laser Lipo treatment uses a low-level laser that stimulates the adipocyte cells, resulting in the breaking down of the stored triglycerides into free fatty acids and glycerol, releasing them via the channels in the cell membranes.
The process of fatty acid release is how the body uses the stored energy reserves, thus making the Strawberry treatment a natural process. In addition, this process will not harm surrounding structures, vessels, or nerves.
The expelled fat and fluids are released into the interstitial space and transported to the body’s lymphatic system.
It is highly recommended that physical exercise follow to ensure the disposal of the fat efficiently and preventing reabsorption.
Proper nutrition and exercise will both enhance results and prolong them long-term. The Strawberry Laser does not destroy cells. The process shrinks cells, causing inch loss in more natural, non-invasive approach.
FDA Approval: “non-invasive reduction in fat layer for body contouring”
The mechanism behind the technique:
The Strawberry Laser is a non-invasive class 2 cold laser. The laser reduces the size of adipocyte without destroying or damaging the cells.
The end result is inch loss in the treated areas. The common treated areas are abdomen, hips, thighs, knees, legs, ankles, back, arm, male chest, jowl and buttocks.
The most popular, and one that you must understand is the CoolSculpting® “Freeze your fat” technology, which utilizes Cryolipolysis®. ZELTIQ is a science-based medical device company located in the San Francisco Bay Area, and has licensed the commercial rights to Cryolipolysis®, from Massachusetts General Hospital (MGH).
FDA Approval: “affect the appearance of visible fat bulges in the submental area, thigh, abdomen and flank”
The mechanism behind the technique:
When patients receive CoolSculpting® treatments for non-invasive fat removal, a specially designed cooling applicator is applied to the desired area of fat reduction to extract energy from (or cool) the underlying fat tissue without damage to other tissues.
Most of the CoolSculpting® applicators use vacuum pressure to draw the tissue between the cooling panels. The CoolSculpting® procedure safely delivers precisely controlled cooling to gently and effectively target the fat cells underneath the skin.
Exposure to cooling via energy extraction results in apoptosis – a natural, controlled cell death – which leads to the release of cytokines and other inflammatory mediators that gradually eliminate the fat cells in the ensuing months.
Untreated areas will have no change in fat cell distribution, leaving a more sculpted body.
There have been over 3 million CoolSculpting® procedures and the procedure offers 95% proven results and a high patient satisfaction rate (75% to 95%).
A CoolSculpting® treatment lasts between 35 minutes to one hour. Depending on the patient’s desires, several treatments may be required (one for each area of concern), typically 3-6 treatments are required per patient.
A huge negative to CoolSculpting® is that it requires pricey consumables each time you do a treatment (currently between $125-175 per application).
For further detailed information regarding the consumable costs associated with offering CoolSculpting® to your patients, please refer to our article on “The Cold Hard Truth About CoolSculpting®.”
BTL Vanquish ME® is a non-invasive, contactless Radiofrequency fat removal procedure. One of the procedure’s selling points is that it has the largest treatment area, allowing you to treat the upper and lower abdomen, and both flanks at the same time.
It allows physicians to reduce circumference of the entire abdominal area or tone the legs. It is FDA approved for the “Non-Surgical Circumferential Reduction of the Abdomen”.
Treatment sessions are short (30-45 minutes depending on the area) and are very comfortable. This is great equipment for extenders to use since it offers little risk of side effects, no pain, no downtime and proven lasting results.
FDA Approval: “temporary reduction of the circumference of the abdomen”
The mechanism behind the technique:
The system’s patented technology creates a high-frequency energy field that targets the thermal effects into the fat layer while protecting the surrounding skin tissue.
Being an affordable treatment without pain or downtime and also an operator independent procedure, Vanquish® yields higher patient retention and conversion rates.
One of the best things about the Vanquish® is that is doesn’t require any consumables, so its one of the most profitable fat-elimination equipment options of the list.
BTL Exilis Ultra™ is unique in that it is the first non-invasive aesthetic device that simultaneously transmits radio frequency and ultrasound energy.
By combining energies, the delivered therapy is safer and more comfortable, with consistent results for a wide variety of patients of various age, body mass index, and skin type.
BTL Exilis™ has a simultaneous adjustable cooling system. The device improves skin laxity and has anti-aging effects.
Other important features are operator ease-of-use and a convenient user interface.
The benefits also extend to a practice’s return on investment (ROI) and the fact that the system requires only the minimal, inexpensive disposables (approximately $8-12/treatment).
In a 2014 study published in the Journal of Drugs in Dermatology, an evaluation of the Exilis™ technology demonstrated a 35% reduction in skin laxity, a 42% reduction in fine lines and wrinkles and a 33% decrease in the appearance of photodamage.
FDA Approval: “treatment of facial wrinkles and rhytides”
The mechanism behind the technique:
The Exilis™ uses a layering technique. Layering simply means that energy is delivered to the various depths in the tissue.
Changing the cooling during treatment allows you to treat deep tissue all the way up to the superficial layer.
New on the market, SculpSure® is the world’s first FDA-cleared laser treatment for non-invasive lipolysis of the flanks and abdomen.
It is a state-of-the-art, controlled light-based technology, targeted to patients looking to get rid of stubborn fat.
One of its primary benefits is time. Cynosure’s one 25 minute SculpSure® session will melt up to 24% of unwanted fat in your desired area (which with the CoolSculpting® new 35 minute applicator, this is not that big of a benefit).
Similar to the Exilis™, the SculpSure® has the added benefit of skin tightening (which with all of these devices is not that amazing).
FDA Approval: “affect the appearance of visible fat bulges in the abdomen and flanks”
The mechanism behind the technique:
The equipment is powered by a 1060 nm wavelength controlled hyperthermic fat reduction technique which has specific affinity for adipose tissue, coupled with minimal absorption in the dermis.
It elevates adipose tissue temperature between 42°C and 47°C, inducing apoptosis of the fat cells. Its special proprietary algorithm of Contact Cooling TM for patient comfort, prevents any damage to the skin and surrounding tissue.
SculpSure® is comfortable and well-tolerated, used on all skin types and offers over 90% patient satisfaction rates (this is a pretty high satisfaction rate for the newest entry in the market, I’m sure we will see that go down as more procedures are completed).
As well, SculpSure® has pricey consumables required for each treatment.
UltraShape’s® pulsed delivery of focused ultrasound energy causes immediate fat tissue destruction, enabling noticeable and long-lasting results.
FDA Approval: “non-invasive reduction in abdominal circumference”
The mechanism behind the technique:
UltraShape® is a FDA-cleared, non-invasive body-shaping procedure that uses focused pulsed ultrasound for selective fat-cell destruction.
UltraShape® ultrasound energy destroys the walls of fat cells, releasing the fat in the form of triglycerides.
The triglycerides are then processed through the liver and eliminated from the body naturally. The surrounding tissues, nerves, and muscles are left unharmed.
UltraShape® is virtually painless and leaves no visible signs of treatment.
Liposonix® uses high-intensity focused ultrasound to treat and eliminate stubborn fat. Like everyone else, they say its “perfect for people close to their ideal size and shape but need help where diet and exercise just won’t work”.
FDA Approval: “non-invasive waist circumference reduction”
The mechanism behind the technique:
Liposonix® is a high-intensity ultrasound energy that focuses on the targeted fat, destroying fat cells beneath the surface layers of the skin.
A continuous lesion is created in the targeted fat and the skin layer is not harmed. The treated fat tissue is removed through the body’s natural healing and elimination process, leaving you with a thinner, more contoured waistline.
TruSculpt® a product of Cutera, is high-powered radiofrequency technology. TruSculpt® features a large, ergonomic, 40 cm2 hand piece to conveniently treat larger zones of the body.
FDA Approval: “relief of pain” and “temporary reduction in the appearance of cellulite”
The mechanism behind the technique:
TruSculpt® has fast, intelligent and efficient operator control.
This latest non-invasive technology addresses a wide set of concerns on the body. TruSculpt® is clinically proven to deliver deep, uniform heating to all body areas with comfort and ease.
Its unique electrode design delivers deep, uniform, temperature distribution, while the proprietary coating on the electrode surface eliminates potential hot spots or edge effects—ensuring optimal patient comfort and safety.
The TruSculpt® system features a built-in temperature monitoring and feedback system, providing real-time readings of skin temperature to ensure that required therapeutic parameters are achieved and sustained for a period of 3 minutes.
You would think that Venus Freeze™ also uses cyrolipolysis but it doesn’t, it uses a combination of Radio Frequency (RF) and Pulsed Electro Magnetic Fields.
Venus says this combination provides the added benefits of increased oxygen, nutrients, and blood to the skin, giving it an immediate, long-lasting glow.
They say it not only reduces a patient’s circumference, but also improves the appearance of cellulite, tightens skin, and reduces the appearance of wrinkles.
FDA Approval: Oddly, the Venus Freeze™ is not approved for any body treatments, but is only authorized for “facial wrinkles and rhytides”.
The mechanism behind the technique:
Venus Freeze™ combines Multi-Polar Radio Frequency and Pulsed Electro Magnetic Fields, which produce a soothing and therapeutic heat matrix over the skin.
Skin tightening, wrinkle reduction, and cellulite reduction occur because the radio frequency causes a thermal reaction in the tissue, which stimulates the body’s natural healing response.
This restoring response causes new collagen to form, along with the increased production of fibroblasts and new elastin fibers.
The active collagen in the skin contracts, achieving a tighter appearance, along with softening of wrinkles and reduced cellulite.
i-Lipo™ uses a low-level laser device for smoothing cellulite, laser fat reduction & laser body contouring. The i-Lipo™ uses photobiomodulation to stimulate the body’s natural process for releasing stored content in the adipose cells.
The procedure is non-invasive with no pain, no needles, and no downtime.
FDA Approval: for the “temporary reduction in the circumference of the waist”
The mechanism behind the technique:
The i-Lipo™ emits low levels of laser energy, which creates a chemical signal in the fat cells, breaking down the stored triglycerides into free fatty acids and glycerol and releasing them though channels in the cell membranes.
The fatty acids and glycerol are then transported around the body to the tissues that will use them during metabolism to create energy.
A period of exercise post treatment will ensure the complete metabolism and thus elimination from the body of the freed fatty acids.
The BodyFX™ (formerly known as TiteFX) body contouring procedure provides improved circumferential reduction through a combination of vacuum and RF energy.
FDA Approval: “reduce the appearance of cellulite”
The mechanism behind the technique:
BodyFX™ uses a vacuum applicator that draws the skin and fat into the applicator, where radiofrequency (RF) energy targets the fat.
One of the selling points is that the fat is pre-heated, giving you better results. RF has been demonstrated to provide tightening results on the skin.
Erchonia, the maker of the Zerona, now offers the Verjú which uses 532 nm laser diodes, that painlessly reduce inches and remove stubborn body fat.
The Verjú delivers a non-invasive treatment for body contouring and a treatment for the appearance of cellulite.
FDA Approval: is not for actual fat reductions but as “an adjunct for individuals intending to undergo liposuction for the reduction of circumference of hips, waist and thighs”
The mechanism behind the technique:
As with the other treatments, Verjú causes the release of fatty lipids from within fat cells causing the fat cells to collapse and shrink to a smaller size, which reduces the circumference and the appearance of cellulite.
The fatty lipids then enter the lymphatic system where they are broken into free fatty acids and used as energy in the cardiovascular system.
The Verjú laser system penetrates the skin to treat hypertrophic adipocytes while increasing dermal collagen and stabilizing the fibrotic septae collagen.
The vShape Ultra (from Alma Lasers), with its JuVaShape technology, has the highest frequency and power in the market. vShape focuses thermo energy to address fat reduction and loose skin in the neck and face and address unwanted fat in the neck and chin area.
The radiofrequency technology destroys the fat cells out of the body, the body will flush the fat cells naturally.
vShape Ultra is ideal for people with stubborn fat or problem areas like the lower belly, outer or inner thighs, fat around the bra line area and the jawline.
FDA Approval: vShape Ultra is FDA approved for selective fat cell destruction using its patented shear wave ultrasound technology.
It is also FDA approved for skin tightening and cellulite reduction using its patented radiofrequency technology, that is the most powerful in the market.
The procedure targets and instantly destroys stubborn fat and tightens and tones the skin, without pain or downtime.
The mechanism behind the technique:
The vShape device is very powerful, and its advanced Radiofrequency (RF) technology helps target fat, tighten skin, reduce stretch marks, and treat cellulite all in one treatment.
vShape Ultra delivers selective cold shear wave ultrasound technology directly into the problem areas below your skin’s surface with controlled depth settings for maximum results in all the layers.
The ultrasound energy causes the fats cells to rupture – all while leaving the surrounding areas (nerves, blood vessels, skin, ect.) unharmed.
The radiofrequency technology supercharges water molecules in your skin, which in turn cause a heat reaction to tighten and tone the skin, even within the first treatment.
The Strawberry Laser Lipo treatment uses a low-level laser that stimulates the adipocyte cells, resulting in the breaking down of the stored triglycerides into free fatty acids and glycerol, releasing them via the channels in the cell membranes.
The process of fatty acid release is how the body uses the stored energy reserves, thus making the Strawberry treatment a natural process. In addition, this process will not harm surrounding structures, vessels, or nerves.
The expelled fat and fluids are released into the interstitial space and transported to the body’s lymphatic system.
It is highly recommended that physical exercise follow to ensure the disposal of the fat efficiently and preventing reabsorption.
Proper nutrition and exercise will both enhance results and prolong them long-term. The Strawberry Laser does not destroy cells. The process shrinks cells, causing inch loss in more natural, non-invasive approach.
FDA Approval: “non-invasive reduction in fat layer for body contouring”
The mechanism behind the technique:
The Strawberry Laser is a non-invasive class 2 cold laser. The laser reduces the size of adipocyte without destroying or damaging the cells.
The end result is inch loss in the treated areas. The common treated areas are abdomen, hips, thighs, knees, legs, ankles, back, arm, male chest, jowl and buttocks.
No anesthesia, no downtime, nominal pain, minimal side effects, and immediate recovery are the key features of these procedures.
These non-invasive, non-surgical techniques are designed specially to target the adipose fat cells, without damaging the skin and subcutaneous tissue itself.
The equipment, through various mechanisms, in effect disrupts the fat cells by inducing a non-inflammatory, apoptotic death of the fat cell (accelerated natural cell death) in the treated area.
Gradually, in a matter of few weeks the damaged fat cells are removed by body’s lymphatic system leaving behind a smart, slim, contoured body area.
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The body removes damaged fat cells gradually, but most patients begin to see visible results at about 6 weeks and optimal results at about 12 weeks.
This is one of the biggest issues with the equipment, that the patient doesn’t see an immediate change.
This is usually the result of either the slow fat loss over a long period of time is just not noticeable to them; or they gain weight during the next couple of months (thinking they just zapped the fat, so they can go back to eating and drinking all that bad stuff!).
It is very important to take baseline measurements (weight and body measurements), and photos of every patient before and 9 to 12 weeks after the procedure.
You may also want to invest in a comprehensive camera system that can accurately measure the before and after a circumferential change in every patient. The most reasonably priced camera system I’ve found is the AccuView measuring tool.
Here is what you and your patients will see with the AccuView:
In recent years, nonsurgical alternatives to liposuction have exploded onto the aesthetic market. Over the years, the results have also progressively gotten much better, giving you some amazing before and after photographs.
With the popularity of many daytime talk shows, advertising and social media, we are seeing more and more conversations about these procedures, which is increasing the demand.
For the most part, these techniques are ideal for patients with good skin laxity and for those who can’t undergo invasive procedure due to their underlying medical conditions (not fit for anesthesia, taking blood thinners etc.), and will accept a 1 or 2-inch loss.
The results may vary individually and appear around 4-6 weeks after the procedure. So, make sure your patient knows what to expect.
It must be clear, that the remaining fat cells can expand to take the place of the dead ones. So if they want to keep the results they need to maintain a healthy lifestyle post procedure.
Since most of these machines cost in excess of $80,000, it is important to make the right decision. Before you buy, here are some tips:
The bottom line is, patient selection is very important and patient expectations must be clear and discussed up front.
None of these machines give you surgical results, and those outcomes should never be promised to patients.
As well, none of these machines will give you weight loss, that needs to be accomplished either with liposuction or diet and exercise!
However, you will be surprised how many patients are still fine with only losing an inch or two and being able to fit into those jeans or their little black dress.
As a bonus, the new revenue generated for your practice by these machines is very lucrative.
The bigger opportunity is that these procedures bring in patients who you can now offer complementary procedures, including: skin tightening, weight loss, Botox and fillers, microdermabrasion, chemical peels!
If you are a physician or healthcare provider looking for more information on adding non-invasive body sculpting procedures to your practice, consider attending the IAPAM’s Aesthetic Medicine Symposium’s medical weight management program.
Whether you are new to Botox injections or an experienced injector, read these Botox best practices.
Whether you are new to Botox injections or an experienced injector, read these Botox best practices.
Botox® Brow Lift Before and After A traditional brow lift, also called a forehead lift, is a surgical procedure that involves physically lifting the muscles
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