Dr. David Smart talks about two medical treatments developed by dermatologists to target those areas and help you lose up to 20 percent of that stubborn fat.">

Jun 1, 2016 — You diet. You exercise. You do everything you can to live an active and healthy life, but you still have fat in those ‘problem areas.’ Those love handles, muffin tops and stomach rolls. Sometimes it just doesn’t seem fair. Dr. David Smart talks about two medical treatments developed by dermatologists to target those areas and help you lose up to 20 percent of that stubborn fat.

Interview

Announcer: Health tips, medical news, research and more for happier, healthier life. From University of Utah Health Sciences, this is The Scope.

Interviewer: Sometimes it just doesn't seem right. You exercise. You're leading a healthy, active life. Maybe in another life, you have a little too much fat, but you fixed that, right? You're trying to lose it, yet some of those stubborn areas just won't go away. Well, I want to talk about two non-invasive fat reduction techniques. One is called the CoolSculpting; the other is Kybella. Dr. David Smart is a dermatologist with the University of Utah Health Care.

First of all, I always get little bit skeptical when I hear about non-invasive fat removal. I mean, I kind of hear the ads on the radio. I'm told there's no such thing as a quick fix. So your job . . .

Dr. Smart: Yet, here I am with quick fixes.

Interviewer: So your job is to convince me.

Dr. Smart: Got you. Let's take CoolSculpting. That's a great example. Cool Sculpting is a machine that was invented and developed by dermatologists. It's all based on this principle: fat cells are more sensitive to cold than skin cells, and muscle cells, and all the cells around it.

Interviewer: So they freeze easier?

Dr. Smart: They freeze easier and then they die from being frozen more easily. This has been well known in dermatology for some time. With frostbite, even sometimes, equestrians, it's called equestrians. It's equestrian fat loss. When they're riding horses in the very cold, those inner thighs that are really cold on that saddle, they'll actually start to lose fat on the inner thighs.

Interviewer: Because their fat's freezing?

Dr. Smart: Because their fat's freezing. Also, little children with popsicles, those popsicles sometimes will cause . . . if the popsicles been in the mouth too long, it will cause a fat loss in certain areas. So it's just this cold is killing off the fat. CoolSculpting has been around now for a long enough time, several years.

There have been hundreds of thousands of cases of CoolSculpting done and the results are very reliable. It's not a brand new fad, although there are a lot of machines in the same sector of non-invasive fat loss that I personally do not believe in and have used and thought, "Hey, this doesn't do anything." CoolSculpting is not one of those. CoolSculpting does show results.

Interviewer: So as a doctor, I would think that you would be more to encourage somebody to exercise to get rid of that fat. You know? That last five pounds or those little stubborn areas, "Just keep going and you'll get there."

Dr. Smart: It's important to remember or at least recognize that you can't spot treat fat when you're working out. No matter what exercise video says, you can't do more sit ups, necessarily. "If I really do crunches just very hard, I'm going to get rid of that fat right around the belly button or I'll do these side bends and that would get rid of my love handles." That's just not how the body works. You don't spot treat fat when you exercise.

The ideal candidate for one of these procedures, whether it's Kybella, CoolSculpting, is a person that is in relatively good shape, you haven't just started your weight loss journey, you're not necessarily more than 30 pounds outside of your weight goal, but you have a few stubborn pockets of fat that just don't seem to go away.

Interviewer: Because each one of us has our own little . . .

Dr. Smart: We've all got.

Interviewer: No matter how lean you are, like for example mine is right here on the backside, right?

Dr. Smart: Exactly. So are mine.

Interviewer: I could have a six-pack and I'd still have this roll a little bit.

Dr. Smart: On the back. This little love handle, it just wouldn't do away.

Interviewer: Is that what the CoolSculpting would treat?

Dr. Smart: Precisely, that is what is why it's developed to treat. It was rigorously studied by the scientists that made it in Harvard. It was not created by some company looking to make a quick dollar.

Interviewer: So there's actual evidence-based support?

Dr. Smart: Significant evidence to support this. It is a really great treatment for those areas. For men, right around the love handles, that's a very common area for men to have little pockets of stubborn fat. Women, outer and inner thighs and around the belly button. All these places are potential areas of opportunity to get rid of.

Interviewer: So can I use multiple treatments to treat multiple areas?

Dr. Smart: You sure can. Now CoolSculpting, that treatment was not designed to be a treatment course in the sense that very reliably with one treatment of the area that's treated, about 20% of the fat will leave. But depending on how much fat you have, you might need to do more than one.

Interviewer: So CoolSculpting works different areas of the body. Kybella works primarily for fat under the chin?

Dr. Smart: True. Now that's because it's FDA approved for that area. Kybella is actually a very, sort of groundbreaking, very exciting product. It's less than a year old now, as far as the FDA is concerned. It was FDA approved less than a year ago for the treatment of the submental fat pocket, which is just the double-chin area. That doesn't mean that fat in other areas doesn't respond to it, it just means that the studies were done to get FDA approval were done just there.

Interviewer: Is it the same technique? Is it freezing the fat or is it different than CoolSculpting?

Dr. Smart: It's different. So Kybella is a liquid. It's a chemical that's naturally found in the body. It's produced by the liver and helps to absorb fats in your diet, but if you inject it directly into the fat, it dissolves fat cells. So it's been done for many years in different countries, but it's not just been regulated. Finally, a company here developed a formulation and went through the very rigorous testing to get it safety and efficacy approved by the FDA.

You inject it in a series of injections, so similar to Botox, in very small needles under the chin and it dissolves fat. Most people need to do that injection anywhere from two to four times and it really sharpens the jaw and gets rid of the fat under the chin.

Interviewer: Side effects for either one of these two treatments?

Dr. Smart: With CoolSculpting, there's no cutting, there's no downtime, there's no nothing. As you can imagine, it's destroying some of the fat there. You do get some bruising and a little bit of tenderness that would come from feeling like, "I got a good bruise in this area." Those are the most common side effects. They happen pretty regularly.

Interviewer: What about Kybella?

Dr. Smart: Kybella, those are injections. You do have to be okay with some very small needle pokes. And then I would say that the most common side effect with Kybella is swelling. Most of the time, it's pretty mild. But about one in 10 get a good amount of swelling under the chin, to the size of almost like a golf ball or an Easter egg. So you definitely don't want to do Kybella right before you have some sort of event or some pictures to be taken. You'll most likely be okay, but pretty normally, like I say, about 10%, one out of 10 people, I feel like, get pretty appreciable swelling under the chin.

Interviewer: If somebody is interested in the Kybella treatment, that's physician only.

Dr. Smart: That is available only to physicians and specifically only to physicians that have been trained in Kybella. Allergan, the company that owns Kybella, was very particular about this when they released the medicine. A lot of things in cosmetic medicine get taken up by people that don't know how to use them and it gives the product a bad name because they're using it incorrectly, getting side effects and that's bad for the product, it's bad for the company. So the company was very sure to only release it to physicians that they have specifically trained to do this that have the pathology knowledge to handle any potential side effect that may come up and that aren't going to use it irresponsibly.

Interviewer: So with the case of CoolSculpting and Kybella, what else would a listener need to know to make an informed decision about using one of these procedures? What do they need to know?

Dr. Smart: The amount of people that could benefit from these procedures is enormous. We all have these areas of fat that really tend to bother us. What they should know is that it really does work. It is not a substitute for weight loss and that's probably what I would say to someone who's interested in CoolSculpting.

Whenever anyone comes in and they're interested in body shaping, whether that's liposuction, CoolSculpting, Kybella, we have a discussion about what your outcomes are and where you're starting from, as long as your expectations are realistic. It is not going to change your weight. If you're looking to lose weight, these aren't the treatments for you. If you're looking to simply sculpt some areas of the body, you're the perfect candidate.

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