SINGAPORE, May 13 — When dieting, weight-training and calisthenics did not help Eliana Abatti get rid of pockets of excess fat around her waist, the 40-year-old copywriter shelled out several thousand dollars for non-invasive fat reduction treatments.
Over the last three years, Eliana has had her belly fat and love handles subjected to extreme cold, zapping and heating with radiofrequency energy.
Recently, she underwent a novel treatment using microwave energy to get rid of excess fat along the flanks. Introduced in the Singapore market last year, the treatment utilises a new microwave technology to eliminate fat cells.
“I love clothes and am particular with what I wear. When I put on some weight, it tends to accumulate around the chest area. By reducing my bra fat, I look forward to fitting into one of my old tailored dresses and having it zip up properly again,” she said. “For me, it’s a personal achievement to stay in shape for the longest time.”
Despite her eagerness to shape up fast, Eliana said she would not go under the knife for more drastic results.
As new non-invasive fat blasting technologies hit the local market, more aesthetically-conscious people are turning to no-cut procedures as an alternative to surgery.
Since October last year, plastic surgeon Lee Shu Jin has seen an estimated increase of at least 300 per cent in requests for non-invasive fat loss treatments.
The most sought-after fat loss procedure at her clinic, Plastic Surgery by SJ Lee, is a non-invasive treatment known as Onda, which uses microwave energy. Coming in second is the more invasive procedure, liposuction.
Patients as young as teenagers (with their parents’ approval) have undergone the fat loss procedure. Her oldest patients are in their 70s.
Dr Kenneth Thean, co-founder and medical practitioner at Ensoul Medical Clinic, has seen more men requesting for body sculpting treatments.
While most are middle-aged women in their 40s, men make up 30 per cent of the growing number of patients he sees for non-invasive fat loss treatments.
“I have done neck lumps and even one side of a lopsided shoulder to balance overall appearance. There are also muscular lean men who want their little abdominal fat and small love handles reduced even further for a better-defined waistline and more prominent six-pack,” said Dr Thean.
Extreme cold, radiofrequency, microwave energy
Current non-surgical options in the market are based on three main technologies, namely cryolipolysis (which destroys fat cells by exposing them to extreme cold), radiofrequency (used to reduce the size of fat cells) and microwave technology, said Dr Lee and Dr Thean.
The latter treatment, the latest in the market, targets and destroys fat cells using microwave energy, which is a type of electromagnetic radiation. Fat cells that are destroyed are removed via the body’s lymphatic system.
Applicable to many areas of the body, such as the thighs, abdomen, chest and flanks, as well as the arms, neck and lower portion of the face, these procedures offer a quick fix for those looking to sculpt specific areas of their body without surgery, said the experts.
“It is not possible to reduce weight in specific areas such as the abdomen and arms by doing targeted exercises. Due to family and work commitments, most people are also unable to put in the number of hours in the gym or subject themselves to lean diets over long periods of time,” said Dr Thean.
According to Dr Thean, the best candidates are people who are not grossly overweight but have stubborn subcutaneous pockets of fat that do not respond to regular exercise and a balanced diet.
Less dramatic than liposuction
The results, however, are typically less dramatic than that of more invasive options like liposuction.
In general, about two litres of fat can be safely sucked out during liposuction carried out as a day procedure, said Dr Lee. Some surgeons set a maximum extraction limit of five litres for all patients, regardless of variation in weight or body fat, she said.
“For patients who have undergone non-invasive treatments, we will not be able to measure the amount of fat loss in litres, like we do in liposuction, as these treatments do not involve physical fat extraction. We look at more subtle indications, such as inches lost, if the patient is able to fit into clothes they have not been able to wear previously or if their day-to-day clothes feel less snug after treatment,” said Dr Lee.
While liposuction brings about more rapid fat loss, Dr Lee said it is a major, invasive procedure which involves higher costs, anesthesia and longer downtime or recovery periods.
“There are clear reasons why non-invasive fat removal procedures are becoming more popular than invasive options. Liposuction has far greater risk of complications, and these risks increase if the surgeon works on larger areas of the body, removes larger amounts of fat or performs the procedures on two or more areas at a time, said Dr Lee.
Potential complications include permanent uneven skin contours and temporary pockets of fluid that need to be drained with a needle. More serious and potentially life-threatening risks include infection, kidney and heart problems and fat embolism, where pieces of loosened fat break away from the treated area and become trapped in a blood vessel or organs, said Dr Lee.
“Compared to liposuction, non-invasive treatments have zero downtime, are usually more comfortable and cost considerably less. Patients may choose to have as many non-invasive treatments as they need upon consultation and under their physician’s supervision,” she said.
According to Dr Lee, non-invasive fat reduction treatment costs around S$600 per treatment area, depending on the clinic and treatment. Liposuction may cost around S$2,000 to S$3,000 for a small area correction, or up to tens of thousands for surgery under general anesthesia, she said.
Potential side effects of non-invasive treatments, like redness, a stinging sensation, bruising, skin sensitivity or itching in the treated area, are usually transient, she said.
Dr Tan Ying Chien, consultant plastic surgeon at SW1 Plastic Surgery, said that while non-invasive treatments have minimal or no health risks, there are financial risks, meaning patients may pay for something with no results.
It is not possible to lose a few inches off the waistline with non-invasive treatments, said Dr Tan, who has turned down people with unrealistic expectations of non-surgical fat reduction treatments.
“Liposuction remains the gold standard for fat reduction. In the hands of a competent surgeon, it can be performed safely with good results and a downtime of about three to five days,” he said.
Not a weight loss programme
Dr Lee and Dr Thean said that non-invasive fat loss treatments should not be treated as a weight loss programme. They are not recommended for pregnant women, severely overweight patients and those who have an excess of loose skin, said Dr Lee.
“Before any patient embarks on any kind of body-shaping procedure, I always ascertain that he or she is within the healthy weight range. If not, I will advise the patient to lose weight the old-fashioned way through exercise and dieting,” she said.
To maintain the effects, patients will also need to improve, if not maintain, their exercise and diet.
People considering fat loss treatments should also be aware that they only address the “pinchable” subcutaneous type of fat stored beneath the skin, said Dr Lee.
They do not get rid of the more dangerous visceral fat that is linked to life-threatening chronic diseases.
“This type of fat can be stored deep in your mid-section, surrounding your lungs, heart, digestive tract and liver. It puts out inflammatory substances called cytokines that can be damaging to your organs. Even if you don’t have a lot of visible subcutaneous fat, you may still have too much hidden visceral fat, which is why dieting and exercise are the healthiest ways to lose weight,” said Dr Lee.
Don’t get too fixated
It is important that individuals seeking such treatments do not become overly fixated on various areas of their bodies.
“It is absolutely possible for people to develop an unhealthy obsession (with sculpting their bodies to perfection),” said Dr Tan.
An obsession may be represented by recurrent thoughts throughout the day and, sometimes, the need to do something to relieve the tension, said Dr Kim Lian Rolles-Abraham, principal clinical psychologist at the Better Life Psychological Medicine Clinic.
“For example, there may be a need to check various body parts in the mirror to reassure themselves that they don’t look too bad or to seek reassurance from clinicians about the body part they are unhappy about,” said Dr Rolles-Abraham.
“When the person is able to say, ‘Wait a minute, I’m thinking about this the whole day... I’m wasting so much time, energy and money on something that still doesn’t look perfect but I can’t help myself’, then it would be time to get some advice or see a professional to assess if (his or her) thoughts and behaviour have become pathological,” she added.
Do’s and don’ts of fat-loss treatments
When considering non-invasive fat loss treatments, Dr Kenneth Thean of Ensoul Medical Clinic has the following advice:
Look for technologies that have been approved by the United States Food and Drug Administration and are backed by clinical studies demonstrating their efficacy.
The treatments should be administered in medical clinics run by doctors who are trained to advise and manage adverse effects from treatments.
Watch out for treatments that induce perspiration. In many instances where slimming wraps and saunas are used, the person loses water which they will regain in no time.
Beware of diets that involve severe calorie restriction with meal replacement powders. They are unsustainable in the long term.
Be wary of weight-loss supplements and teas that claim to be able to make one lose large amounts of weight in a short period of time without offering scientific evidence. Evidence shows that people who lose weight steadily, at no more than a kilogram per week, are more likely to keep their weight off longer. — TODAY