Features
On the right wavelength
Body contouring can truly help patients achieve the figures they want, but hype and false statement are common and simply confound the patient, writes Mr Christopher Inglefield
Cosmetic surgery procedures have continued to increase, but nowhere as near as much as the non-surgical variety. According to one source, these have multiplied by nearly 800 per cent since 1997. Clearly, patients want non-invasive procedures, and non-invasive liposuction is attractive to patients because they do not want the risks, scars and general complications of surgery.
It doesn’t matter whether I say I am the best liposuction surgeon in the world. Most patients don’t want me to stick cannulas into them. Why don’t they want surgery? Because everything they consider that’s invasive involves an anaesthetic, has risk, creates scars, causes down-time, and there’s the stigma of surgery.
What patients want from us is a treatment that’s safe, effective, comfortable, doesn’t induce suffering, doesn’t require numerous repeat visits, and has virtually no down-time—because we’re all living in a busy world. They can’t afford three to six weeks of downtime, and they want long-lasting treatments with few maintenance procedures.
Terminology
A problem patients have is confusing terminology, particularly non-invasive liposuction and non-invasive fat reduction. Do a search on the web for non-invasive liposuction and both terms feature interchangeably.
The following is quoted from a popular website. “Vaser liposuction, the latest fat removal technology, is a minimally invasive procedure under local anaesthetic. It is less invasive than traditional liposuction. There is no hospital stay. Vaser lipo is a walk-in walkout procedure with minimal downtime. You will be able to leave our clinic straightaway after your vaser liposuction procedure.”
But this and other so-called “non-invasive” liposuction is still surgery. It might be minimally invasive, but it is surgery and we need to be very clear about that.
We have injections, lipotherapy, laser, lipolaser, lipolights, radio frequency—there is much confusion. There is much collective deception for marketing purposes that does the industry no good. If we want to be treated with respect and with high esteem within the medical profession, not just the cosmetic industry, we need to raise our game.
Key technologies
Water-assisted, ultrasound-assisted, laser-assisted and radio-assisted frequency liposuction are key technologies that use different energy sources. The Body Jet is using pulsed water; Vaser is using sound for cavitation, Smart Lipo is using laser light for a thermal result, and radio frequency (RF) is devised for a thermal result.
Selectivity is important because it impacts on possible side-effects. RF has been called “very selective”, but yet patients present with paraesthesia in the treated area for three weeks. If it is highly selective, why is paraesthesia caused?
With Body Jet and RF you have the advantage that the fat removal is done in a synchronous manner, whereas with Vaser and Smart Lipo you have to do the treatment and then suck the fat out.
The fiction is that surgery is about invasion or it involves pain, that there is always bruising, that it requires a hospital stay and that there is always a recovery.
There is nothing marketed as non-invasive that you can say is truly not invasive. Pain should be minimal for 99% of the patient procedures that we do. It should be well controlled, but we should not be talking about something that is better because it causes no pain. There should be minimal bruising for all our patients because we should be good at performing the procedures and we should not be getting much bruising.
About 99% of the procedures I do now are day cases. When I started in plastic surgery, patients in the NHS for abdominoplasty were in bed for five days. They were ill for five days occupying a hospital bed. I haven’t had an abdominoplasty patient stay overnight in hospital for the last seven years. These patients just do not stay in a hospital. Patients having a procedure lasting longer than four hours must stay in hospital overnight.
All of these procedures have a recovery period from weeks to months. They are not “a lunch hour procedure” after which patients can go back to work and be fine. Most of the body contouring procedures have recovery periods.
Patients expect the highest standard of care from us. The techniques we incorporate must meet those standards. As practitioners we must ensure that when patients ask us to use a Body Jet system that it can do what we want to get the results.
Minimally invasive devices must demonstrate the same safety and efficacy as surgery. Beyond that, they have to achieve much more than non-invasive procedures, because if you have a truly non-invasive procedure that really has no down-time, then your minimally invasive procedure must be pushing the boundaries to be better than that, not worse.
You have a duty of care to stick to the facts and not deceive your patients into saying we offer the latest non-invasive techniques when what you are doing is an updated version of liposuction. Avoid the fiction please; it does not do us any good.
As effective as some of these non-invasive techniques can be, the most successful form of body sculpting is carried out five times a week for a mere 30 minutes and it is a unique combination of therapy. We like this idea of combining therapies. It is exercise and a healthy diet.
Mr. Christopher Inglefield BSc, MBBS, FRCS (Plast) is a plastic surgeon who practises at London Bridge Plastic Surgery & Aesthetic Clinic, 54 Wimpole Street, London W1. W: lbps.co.uk
