In the neverending quest to shrink saddlebags, trim flabby thighs, and whittle away love handles, people have tried all sorts of procedures. When no amount of gym time burns away stubborn pockets of fat, and liposuction is dismissed for being too expensive/invasive/painful/scary, that’s when weird massages, slimming creams and “as seen on TV” gadgets start to sound appealing.

Except they don’t really work now, do they.To fill the gap between surgery and quackery, non-invasive lipo alternatives done at a plastic surgeon’s or dermatologist’s office seem ideal. Many versions have come out over the past several years, including devices that claim to heat, cool, laser or radiate fat cells into submission, but many doctors (and patients) haven’t been thrilled with the results, or have been frustrated by the limited amount of body parts you can use them on. Until now. Meet the two newest fat-targeting machines that were FDA-approved in 2014 and have docs excited.

 

CoolSculpting

For those stubborn spots that you’re not going to get rid of even though you eat pretty well and exercise regularly, there’s CoolSculpting. It’s not about shaving off major pounds, but knocking out those lumpy bits that leg lifts and crunches never touch. The results get rave reviews.CoolSculpting made a splash when it first got FDA clearance in 2010 to get rid of love handles, then in 2012 for abdominal fat. And this year, Zeltiq, the medical device company that developed the procedure, got government approval to use it against fat deposits on the upper, inner and outer thigh.

The name describes what it does: sculpts by cooling.At the core of CoolsSculpting is a process called cryolipolysis—freezing (cryo-) fat cells (-lipo-) until they’re destroyed (-lysis). It exploits the fact that fat cells, called adipocytes, are more susceptible to cold than other skin cells, so you can blast an area with frigid temperatures that are tolerable to most cells (if a little uncomfortable to you), but deadly to fat cells. It’s like a selective freeze ray. When the adipocytes die, they’re eaten by immune cells called macrophages. Fat goes bye-bye.Performed by dermatologists, plastic surgeons and aestheticians who have CoolSculpting equipment in their offices, the procedure costs in the neighborhood of $700 to $1,500 per treated area (so double that for both thighs or love handles). It takes anywhere from 30 minutes to a couple hours, depending on the size of the target area—and it’s kind of no big deal. The company says “many people read, check email, or even take a nap during their sessions.” The doctor puts a special applicator over your squishy parts (it’s reminiscent of the Bliss cellulite massager, or a souped-up Flowbee), and it suctions the fat in toward the cooling plates. It feels really cold, naturally, and there’s tugging and tingling. There’s no post-procedural downtime, though the suction can leave some redness and bruising. For the flank, one treatment is usually enough; sometimes the thighs need two or more treatments, spaced eight weeks apart. Since there’s a whole biological process that needs to take place for cryolipolysis to do its thing, it takes a while to see your results. The effects start to show in a few weeks, and full results in two to four months.

 

UltraShape

Plastic surgeons and dermatologists have been eagerly awaiting FDA approval of UltraShape, which has been zapping fat in Europe, Canada and Asia since 2005. Renowned dermatologist Dennis Gross was the first doc in the U.S. to get a machine, and our own plastic surgery advisor (and resident skeptic) Arthur Perry, M.D., F.A.C.S. also offers it in his practice.Ultrashape targets subcutaneous fat, which is the stubborn fat directly under the skin that likes to cling for dear life in fun places like the hips, thighs, arms, belly and back. For people predisposed to carrying fat there, no amount of dieting and exercise will get rid of it.

UltraShape uses the same ultrasound technology that’s used to treat kidney stones to break up fat cells into tiny molecules that are then processed by the liver and disposed of. If that sounds like a lot of stress on your system, fear not. It’s no worse on your liver than eating a junky fast food meal.The procedure is painless, requires no medications or downtime, and can be used on all skintones. The average treatment time is 45 minutes, but it depends on how many areas you are working on at a time. Butt only will be a lot quicker than a full body situation. The thing practitioners like about UltraShape is how customizable it is, and how you can target specific trouble zones such as back fat and flabby knees.

Most people need two to three sessions to see full results (but if you only want a little smoothing, it could potentially be done in one) and it’s pricey at $800-$1,000 per session. But if you’re just sick of your touble spots, this could be the solution for you.Caveat: Neither of the above procedures is meant to be a weight loss tool—if you’re looking to drop serious poundage, old-fashioned diet, exercise and, if you want to go there, lipo is still the way to go. And even though these treatments will sculpt your body without the gym, don’t think that gets you off the hook with exercising. It’s still super important for your health and beauty. But if you need a little help to boost your body confidence and make your clothes fit better, go for it.