PracticalDermatology

The business of body contouring is exploding. There are a growing number of noninvasive body contouring devices available today with more in the pipeline. It can be said that this market is growing as rapidly as the American waistline. The main modalities induce fat cell apoptosis via ultrasound, laser, radiofrequency, or cryotherapy, essentially melting or freezing unwanted fat.

Given the myriad options, the challenge becomes matching the right device with the right patient for maximum results and satisfaction.

Making Choices

Appropriate patient selection is key. Some modalities are best for individuals who can pinch a little more than an inch. By contrast, Perigee Medical’s Futura Pro is well suited for patients who have more fat, but who do not want or can’t tolerate surgery, including liposuction. I use this device for patients who want to dramatically decrease their waistline, upper back, mid back, buttocks, and/or thighs without surgery. This dual-modality fat reduction system is a US FDA-cleared 510k Class II Medical Device. It utilizes
1 MHz Ultrasound Technology combined with a muscle re-education system to simulate natural muscle activations and increase local blood circulation.

In my practice, a medical assistant applies the ultrasound for 20 to 30 minutes on the area of the body the patient is targeting to emulsify the fat. After applying the ultrasound, electric muscle stimulation pads are placed on the patient to contract the muscles. The pads, which use proprietary TranStim technology, move emulsified fat to the circulatory lymphatic system where it can be metabolized, resulting in the rapid loss of inches and gradual weight loss. Like other methods on the market, the fat is naturally excreted in urine. Some patients will see decreases in triglycerides and cholesterol with time.

Results

Results vary by patient. Patients who are very overweight can lose more than two inches in the first treatment, while patients who are just 10 to 15lbs overweight may lose 0.5-0.75 inch after the first treatment. Unlike other methods of non-invasive fat reduction, these results are immediate. I ask patients to bring a pair of “skinny jeans” with them on the day of treatment. I have them try the jeans on before and after the treatment, as skinny jeans don’t lie. My patients are consistently amazed.

The secret to success is that the device works out the patient electronically via very deep and prolonged muscle contractions.

There is no downtime with Futura Pro, but patients do feel some muscle stiffness and burning during and after muscle bio-stimulation. It is similar to doing 1,500 sit-ups. I find non-exercisers dislike the feeling more than exercisers. The cost is significantly less than other available non-invasive fat removal methods, ranging form $600 to $800 per session. A series of about eight treatments is typically needed.

I offer an a la carte approach to body contouring to my patients. For example, I’ll use the Futura Pro to help with the fat and then I’ll use BTL’s Vanquish to decrease large areas of fat as it has a multi-polar radio frequency extra large spot size. I will also use the Vanquish Flex applicators for the thigh with Kybella injections to further decrease fat. I may also suggest BTL Exilis or ThermiSmooth to heat up tissue and tighten the skin before I use the Futura Pro. In other patients, I will introduce a device that helps reduce the appearance of cellulite.

Tangible Results, Few Risks

With the multiple devices available, used together or alone, we can provide patients with a more chiseled result that is closer to what was once only achievable with surgery. It is very exciting and rewarding to offer patients tangible results without the risks and downtime associated with surgery. n

Jeanine B. Downie, MD is the director of Image Dermatology P.C in Montclair, NJ. She is also an assistant attending dermatologist at Mountainside and Overlook Hospitals in Montclair, NJ. Dr Downie originally made this presentation at the 2015 Cosmetic Surgery Forum in Las Vegas.

Dr Downie’s disclosures include:

- Johnson & Johnson -- consultant, researcher, lecturer

- Allergan -- consultant, researcher, lecturer

- Valeant (Medicis) -- consultant

- Pfizer -- consultant, lecturer

- Galderma -- consultant, lecturer

- Novartis -- consultant

- Intendis (Bayer) -- consultant

- Skin Medica -- consultant, lecturer, lecturer

- Stiefel (GSK) -- consultant, lecturer

- Merz -- consultant, researcher

- BTL -- consultant

- Kythera -- researcher

- Innocutis -- consultant

- Proctor & Gamble- consultant

- Revance – researcher

- Restorsea -- consultant

- Theraplex LLC -- consultant

- Lifes 2 Good -- Viviscal consultant

- Perigee Medical – consultant