NEW AND INNOVATIVE TECHNOLOGIES FOR BODY SHAPING

WITH JEANINE DOWNIE, MD
Dr. Downie is founder and director of image Dermatology in Montclair, NJ. She is on staff at Mountainside and Overlook Hospitals. A popular lecturer, she has made frequent media appearances, including on The Today Show.

WHAT'S NEW WITH BODY SHAPING TECHNOLOGIES?

Patients are looking to target all different parts of their body for fat melting, particularly in areas with stubborn fat, like the thighs, says Jeanine Downie, MD. Recently, two companies introduced new applicators—Zeltiq announced the launch of the CoolSmooth PRO and BTL added the Vanquish Flex applicator.

CoolSmooth PRO is a second generation surface applicator that features non-vacuum based cooling to treat non-pinchable fat bulges, like the outer thigh area. The company also received FDA clearance to perform the CoolSculpting® procedure at lower temperatures, which will enable shorter treatment times. The new treatment parameters will be offered with the CoolSmooth PRO applicator, which is designed to safely control treatments at colder temperatures.

The Vanquish Flex applicator is a two-panel system designed for use on the thighs and saddlebags. The noncontact Flex hovers over upper legs and delivers selective RF energy to heat the deep tissue layer. The noninvasive technology creates an electromagnetic field with energy flow control to safely target and destroy fat cells, resulting in a reduction in entire upper leg circumference.

“What patients are really looking for is how do I get this stubborn fat off of my thighs,” explains Dr. Downie, who recommends six treatment sessions with the Vanquish Flex. “I think the original protocol recommends four, but I recommend six. And you treat 30 minutes on one thigh and then 30 minutes on the other thigh, so the patient is in your chair for an hour.” In her office, Dr. Downie says, medical assistants put the thigh applicator on and monitor patients to make sure it's not too hot. She says her patients have responded positively and that she has seen excellent results so far. She does offer one caution for patients who sweat a lot. If a patient sweats a lot as a result of the heat on their thigh, office staff might have to hold a fan so that it's blowing cool air, because a lot of sweat could result in a blister.

Patients are excited about this technology, Dr. Downie says. Some new patients are coming in because they want to target areas like the thighs, and others are excited because they've already been treated with a device for body shaping or fat melting on their abdomen and they're excited about new areas that we can now target.

WHAT OTHER FAT MELTING TECHNOLOGIES ARE YOU USING?

Dr. Downie also uses the Futura Pro from Perigee Medical, an FDA-cleared, 510[k] Class II Medical Device that offers 1 MHz Ultrasound Technology combined with a muscle re-education system to simulate natural muscle fiber activations and increase local blood circulation. Dr. Downie explains that because the ultrasound wave is a focused ultrasound but not a high-frequency focused ultrasound, there is no pain or discomfort from treatment. In her practice, she says a medical assistant applies the ultrasound for 20 to 30 minutes on the area of the body the patient is targeting—which could be the abdomen, the buttocks, the thighs, or upper back—to break up the fat. After applying the ultrasound to that area for 20 to 30 minutes, electric muscle stimulation pads are placed on the patient to contract the muscles. For example, Dr. Downie explains, on the abdomen, it's almost like the patient has done 1,000 sit-ups during the 45 minutes the electric muscle stimulation pads are on the patient.

“The electric muscle stimulation pads are very much the same things that have been used in physical therapy for years. And what they're doing is they're really intensifying the amount of fat that's lost because of the contraction of the muscles,” Dr. Downie says. And patients actually lose weight through this treatment because the fat is kicked out into the patient's system and then all the muscle work actually burns the fat—so patients actually lose weight and lose inches.

“And it's front loaded, so someone who is heavier is going to have a better result than someone is lighter,” she adds, explaining that one of her physician assistants actually lost two and three-quarter inches after the first treatment. “Typically, heavier people lose one and half inches or more and thinner people lose about a half to three quarters of an inch, and everyone is extremely happy with what they've lost. It also decreases triglycerides and cholesterol.”

And for patients who are interested in skin tightening, such as patients who have lost weight or post-pregnancy, the Exilis is great option.

Dr. Downie says she also regularly uses several of these technologies in combination. For example, she says, “I'll use the Futura Pro and that will help with the fat, and then I'll use the Vanquish. Patients lie under that, which they love because they can fall asleep and that results in consistent loss of inches. I'll use the Exilis with the Vanquish with the Futura Pro all in combination with each other.”

In addition she uses the Protégé—or the baby Exilis—for the face for tissue tightening of the eyelids and for the lower jaw to keep that square face look that patients get as they age from getting too significant.

DO MOST PATIENTS KNOW THESE OPTIONS EXIST? DO PATIENTS NEED A SIGNIFICANT AMOUNT OF EDUCATION?

Dr. Downie says that a lot of patients come in to her office asking about a specific treatment because someone they know had treatment. But there are also a lot of people who have no idea. “I would say a quarter of people know and 75 percent need to be educated.”

Although discussing the need for these treatments can be difficult to bring up, Dr. Downie says that if a patient expresses that they've been having an issue with their weight, they are typically happy to hear that these options exist for helping them “fight the battle of the bulge.”

And a benefit with these treatments is that there is no pain, and there is no downtime. Patients can drive themselves to and from treatments.

WOULD YOU RECOMMEND INVESTING IN TECHNOLOGY FOR BODY SHAPING TO YOUR COLLEAGUES?

“Unfortunately, our waist lines in America keep growing, so we keep wanting more ways to melt the fat,” says Dr. Downie. “So I would say 100 percent that we definitely are going to keep using these fat melting machines and probably use even more.”

IS THERE ANYTHING ON THE HORIZON?

Xiaflex is an injectable being studied now for its ability eliminate cellulite, says Dr. Downie. Xiaflex is a prescription medicine currently FDA approved to treat adults with Dupuytren's contracture when a “cord” can be felt and for Peyronie's disease.

And, she says, Kythera's ATX101 for submental fullness will hopefully be FDA approved soon.