Straight Talk about Cosmetic Surgery

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For the last three decades, the final arbiter of our battle with our genes has been the liposuction machine. The most popular cosmetic surgical procedure over the past 28 years, liposuction, is an outpatient procedure that removes up to 10 pounds of fat through a few tiny incisions. Performed by board certified plastic surgeons, liposuction is an incredibly safe procedure, as long as you are healthy and as long as not too much fat is removed. But, like all surgery, liposuction does have its risks, and there have even been deaths with this procedure. More common problems include an unattractive cosmetic result.

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So while hundreds of millions of people could benefit from liposuction, only hundreds of thousands of people actually have it. While many people cannot afford the surgery, many others simply can’t fathom the idea of going under the knife for purely cosmetic reasons. And others are afraid of complications.

Fast forward to 2012. Liposuction goes on the endangered species list. The first noninvasive technologies that can destroy fat without surgery are introduced. Zeltiq freezes fat, killing and subtly removing some. Zeltiq came in with much publicity, but the results may be too subtle to make this technique commercially viable. Another technique uses high-energy focused ultrasound, a space age technology that harnesses the energy in sound like the laser harnesses light. Liposonix has won the FDA’s approval first, and soon you won’t be able to turn on the television without hearing about this new technology. That sound energy sears right through belly fat, and in about three months, you’ll be about an inch smaller around your waist. A competing technology, Ultrashape, has yet to receive FDA approval.

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These new techniques won’t zap off 20 pounds—you’ll still have to listen to Dr. Oz to do that. But if you’re close to your ideal weight, Liposonix might be right for you. In about an hour, you can have your tummy treated, and you’ll see the results in about three months. As the technology progresses, it may well be used to remove even more fat and even tighten loose skin.

As a surgeon I love performing surgery. But I see the handwriting on the wall of the cave. Invasive fat removal is going the way of the mastadon...