One of the newest fat reduction technologies is RF, which delivers energy to fat deposits by driving controlled heat deep within the fat cells and destroying them. While RF has not yet been approved by the US Food and Drug Administration (FDA) for fat removal, the technology is being widely used by dermatologists with much success for people with pockets of excess fat. Since there is no downtime with this procedure, patients can resume their regular activities immediately. Another benefit of RF is its ability to both reduce fat and tighten the skin by directing energy to targeted collagen tissues.

A new, noninvasive procedure that is approved by the FDA is cryolipolysis, which is being used to remove localized areas of fat in the lower abdomen or along the sides of the body. Since fat cells are more sensitive to cold temperatures than other skin cells, cryolipolysis freezes the lipids in fat cells, which then slowly dissolve with no trauma or injury to surrounding tissues. For this reason, results are not immediate and fat layer reduction becomes visible gradually over the course of two to six months. Currently, cryolipolysis only allows for the treatment of larger areas of fat, but future developments could enable dermatologists to treat the inner thighs, neck, and arms for more refined fat reduction.

A third technique under investigation is using high-intensity, focused ultrasound waves to cause destruction and leakage of fat cells. Similar to the other noninvasive procedures used for fat reduction, the ultrasound energy penetrates through the skin layers into the targeted fat without harming skin or surrounding tissues. The difference is that ultrasound involves the mechanical destruction of the fat cells which then dissolve gradually over time, rather than destruction by temperature extremes.

“Fat cells are by nature very different than other cells, particularly in how they respond to stimuli such as temperature,” said dermatologist Lisa Donofrio, MD, of the department of dermatology at Yale University School of Medicine (New Haven, CT, USA). “Most of the new technologies recently introduced for fat removal were developed based on this knowledge and, as a result, can target specific areas of body fat using energy delivered as either heat or cold.”

The noninvasive procedures are not meant to replace tumescent liposuction for fat removal, a controlled, precise procedure that differs from the novel “wait-and-see” external fat reduction approaches, and the candidates are not in the same class either. For example, patients who are taking blood thinners or have a contraindication for surgical procedures are not good candidates for tumescent liposuction, but could be candidates for a noninvasive procedure.

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Yale University School of Medicine