I've daydreamed about getting felt up by a hot doctor (imagine George Clooney in ER, circa 1994). But as New York City-based dermatologist Eric Schweiger, MD, gently pinches my outer thigh, I find myself wishing I'd gone with a slightly less attractive Anthony Edwards type. There's nothing like having a dashing young doc inspecting your wobbly bits under the unforgiving glare of overhead lights-especially when you're a cosmetic-procedure virgin. (I'm 31 years old, and the most I've gotten "done" is a professional teeth whitening.) As I stand, holding my paper-thin robe to my waist, the only thing that keeps me rooted to the cold floor is knowing that if Schweiger deems me a candidate for Zeltiq CoolSculpting-the fat-blasting device du jour-I might have a shot at reducing my stubborn saddlebags and shimmying into my skinny jeans without toppling over.
Freezing Your Fat Off
Hailed by renowned dermatologist Frederic Brandt, MD, as "the greatest thing ever," CoolSculpting was FDA-approved last year and is the first cryolipolysis (translation: fat-freezing) machine. During the noninvasive procedure, a doctor places a coffee-saucer-size suction cup on the skin to gradually extract body heat.
"Over the course of an hour, the area covered by the applicator cools to a point where fat cells, or lipocytes, become damaged but surrounding cells are left unharmed," says Schweiger. "In the next three to four months, these lipocytes die and are recycled through the lymphatic system and liver."
"I'm not sure you have enough fat for the attachment to form a vacuum," he says suddenly. Bless. His. Heart. "If you do, you'll see results, but they might not be as extreme as other cases." To find out for sure, Schweiger fires up the CoolSculpting instrument. As it softly hums, he attempts to push the chunk of fat between my hip and lower thigh into its plastic cup. Against my usual train of thought, I find myself hoping my leg is big enough to fit. Soon I feel a burst of pressure. It's as if the bulbous knob is being sucked out by a jellyfish. And it feels good.
"Are you okay? How does that feel?" asks Schweiger.
I give him a conservative answer. "It feels weird and really cold, but it's not painful," I assure him, adding gleefully, "I knew I had enough there!" For the next two hours, I lie on my stomach while the device freezes the fat on the side of my left thigh, then my right. I spot a couple of barely noticeable mini bruises after the treatment, but they don't hurt.
According to Schweiger, who has done cryolipolysis on 200 patients since January, the CoolSculpting appliance depletes targeted body fat by an average of 20 percent. He says that skin treated by it will remain tauter, even if you gain weight elsewhere. I hope he's right-and that after a few months of waiting impatiently, I'll notice a difference.
Hot and Cold
I'm wary of needles, incisions, and anesthesia-which is why the noninvasive, anesthesia-free cryolipolysis technique appealed to me. But what about those who can stomach more in the name of self-improvement? I wonder how the effects of cryolipolysis compare with those of surgical liposuction-and how one might choose between the two procedures.
"Cryolipolysis is not meant to replace liposuction," explains Schweiger. "Liposuction definitely has its role and is going to give you a more dramatic result. Cryolipolysis treats the superficial fat underneath the skin, not the deeper layer, like liposuction does."
As with cryolipolysis, liposuction by an experienced medical professional takes up to an hour per area (think the abs, hips, and thighs), says New York plastic surgeon Douglas Steinbrech, MD (think the abs, hips, and thighs). The ideal candidates for each procedure are also similar. "They're basically in good shape-within 15 to 25 percent of their target weight-but have pockets of fat that won't go away with diet and exercise," says Steinbrech. Their skin also has a modest to moderate laxity to it. "Cryolipolysis and liposuction can do only so much-they're not going to work on sagging, excess tissue," adds Steinbrech.
He says that laser liposuction is especially popular because it can be performed with local anesthesia, and the incision mark is smaller. How the method works: Using a cannula with a laser at its tip, the beam of light is pointed along the deepest layer of skin to rupture fat cells and suck them out. "Laser liposuction uses heat to cause collagen synthesis which, in turn, tightens up the dermis," says Steinbrech, who adds that, post-procedure, there will be soreness, swelling, and bruising for a week to 10 days. "You'll begin to see results after the first two weeks, when there's less swelling."
In terms of cost, cryolipolysis is $750 to $2,000 per area, and liposuction is anywhere from $5,000 to $35,000. "Certain doctors have a strong reputation and proven track record, so they charge higher prices," says Steinbrech, who is a member of the American Society of Plastic Surgeons and emphasizes the importance of going to an experienced, board-certified expert.
Three and a half months after my CoolSculpting session, fall has officially arrived. My jeans feel as snug as they always have, and, peering in a full-length mirror, I don't discern a visible difference in my lower half (my hips and thighs are still wider than I'd prefer!). That said, when I look down at my saddlebags, the aerial view has improved. Before, I was shocked at the formidable growth of fat extending outward, but the bump now seems to have receded; there's less to grip onto when I give it a squeeze.
When I tell Schweiger about my observations, he notes that CoolSculpting's effects on the thighs are, in fact, less consistent. "The areas that see the best results are the lower abdomen-love handles and upper bra fat," he says. "We're getting more experience with the thighs, but there's not as much data for that area. Most patients still see improvement there, but not all."
I also tell him how, despite being a tad more toned, my outer thighs still have cellulite. (I'd secretly hoped a side effect of the treatment would be less ripples!). "Cellulite is more of a skin issue. CoolSculpting isn't for cellulite-it's meant to reduce a firm bulge of fat beneath the skin, not the skin itself," says Schweiger, bursting my bubble. He then goes further: "There's no great treatment for cellulite. I have yet to see a device or procedure that yields reliable results."
Stopping the Dimple Effect
Even so, a new laser is giving women with cellulite reason to hope. Already approved for use in Europe and Canada, Cellulaze is currently undergoing U.S. clinical trials. "Cellulaze is less invasive than laser liposuction and treats smaller portions," says Steinbrech. "The tip of its laser is like a pen; it's inserted just below the skin and is supposed to melt away superficial fat and increase collagen production for a smoother appearance."
While some eagerly anticipate FDA approval of Cellulaze, Steinbrech is cautiously optimistic. "Theoretically, Cellulaze is a good idea, but I haven't seen concrete evidence that it's an effective procedure," he says. "If it proves to be effective and there's a significant patient satisfaction from it, then I'm all for it. But in my mind, it's too soon to tell."
So how do I deal with my pesky cellulite in the meantime? Apparently, the first step is to stop being so hard on myself: "Cellulite is oftentimes genetic and can develop no matter how healthy or unhealthy your diet is," says Keri Glassman, RD, Nutritious Life founder and celebrity dietitian (Jennifer Lopez and Drew Barrymore are clients). "Maintaining a healthy body weight and increasing muscle mass and tone will decrease the visibility of dimples."
I guess that means, despite being allergic to regular exercise, I'll have to pump iron to reduce my micro-size fat puckers and my thigh circumference. "When you build muscle, you burn more fat and increase your metabolism-adding even the slightest bit of resistance or weight training to your workout forms lean muscle and lowers your body-fat percentage," says fitness guru Juliette Kaska, who trains actress Stacy Keibler.
Sounds good to me. Next stop: to the gym for a workout with a not-too-hunky personal trainer.
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