What to Know About Lipolysis for Fat Removal

Lipolysis involves nonsurgical, minimally invasive fat removal. Fat can be removed from areas of the body such as the belly, flanks, or back, using several different handheld devices that destroy fat cells through cold, heat, or sound waves. Injections that dissolve fat cells are approved by the Food and Drug Administration (FDA) to treat the chin area.

This article will discuss how lipolysis works, what to expect, and where to find it.

Lipolysis Definition 

Lipolysis is a group of nonsurgical, minimally invasive procedures that selectively break down fat cells in subcutaneous (beneath the skin, above the muscle) fat deposits that don't respond to diet and exercise.

Treatment can involve targeting fat cells with energy sources, such as a laser or freezing energy, or using injections designed to dissolve fat cells.

Lipolysis can be used as a less-invasive alternative to liposuction or in combination with liposuction.

Goal of Lipolysis 

Lipolysis targets pockets of fat that have not responded to diet and exercise. It is a cosmetic procedure meant to create body contouring effects in areas such as:

• Face and chin
• Upper arms
• Abdomen
• Back
• Flanks ("love handles")
• Thighs
• Knee area
• Calves

An injection of the chemical deoxycholic acid is FDA-approved for use in the area underneath the chin ("double chin").

Lipolysis does not require general anesthesia, it usually has minimal side effects and downtime, and it involves no incisions or scarring.

Lipolysis vs. Liposuction 

Liposuction is a cosmetic surgical procedure that removes subcutaneous fat. It is the most common cosmetic surgery procedure. Like lipolysis, liposuction has benefits and downsides.

Liposuction is a onetime procedure, and results are noticeable more quickly than with lipolysis. It also allows for more sculpting than lipolysis.

Liposuction is more invasive than lipolysis and carries the risks associated with surgery. It often requires general anesthesia, which also carries risks.

Lipolysis is less invasive and poses fewer risks. It is also generally less expensive than liposuction.

Lipolysis has its own limitations. The exact amount of fat that will be lost can't be chosen, just an estimated percentage. Multiple treatments may be needed. It may not be appropriate for people who have a significant amount of fat to lose. It reduces fat only, with minimal sculpting.

What Happens During a Lipolysis 

Several FDA-approved lipolysis treatments are available.

Cryolipolysis:

• Brand name: CoolSculpting
• It uses a device placed on the skin that dismantles fat cells with extreme cold.
• It does not harm muscle, skin, and nerve tissue as they have lower freezing temperatures than fat.
• It is used on the abdomen, hips, thighs, back, upper arms, under the butt, and under the chin.
• Typically produces up to 25% fat reduction per treatment.
• Usually requires one to two treatments lasting 35 to 60 minutes each.
• Serious side effects are very rare.
• Common side effects are temporary and mild, such as swelling, numbness, redness, and tingling.
• Results start to be noticeable within a month and are final after two to three months.
• Results usually last unless significant weight gain occurs.

Laser Lipolysis:

• Brand name: SculpSure
• Subcutaneous fat cells are broken down using controlled heat created by delivering a specific laser wavelength through the skin.
• A cooling mechanism is used to prevent skin from being damaged during the process.
• It is used mainly on the abdomen and flanks but can be used in other areas.
• It is typically painless; you may feel a warming sensation.
• Treatments take 25 minutes in each targeted area.
• Results begin to be noticeable in about six weeks and are final in about 12 weeks.
• Results are usually lasting unless significant weight gain occurs.

Injectable Deoxycholic Acid:

• Brand name: Kybella
• Deoxycholic acid occurs naturally in the body and helps break down fat for digestion.
• In injectable form, deoxycholic acid can break down fat cells on contact.
• It is used for isolated reduction of fat in the under-chin area.
• Multiple injections are administered under the chin with a very thin needle, using a grid pattern.
• Injections take about 20 minutes.
• Local anesthetic may be used for comfort.
• For optimal results, two to four treatments are given spaced one month apart.
• Common side effects are usually temporary and mild, such as swelling, numbness, redness, or bruising at the treatment site.
• Serious side effects are rare and usually improve on their own but may include facial weakness or prolonged numbness.
• Results should last unless significant weight gain occurs.

Radio Frequency Lipolysis: 

• Brand name: Vanquish
• An applicator that emits a radio frequency is held about 1 centimeter from the skin.
• Fat cells are heated without impacting other tissues.
• Each treatment takes about 30 minutes.
• Treatments are weekly for about four weeks or as determined.

Before

Before whichever treatment is administered, there will be a consultation with the cosmetic surgeon to:

• Discuss your medical and family history, including conditions, allergies, and previous surgeries and treatments
• Evaluate your general health
• Ask about your current medications, herbal supplements, vitamins, and alcohol, tobacco, and drug use
• Go over your goals
• Discuss your options and make recommendations
• Outline risks, potential complications, and likely outcomes
• May take photos
• Give instructions to prepare for the procedure if necessary

Recovery 

Lipolysis typically requires no downtime, and normal activities can be resumed immediately.

Some people may experience temporary side effects such as:

• Swelling
• Bruising
• Discomfort or tenderness
• Redness
• Burning, stinging, or a pins-and-needles sensation in the treated area

Risks 

Serious complications are rare with any type of lipolysis, but may include:

• Cryolipolysis: Long-term pain or an increase in the amount of fat in the treated area
• Injection lipolysis: Nerve injury, an uneven smile, difficulty swallowing
  
• Radio frequency lipolysis: Mild erythema (a type of skin reaction) has been reported
  
• Laser lipolysis: Temporary redness, tenderness, and/or swelling

Lipolysis Cost 

According to 2020 statistics from the American Society of Plastic Surgeons, the average cost of nonsurgical fat reduction is $1,437, and the average cost of injection lipolysis is $941.

Prices will vary depending on factors such as the surgeon's experience and geographic location.

There may also be additional costs, including:

• Surgeon's fee
• Surgical facility costs
• Medications
  

Who Is Eligible?

Lipolysis may be an appropriate option if you:

• Are at or near your preferred weight
• Do not need significant reshaping in the targeted area
• Have isolated pockets of fat that are resistant to diet and exercise
• Can't or don't wish to have surgery
• Have realistic expectations about results

Finding a Cosmetic Surgeon

Start by consulting with a board-certified cosmetic surgeon or dermatologist. Plastic surgeons should be certified by the American Board of Plastic Surgery and dermatologists by the American Board of Dermatology.

Noninvasive procedures such as CoolSculpting or SculpSure may be performed by a licensed, trained aesthetician working under the supervision of a physician.

Injection lipolysis requires advanced knowledge of anatomy. It should only be performed by a qualified cosmetic surgeon (or a healthcare provider with equivalent training and experience).

Make sure to do your research before choosing a surgeon, including asking about certification, training, experience, and before and after photos of your desired procedure performed by that surgeon.

Summary

Lipolysis is a set of nonsurgical, noninvasive procedures that are used to remove fat pockets in areas such as the abdomen, back, flanks, face, legs, and chin. Depending on which procedure is used, fat cells are destroyed using cooling, heating, or chemical injection.

Serious complications from lipolysis are rare but can occur. Make sure to choose a board-certified cosmetic surgeon, and do your research before having lipolysis.