By Doctor Valéria Romano

Slimming down is not easy, and localised weight loss is even more difficult.

A clean lifestyle is not enough, and the surgical option is often rebuffed (downtime, scarring). Anyway, surgery is not effective against water retention and superficial imperfections.

When analysing a patient’s figure, we must identify the causes of the localised fat stores. This might be water retention, adipose tissue or fibrotic tissue.

Before performing any medical procedure, we must identify and eliminate any contributing factors (sedentary lifestyle, insufficient hydration, etc.).

Several techniques are available.

Shock waves are acoustic waves with an extremely high peak in energy.

We use them to improve sluggish microcirculation in areas with cellulite, to reduce fibrosis and stimulate the destruction of fat cells.

We carry out 2 to 4 sessions to reduce the adipose panicle, and 8 to 10 sessions to treat orange-peel skin.

The results are not amazing, and the number of sessions required is quite high, so we might use it to improve the results of cryolipolysis, for example.

Cryolipolysis is a technique that destroys fat cells through cold. Fat cells are much more sensitive to the cold than other cells. When exposed to temperatures lower than zero degrees, lysis is triggered.

One or two sessions are required, depending on how thick the adipose panicle is.

This method is effective and might be considered as an alternative to surgery, providing that a good machine is used, the handpieces are placed in the correct position, and that it is used for the right indication. In my opinion, this procedure should not be delegated: it should be performed by a qualified doctor in order to guarantee maximum safety and efficacy.

Radiofrequency involves passing a current between two electrodes (several electrodes to treat the body). The body resists the current, and this resistance produces heat.

In the deep fat layers, the temperature reaches 65°, which leads to the destruction of the fat cell membranes. At the surface, in the dermis, the temperature reaches 42°, stimulating dermal synthesis, which improves the uneven, orange-peel appearance.

Some devices associate radiofrequency with a vacuum and subdermal tissue massage to act even deeper inside the fat layers.

The treatment protocol suggests 6 to 10 sessions.

This method requires precision and patience, but with it I have achieved great results on sagging skin, centimetre-loss and body shaping.

Water retention is usually treated using mesotherapy (or radiofrequency with an integrated subdermal tissue massage system). We inject draining actives into the skin.

Depending on how much retention there is, 2 to 6 sessions are required.

I am quite satisfied with the results, which are visible the next day.

Focused ultrasounds destroy fat cells thanks to their thermal effect. The treatment can be performed at various depths: deep within the tissue (13mm, 8mm and 6mm) to destroy the adipocytes using heat and/or nearer the surface (4mm, 3mm and 1.5mm) to treat sagging skin.

One or two sessions are required. The treatment is quite expensive, and the results are not always worth the price paid. The thickness of the adipose panicle is reduced, but the results on sagging skin and body shaping are mediocre.

Doctor Valéria Romano

Former Paris Hospitals resident doctor. Degrees in anti-aging and morphological medicine, medical lasers, surgical dermatology, mesotherapy, the treatment of hair loss, and the evaluation of injection and filler techniques, in dermatology and plastic surgery. Member of the French Aesthetic Medicine Society (SFME), the Francophone Society for Medical Lasers (SFLM), the Advanced Society of Aesthetic and Plastic Medicine and Surgery (SAMCEP), the French Mesotherapy Society (SFM), the European LED Academy, and the World Society of Interdisciplinary Anti-Aging Medicine.

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