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Abu Dhabi, UAEWednesday 18 July 2018

The latest advances in liposuction

Liposuction has grown in popularity in the Emirates. We talk to the experts about the latest techniques.
Some experts believe that patients who have had liposuction will often see the fat return to the treated areas in a year's time.
Some experts believe that patients who have had liposuction will often see the fat return to the treated areas in a year's time.

Liposuction has grown in popularity in the Emirates. Patricia Carswell talks to the experts about the latest techniques

Keeping your body in shape is hard work, so the idea that you could lose your flabby bits overnight seems almost too good to be true. Yet for the past 20 years, liposuction in its various guises has been doing just that, probing unsightly folds of flesh and literally sucking them away.

In its most basic form, a small tube called a cannula, attached to a suction machine, is inserted through small incisions and pushed and pulled vigorously by the surgeon to break down the fat cells, which are then suctioned out.

Fat removal procedures have grown in popularity in the Emirates over the past decade. According to Dr Max Sawaf, the chief executive and medical director at Cosmesurge and the Emirates Hospital, liposuction is the number one procedure at his offices in Abu Dhabi and Dubai.

Now, however, researchers at the University of Colorado, in Denver, have come up with evidence that our bodies tend to replace the fat that is suctioned away.

In a study published in April, the researchers worked with two groups of women. One, made up of 14 people, was given liposuction in the thighs, hips and (in most cases) lower abdomen; the other - a control group of 18 - was not. At the beginning of the study, they were all weighed, had extensive body measurements taken and their fat percentage assessed.

A year later, the liposuction patients' body fat had returned to the level it had been at before the treatment. Significantly, though, it had not returned to the hip and thigh areas from where it had been taken, but to other parts of the body such as the arms. It had also returned to the abdomen.

"We believe that there is substantial evidence that the brain knows how much fat we have when we're adults and are maintaining our body weight, whether at a normal weight, overweight or obese," says Dr Robert Eckel, a professor of medicine, physiology and biophysics at the University of Colorado, and one of the authors of the study.

As to the reasons why the fat does not return to the treated areas (at least in the hip and thigh region), he says: "We think that the trauma of surgery in some prevents the fat from being restored at the surgical site, but this remains a hypothesis only."

Dr Mike Comins, the medical director at the Private Clinic in London and the president of the British Association of Cosmetic Doctors, cautions against drawing dramatic conclusions from such a small study.

"It's an interesting study, but it hasn't really given us any news that we didn't know already," he says. "If you are prone to put fat on in certain areas - some people are prone to put fat on to the thighs - then if you treat the thighs, the fat possibly could come back a little bit, but it's evenly distributed throughout the body so you don't tend to notice any obvious change in specific areas. If everyone had fat arms after you'd taken fat from their thighs, the whole treatment would burn out."

The popularity of liposuction looks set to continue, and there are constant improvements on the technology. Traditional liposuction, often done under general anaesthetic, can lead to bleeding, bruising and discomfort. Not surprisingly, if a large amount of fat has been removed, the skin can be left slack and saggy. These drawbacks have been addressed by the increasing use of ultrasound and laser to break down and liquefy the fat, allowing easier removal. Sawaf explains: "At Cosmesurge we use something called the Acculift. It's a laser that allows us, when we do liposuction of the arms, for instance, to also tighten the skin."

Another new development is a system of fat cooling known as Zeltiq, which is being introduced at Cosmesurge this week. This involves freezing the fat cells using an external cooling solution; the fat is then said to be eliminated by the body without the need for suction.

More cutting-edge still is the use of stem cells in fat transfer. In fat grafts, the fat from liposuction is used to plump up other parts of the body such as the buttocks or the cheeks. According to Comins, this procedure has been problematic.

"Traditionally with a fat graft there has been quite an underwhelming success rate because the fat that is transferred from one area of the body to another doesn't take. The blood vessels don't grow within the graft quickly enough to supply the newly transplanted fat cells with oxygen and essential nutrients and therefore the fat dies and is broken down by the body's own system."

This is where stem cells come in. They are extracted from fat removed during liposuction and stem cell-enriched fat is then implanted elsewhere in the body.

"Stem cells trigger a very rapid growth of blood vessels within the graft, so instead of the blood vessels growing from outside the graft in, the stem cells act like a fertiliser to trigger rapid growth in the blood vessels within hours of being implanted. It significantly increases the chances of the fat surviving."

In the future it is hoped that stem cells might be used to grow fat in chosen areas rather than transferring it.

"We are looking at that", says Comins. "It's called proliferation of the cells, and fat is quite an easy tissue to proliferate. You get the fat cells in the laboratory and divide them and multiply them. The information coming back to me from the lab that we use is that we're not that far off."

Quite apart from their cosmetic potential, doctors hope that stem cells extracted from fat removed by liposuction could eventually be used more widely in medicine.

"There are some really interesting studies coming through from a medical perspective in respect to the benefits of adult-derived stem cells in treating chronic or long-term diseases," says Comins. "It is looking promising".

To that end, some of his liposuction patients are asking to have their stem cells frozen for future use, both cosmetic and medical.

"We've only started doing it in the last few weeks; it's in the really early stages," says Comins. "I'm not really anticipating that many until further studies come out, but there's certainly been some interest."

However advanced the treatment, though, the advice to liposuction patients remains the same as that given to the world at large.

"Immediately after liposuction, become more active and eat fewer calories," suggests Eckel.

It seems even those benefiting from the wonders of modern science still have to fight flab the hard way.