Here's the scenario: A patient comes in with a small pocket of fat she wants removed before taking that beach vacation next week. Minimally invasive high-tech options abound, but they can take weeks and possibly more than one treatment to deliver results. Your patient is looking for immediate gratification. What do you do?
It's this kind of scenario that inspired the targeted fat removal approach I market as FLASH, or Fat Lipo Away Same Hour. It's very effective. It's very inexpensive. And the fat's completely gone in under an hour.
A Simple Syringe
There are multiple minimally invasive treatment options available to address fat in targeted areas, including Kybella (deoxycholic acid) and CoolSculpting (both from Allergan). But if a patient is really bothered by a small area of fat and can't or doesn't want to wait for results with these other modalities, it can be sucked out on the spot using syringe liposuction. Anyone who has experience performing liposuction can easily transfer those skills to FLASH.
FLASH is based on an old school liposuction approach that uses a syringe attached to a very fine cannula to remove small, targeted areas of fat through a tiny incision, all under local anesthesia. Using very fine cannulas in a very superficial plane, the surgeon is able to address the fat just underneath the dermis, which allows for skin remodeling and shrinking. In a deeper plane, closer to the muscle, more debulking will be accomplished. In this scenario, the syringe creates vacuum for suction and makes it possible to avoid riskier cannula-related damage.
The FLASH Technique
Sydney Coleman's luer lock cannulas—designed for small volume fat transfer—not only inspired the FLASH technique but also make it possible. While most cosmetic physicians use luer lock cannulas to perform liposuction with vacuum suction, I combine it with a syringe for small zone on-the-spot fat reduction.
Effectively using FLASH requires understanding how to get into that superficial and deep plane carefully, as this is the layer where the skin will shrink and remodel over the anatomic area. Marco Gasparotti first described superficial liposuction and safely using fine cannulas closer to the skin surface. Taking it one step further, the gentle suction of the syringe makes it possible to safely go very close to the skin surface. It's also the perfect scenario for a two-for-one treatment, as the fat can also then be used as a facial filler.
Recently, a 29-year-old female patient came to see me after consulting with multiple doctors about unwanted saddle bags (Figure 1). She was on the cusp of starting a new job in public relations and wanted to feel confident in her appearance in this position. She was offered cryolipolysis and traditional liposuction methods as options, but she didn't feel like these worked for her desired timeframe: Results with cryolipolysis were not fast enough, and she was unable to take the necessary time off for the more invasive option. Saddle bags were the perfect placement for FLASH. I performed the in-office procedure after her work day, removing 350cc and 375cc of fat from the left and right saddle bags, respectively, and she was able to return to work the next day wearing a compressive foam dressing. After three days, she was able to wear the form-fitting clothing she desired.
A Quick Fix
FLASH is a simple procedure and that's the beauty of it. I still discuss other options with the patient—and each has its place—but FLASH offers a quick fix that satisfies when the desire or need is for instant gratification. It's important to note that this approach is designed to treat small fat zones. For body contouring in larger areas, standard liposuction (with or without mechanical assistance) is more appropriate.
Ultimately, physicians who are educated and trained in liposuction and the art of body contouring will know upon inspection which fat pockets are appropriate for this approach.
1. Gasparotti, M. Superficial liposuction: A new application of the technique for aged and flaccid skin. Aesth Plast Surg. 1992;16:141.