New Forms of Lipo Let You Lose an Inch in a Pinch

Tuesday, February 05, 2008
By Cristina Rouvalis, Pittsburgh Post-Gazette

Nancy Pariza had a SmartLipo to lose a few inches, left. The results are at right.

In surgically enhanced Los Angeles, where size 0 is the new size 4, it's not surprising that women spend their lunch hours having fat cells zapped.

But even in flab-friendly Pittsburgh, so-called lunchtime lipo is becoming popular.

Which is why Nancy Pariza traveled to Mt. Lebanon to spend $4,000 to shed about 1.5 pounds of fat from her size-4 body, ignoring her friends' protests that she was crazy.

"Everyone made fun of me. 'Yeah, you are so fat.' I didn't like the junk coming out of the side of my jeans," she said before going under local anesthesia for SmartLipo surgery at The Skin Center Medical Spa in Mt. Lebanon.

Every week, Dr. Dominic Brandy performs about five to six SmartLipo procedures, comprising about a fourth of his business at the Skin Center. In November, he inserted a tiny cannula with a laser fiber under the skin of Ms. Pariza's lower back and hip to liquefy the fat cells before vacuuming out 650 milliliters of fatty liquid from her waist and hip.

Like a growing number of patients, the 5-foot-4, 122-pound Ms. Pariza wanted to go the minimally invasive route of surgery under an hour.

"I don't want to feel anything," Ms. Pariza, a receptionist who works in Cleveland, said before her surgery. "I had seen traditional lipo done on TV. It looked so brutal. People jabbing the needles in. Oh, man. I had to change the channel."

A sore but happy Ms. Pariza -- sans the love handles -- was back at work four days later.

Sucking out fat, no matter how it is done, is a growing American preoccupation.

Traditional liposuction remains the most popular cosmetic surgery in the United States, with 403,684 operations performed in 2006, up 128 percent from 1997, according to the American Society for Aesthetic Plastic Surgery.

But the less invasive spin-offs such as SmartLipo (which are not tracked by plastic surgery societies) are gaining in popularity. While this has been approved by the Food and Drug Administration, an even quicker procedure that sculpts with chemicals instead of the laser fiber is more controversial.

LipoDissolve, a true lunchtime lipo with no recovery period, allows patients to forgo the knife altogether.

A busy patient can get the microinjections of B vitamins, Phosphatidylcholine and Deoxycholate, and then get back to their life.

Dr. Brandy, one of the first in the Pittsburgh area to offer this European fat-burning method, said the solution bursts fat cells and sculpts problem areas. (The patient gets four treatments spaced four to six weeks apart, and each costs $350 for one area and another $100 for an additional area.)

The FDA has not approved this type of fat-removing procedure (although the chemicals are approved for other uses) and the American Society of Aesthetic Plastic Surgery is investigating LipoDissolve for safety concerns.

"I am not saying that LipoDissolve is bad," said Dr. Leo McCafferty, a plastic surgeon in Shadyside and a spokesman for the American Society of Aesthetic Plastic Surgery. "But we don't know that it is good. What are the breakdown products? Free fatty acids? I don't want to set up a fear factor, but we feel safety comes first. Enthusiasm over new technology is a good thing, but it has to be tempered by scientific data. All of these things may not turn out to be so great."

(Dr. McCafferty said he believes SmartLipo, the procedure Ms. Pariza underwent, is safe, but he doesn't do it because he prefers spot liposuction).

Dr. Stephen Greenberg, a plastic surgeon in New York, likes doing SmartLipo but has problems with LipoDissolve. "The chemicals make me nervous. I think it can cause catastrophic anatomical problems. LipoDissolve is not uniform in the removal of fat. You can get a big dent. I have seen patients done by other people and they were awfully dented. I think the only thing that works is removing the fat."

But Dr. Brandy said none of his LipoDissolve patients have dents because he and his staff inject the solutions carefully in a grid so they are dispersed evenly. "When you inject anything haphazardly, you get bumps."

He also said he has no safety concerns and has not seen bad side effects. "The chemicals are naturally occurring substances in your body. It has been used in Canada for 20 years and there have been no serious side effects. The only side effect is that if you inject too deep, you will have some muscle atrophy and if you inject too superficially, you will have skin alterations. But if you know what you are doing, it is not going to be a problem. It definitely works."

The procedure is being unfairly attacked by the liposuction establishment, said Dr. Khalid Mahmud, board member of the American Society of Aesthetic LipoDissolve, a training organization for physicians. Dr. Mahmud said the complication rate has been less than 1 percent on major studies following 60,000 treatments. And none of those are the serious complications, such as embolism or thrombosis or even death, occasionally found in traditional liposuction.

"They are just trying to protect their turf," he said.

Ms. Pariza opted for SmartLipo because she wanted to quickly remedy her body bugaboo -- her love handles that stubbornly clung to her despite the reps in the gym. The down-to-earth woman with long blond hair generally liked her body but was self-conscious about wearing fitted tops.

She saved up the $4,000 so she wouldn't have to take out a loan. (The procedure costs anywhere from $3,000 to $7,400 depending on the size of the treated area.)

Dr. Brandy sees a lot of trim patients like her who want to be even sleeker. So does Dr. McCafferty, who prefers traditional spot liposuction without a laser. "We do spot lipo with minimum medication with the patient standing. They can go back to work in a few days."

He said while he doesn't have a problem with SmartLipo, he has seen no scientific evidence that it is any better. Dr. Brandy said he has seen firsthand how the laser tightens the skin so it does not sag when the fat is removed.

For her part, Ms. Pariza is happy with her new body. She weighed in three pounds lighter, at 119 pounds. But the big difference was her 28-inch abdomen, down three inches, and her 33 1/2-inch hips, 2 inches smaller than they were.

Three months after the surgery she says she still has a tiny bit of soreness, but she said, "I would do it again in a heartbeat."

Cristina Rouvalis can be reached at crouvalis@post-gazette.com or 412-263-1572.