New 'Wave' Technique May Mean No More Double Chins

From the WebMD Archives

Sept. 14, 2001 -- Wondering what to do with your lunch hour today?

How about having that double chin removed -- without surgery or pain?

Sound too good to be true?

Well, that depends on who you ask.

The latest in body contouring involves the use of external ultrasound to break up fat cells, according to a New York City plastic surgeon. It may be a surgery-free alternative to undergoing liposuction to remove excess body fat, and when used with traditional liposuction, the procedure can reduce complications and get at hard-to-treat areas, says Elliot Jacobs, MD, a board-certified plastic surgeon at the New York Eye and Ear Infirmary and the Beth Israel Medical Center in New York City.

Jacobs reports early success using external ultrasound, or sound waves, to help people remove small pockets of fat such as that pesky double chin or the flab underneath the upper arms.

Here's how:

Plastic surgeons first inject a softening fluid into the problem area and then they apply external sound waves to the area to kill excess fat cells. The body's natural scavenger cells then remove these dead cells. The procedure is done in-office, and Jacobs says the only discomfort comes from injecting the softening fluid.

The sound waves only penetrate about three-quarters of an inch beneath the surface of the skin, he says.

"The results are subtle," he tells WebMD. "It's not meant for major bulges and is used primarily on people in reasonable shape. You have it done and an hour later you can walk out and go back to work."

The procedure costs about $1,500 per treatment and depending on the area, it may take two or three treatments, he says. The technique usually produces a circumferential difference of one-quarter to one-half inch, which shows up in about a month's time. When used with traditional liposuction, the sound waves soften fat, making it easier for doctors to suction it out, Jacobs says.

Jacobs has performed the procedure on about 30 patients. "This is really cutting edge," he says.

But Darrick Antell, MD, a New York City plastic surgeon, isn't quite convinced about the perks of the new procedure.


"I don't believe there are any studies that support that external ultrasound removes fat without liposuction," he tells WebMD.

Antell occasionally uses internal ultrasound with liposuction in areas where fat is thicker and more difficult to get at with traditional liposuction equipment.

To do this, an internal ultrasound probe is inserted into fatty tissue and the top of the probe vibrates at a very high speed, causing fat cells to break-up.

"Ultrasound has its place and it's a tool," he says. But "to tell someone that you can do this and it will replace regular liposuction is a stretch," he says.

And, "if it did work, how do you control the depth of penetration? Will it go into your internal organs as well?" he asks.

Jacobs says the ultrasound has been tested and will not penetrate deeper than three-quarters of an inch.

Ultrasound is not the only new fat-removal method being used. Several U.S. cosmetic surgeons are reporting very early success when they combine lasers with traditional liposuction.

So far, so good, says Robert F. Jackson, MD, a cosmetic surgeon in Marion and Indianapolis, Ind., and the president-elect of the American Academy of Cosmetic Surgery.

Jackson and several others are using a low-level light to cause the fat cells to open up and release fat, he says. Then, they remove the fat via liposuction.

"Preliminary results indicate that the fat comes off easier, is more liquefied, and there appears to be much less bruising when the laser is used, and patients have much less pain," he says.

The new study is attempting to confirm results by a Colombian plastic surgeon, and Jackson says they expect their research to be concluded in late fall/early winter.

WebMD Health News Reviewed by Gary D. Vogin, MD
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