Body Sculpting, Does it Work?

This transcript was exported on January 17, 2024 -view latest version here.

Skincare can sometimes feel overwhelming. Whether it’s finding the right products, ingredients or treatments, there’s a lot out there. But not all of it’s for people of African, Hispanic, Middle Eastern and Eastern South Asian descent. That’s why I set out to educate myself and others, so that we can all feel beautiful in our skin. Hello, and welcome back to The Skin Report. I’m Dr. Simran Sethi, an internal medicine doctor, mom of three, and CEO and founder of ReNewMD Medical Spas and Skin by Dr. Sethi.

The medical aesthetics market has leveraged years of research to develop different body sculpting methods that range in invasiveness and effectiveness. Though these services can differ greatly, they all help patients reach the same goal, subcutaneous fat reduction in one or more areas of the body through a process commonly referred to as body sculpting or body contouring. I’ve previously covered this topic before in season one of The Skin Report, where I’ve discussed body sculpting methods to achieve a reshaped figure before a big date or a significant event. I’ll link that episode in the show notes for anyone who wants to check it out.

Of course, you don’t need a special occasion to seek treatment that will help you feel confident in our skin. With our ongoing weight loss theme, I figured that now would be the perfect time to return to this topic. So with further ado, let’s go over some of the science backed facts surrounding body sculpting, and the different invasive and non-invasive procedures that you can undergo to achieve the body of your dreams.

Body sculpting, or body contouring, describes a process of reshaping an area of the body through targeted volume reduction. The term is often used when referring to methods involving anesthesia and operational plastic surgery. That’s right. I’m talking about surgical liposuction. Liposuction is an invasive method of body contouring, as it creates trauma in the treatment area in order to remove fat. Specifically, liposuction surgery involves devices that use suction to reduce deposits of excess fat in areas like the hips, thighs, stomachs and buttocks.

Now, you may be wondering, “What about surgical liposuction makes it an invasive procedure compared to other non-invasive fat contouring methods?” Well, there are several factors that can go into determining whether a procedure is considered invasive. A good rule-of-thumb is that procedures involving general anesthesia are more commonly considered to be invasive. During surgical liposuction, a surgeon must make an incision in the skin, near the area where the fat removal will take place. This is necessary for the liposuction device to enter the location of the fat deposit so that it can break up and remove the unwanted fat cells. Now, this process might sound a bit painful, but thankfully, most surgical liposuction is performed under a general anesthesia. That means that while the surgery is taking place, the patient doesn’t feel a thing. Still, being that surgical liposuction is invasive, recovery can be painful. But, there are several advantages to this body contouring method.

First, when performed successfully, surgical liposuction provides almost instant results. Patients need only to recover from a single treatment to experience dramatic changes to their body composition. Surgical liposuction is also a highly precise contouring method, as the surgeon can manually control the device to target localized fat deposits in specific areas. This is why many people seek out this treatment for fat in stubborn areas that do not respond to traditional weight loss practices like dieting and exercise. Finally, removing fat through liposuction means that the fat cells are removed forever. With a healthy lifestyle, the long-lasting effects can be a definite advantage of surgical liposuction.

It can sound enticing to reshape your body through a one-and-done surgical liposuction procedure, but this method is not always feasible for people who can’t dedicate the time necessary for recovery. Additionally, surgical body sculpting through liposuction may not be suitable for all patients, especially if they have a darker skin tone, because there can be scarring and hyperpigmentation in the area where the surgical incisions are made.

Coming up, I’ll share more about invasive versus non-invasive body sculpting methods, and why people may choose an alternative to surgical liposuction.

To understand why someone may consider alternative treatments to surgical liposuction, consider this clip from season one, episode 11 show on body sculpting.

Surgical body sculpting is certainly a choice. But it is a better choice for excess fat or skin removal after losing a considerable amount of weight. Surgical body sculpting requires a lot of downtime and runs the risk of scarring, infection, and a longer period of discomfort. Even though it’s a good option for excess fat and skin, it is recommended for people with a BMI of 40 or higher, when the elasticity of the skin is more likely not to regain its original form, as prior to weight gain. However, if you’re looking for a treatment that will target stubborn fat in a certain area, non-invasive body sculpting may be the way to go.

Some people may not meet the BMI range to qualify as a good candidate for surgical liposuction, due to the higher likelihood of ending up with loose skin as a result of the procedure. Meanwhile, other patients may simply have an aversion to invasive body contouring treatments. This is completely understandable, considering the downtime for liposuction can range from a few days before returning to work to several months of longterm recovery, depending on the areas treated and the volume of fat removed. Since surgical liposuction involves making incisions in the skin, recovery can be uncomfortable. Compression garments may also be recommended post-surgery, to promote fluid drainage and reduce swelling, which are both common side effects involved in the body’s natural healing process following the treatment. Avoiding strenuous activity and administering proper wound care may not be possible for everybody who’s interested in body contouring, but price is another significant consideration. Liposuction can range from around 1000 to above 20,000, based on the area treated, the location of the clinic, and a range of other additional costs that may be associated with the surgery.

These factors lead many patients to consider non-invasive approaches to body sculpting. As we continue this episode, I’ll be covering non-invasive body sculpting treatments that do not require incisions and generally require less downtime, and expense, than surgical liposuction. For example, my medical spa ReNewMD offers several different approaches to non-invasive body sculpting through treatments such as EmSculpt NEO, FlexSure, and SculpSure to name just a few. Other popular methods that are commonly offered in many spas and plastic surgeons’ office may include cryolipolysis treatments and ultrasonic habitation. I’ll discuss each of these methods when we return.

Now that we’ve gone over the pros and cons of surgical liposuction, let’s take a closer look at how alternative body sculpting treatments use non-invasive methods to achieve similar results. The first option I want to discuss is SculpSure, an FDA approved treatment that uses a laser to target fat cells beneath the skin’s surface. Like surgical liposuction, SculpSure has the advantage of permanently removing fat cells from the body. But unlike liposuction, it does not involve any incisions. Let’s listen to my review of this treatment method from season one, episode 11.

I want to first tackle sculpture, which is an FDA approved treatment that uses a laser to melt fat cells in 25-minute sessions at a medical spa, like ReNewMD. The sculpture laser is tailored to reach the layer of fat beneath the skin. The laser is a light source and light is energy. When that energy is focused on fat cells, they heat up, becoming unstable and eventually break apart. In essence, the laser breaks down the fat cells, dissipating them permanently. Your body then removes these dead fat cells through the lymphatic system. The laser has been customized so that the wavelengths only target fat and other tissues are left untouched.

The great thing about SculpSure, what gives it an edge over other sculpting procedures, is that it permanently removes fat cells. Once an area has been treated, up to 25% of fat cells will be treated and broken down by the SculpSure laser. These specific fat cells do not return, meaning there are fewer fat cells in that area for your body to store fat.

Another FDA approved tool that provides body contouring results without going under the knife is EmSculpt NEO. Like SculpSure, EmSculpt NEO can reduce fat, but it comes with the added advantage of helping to build and define muscle. Listen to this segment to hear how it works.

EmSculpt NEO is another FDA cleared treatment that not only reduces and melts fat, but it also helps to build and define muscle. It is the first and only non-invasive sculpting treatment that helps to build muscle. While SculpSure uses the heat of the laser to work its magic, EmSculpt NEO utilizes electromagnetic energy, as well as radio frequency technology, to engage the underlying muscles. The electromagnetic energy causes contraction that will, in turn, release fatty acids. The release of fatty acids results in fat cells dying, a process call apoptosis.

EmSculpt NEO doesn’t necessarily reduce weight. Instead, it eliminates fat cells while also stimulating muscles to help define the area being treated. Interestingly, EmSculpt NEO can also be used to help with bad back pain and has been proven by numerous studies to-date. An effective and non-invasive method for improving back pain is by strengthening core muscles by doing exercises such as sit ups and crunches. However, for patients who experience crippling back pain, this is not always possible. This is where EmSculpt NEO steps in.

Remember earlier, when I said that surgical liposuction provides instant results? Well, non-invasive body sculpting does not happen quite as quickly. Everyone loves instant gratification, but when comparing treatment options I like to look at it like this. Invasive body sculpting through surgical liposuction may provide instant results, but this usually comes at a cost of a longer recovery period with more physical discomfort and more expense. On the other hand, non-invasive treatments can require multiple sessions and take more time to produce visible results, but patients will avoid the discomfort, downtime and high price associated with traditional lipo.

There are many reasons why someone may choose invasive or non-invasive body contouring treatments. You should speak with your medical aesthetics provider to determine the best patient plan for your unique needs. Still, I want listeners to remember that each of these options has its benefits and drawbacks. In this upcoming segment, I share more about why it is that non-invasive body sculpting treatments take more time to produce visible changes.

Results vary for every patient. But typically, you can start to see results after the second session. This goes both for SculpSure and EmSculpt, as your body needs time to break down, transport away fat cells and adjust to all the changes. However, EmSculpt and SculpSure can be used in tandem to see the best results in four sessions that usually last 30-minutes each. In fact, in certain parts of the body, like the abs, EmSculpt and SculpSure can be used in tandem to stimulate waist reduction and tightening.

Earlier in this episode, we mentioned how certain body contouring methods, like surgical liposuction, may not be suitable for patients with a BMI of 40 or higher. Well, BMI is just one of the factors to consider when choosing the right treatment. The location of the targeted fat can also impact how it responds to non-surgical treatments. Fortunately, undergoing multiple non-invasive body sculpting methods at once may be able to provide patients with the results they desire, in the case that one treatment alone is ineffective. I explained this process further within the episode, as I describe how FlexSure can be used alongside with other treatments to help patients achieve optimal results.

Sometimes, certain parts of the body, like arms, inner thighs and knees, do not respond well to treatments like SculpSure. For such areas, we can use a device that wraps around the body part to better and more comfortably target areas like arms, inner thighs, or other tough spots. The final non-invasive treatment we’ll discuss today is FlexSure, which uses a peel-and-stick applicator to wrap around the body. By wrapping around areas like the arms, which have more skin laxity, FlexSure provides deep, even tissue heating using radio frequency. Luckily, even though you’re experiencing permanent fat cell breakage during the treatment, you’ll just feel like you’re getting a gentle hot stone massage. Additionally, FlexSure doesn’t have a BMI restriction so you can try the treatment no matter what your current weight is. A FlexSure treatment lasts only 15 minutes and usually needs three sessions per area to really have an impact. However, I’ve found that a series of five to six treatments can produce the most optimal results, and usually have my patients come in every two weeks for their treatment. Just like EmSculpt NEO, FlexSure can be combined with SculpSure, depending on the area we’re treating.

CoolSculpting is another body contouring method that we touched on not long ago, in episode 12 of this season. Take a listen to this brief clip from that show, refresh your memory on this popular non-invasive treatment.

Cryolipolysis is a method of using extremely cold temperatures to freeze and ultimately destroy fat cells. In professional practices, cryolipolysis devices like CoolSculpting are used as a non-surgical fat reduction procedure to remove excess subcutaneous fat deposits in targeted areas. CoolSculpting is a great option for people with stubborn fat in certain areas that have proven to be resistant to exercising and dieting. Common areas may include fat beneath the chin, in the love handles, back and upper arms. Cryolipolysis is non-invasive and effective when delivered in office using a CoolSculpting device.

I also covered the positives and negatives of CoolSculpting in-depth in season one, episode 35, where I talked about aesthetic procedures for permanent fat reduction. Check it out.

CoolSculpting uses a suction device to suction up the part of the body that needs fat reduction, and exposes it to extremely cold temperatures. The result is fat cells shattering permanently, and then dissolving from the area through the lymphatic system. What are the pros and cons of CoolSculpting? On the pro side, we have that it’s permanent. Non-surgical, which means there’s no downtime. No cuts or scarring. The cons, however, include uneven results. Remember, we are warmblooded, which means that the machine has to work very hard to freeze, and the freezing is generally a little uneven. This can cause a shark bite like appearance on the area treated and is the main reason why I prefer heat-based body sculpting procedures. Because we are warm-bodied and it’s difficult to cool fat to the levels needed for fat necrosis, we also need two to three times the number of session of CoolSculpting to produce the same results as heat-based procedures.

Another con is a paradoxical reaction. Although rare, some people can get the opposite reaction, known as paradoxical hyperplasia, or overgrowth of fat cells in the area being treated. The only way to get rid of this is by cutting the fat out of the area surgically. This reaction recently got a lot of media attention when the model Linda Evangelista came out with her experience and the scarring surgeries she has had to remove the hyperplastic fat tissue. Lastly, CoolSculpting can only be used on subcutaneous fat.

So now, you know a bit more about invasive and non-invasive body contouring methods. But there is one more piece of knowledge that I must share, as this is important for people to consider when opting for one of these procedures. That is that every one of these treatments that I covered today requires healthy lifestyle changes in order to be successful in the long run. Even when a body sculpting procedure permanently removes fat cells, they will only remove a portion of the fat cells in that treatment area. Subcutaneous fat is necessary, as it serves an important purpose, to protect the body’s underlying structures and add volume beneath the skin. Therefore, medical aesthetics providers who perform body sculpting must always leave a layer of fat below the skin. And while the destroyed or removed fat cells cannot grow back once they are gone, the remaining fat cells can still grow larger in people whose weight exceeds a healthy range. That said, maintaining an active lifestyle with a balanced diet and regular exercise is essential to maintaining results after both surgical and non-invasive body sculpting procedures.

Thank you all, as always, for listening to this episode of The Skin Report podcast. Until next time, love your skin, love yourself and celebrate your beauty.

If you would like to learn more about science-backed skincare or medical aesthetic treatments, please subscribe to and turn on notifications for The Skin Report so you always know when an episode is up. We have a newsletter that you can sign up for on skinbydrsethi.com, so that you can stay up-to-date on all our latest products and more. Additionally, if you have a skincare question or want to make an episode topic recommendation, please message me at theskinreportbydrsethi.com, which is linked in my show notes, and I’ll be sure to answer your question in an episode soon.

Transcript by Rev.com