Muffin-top, love handles, spare tire. People have a lot of names for it – that extra fleshy bit around the mid-section that they just can’t seem to get rid of, no matter how many crunches they do or how much celery they nibble.

For some, that little paunch can be a big source of dissatisfaction, and many Canadians have been willing to go under the knife to be rid of it. A 2006 Medicard survey found that liposuction is the most popular surgical procedure requested by men and women across the country. While liposuction can provide drastic results, it, like any surgery, comes with risks and drawbacks. Now Canadians have another option, with the introduction of a non-surgical, ultrasound-based treatment for body contouring.

The LipoSonix system, which is 100% non-invasive, permanently removes abdominal fat by using HIFU (high-intensity focused ultrasound) technology. The ultrasound energy is concentrated at specific depths to destroy fat just behind the skin, without damaging the epidermis, dermis or underlying tissues and organs.

“A good analogy is when you’re a kid you take a magnifying glass and the sun and you can move it up and down and get all the light to focus on one spot and you can burn a hole in a leaf or start a fire,” says Dr. Nowell Solish, a Toronto-based cosmetic dermatologist who performs the procedure and is one of the three principal investigators of the system in Canada. “Nothing happens on the way down because all these waves are going down singly and not causing any damage, but when they all join up into that one point all the energy together is enough energy to kill fat cells.”

After treatment, the body naturally transports the destroyed fat cells to the liver, where they are processed as energy. In clinical studies, patients saw results in eight to 12 weeks, with a single one-hour treatment typically resulting in a 2.8 cm reduction in the waistline (equal to dropping one size).

The procedure is meant to augment a healthy lifestyle, not replace it. Solish says patients should know what to expect. “It’s important that they realize it’s not about weight loss; it’s about shaping. Before if they’re exercising routinely and they have a good healthy diet, and they still have some areas that bother them, then this is an ideal procedure for them.”

LipoSonix differs from other fat reduction procedures in several ways. The system uses a higher energy and higher frequency than other ultrasound body-contouring technologies, so a thermal effect is used to destroy fat instead of a mechanical effect. And unlike liposuction, the LipoSonix procedure requires no anesthesia and results in little to no patient downtime. “[In liposuction], you have to make a hole in the skin, you’re withdrawing fat, there is a risk for bleeding, for nerve damage, for infection, for contour irregularities,” says Dr. Jason Rivers, clinical professor of dermatology at the University of British Columbia and co-medical director at Vancouver’s Pacific Dermaesthetics, which has offered the LipoSonix procedure since September.

“A GOOD ANALOGY IS WHEN YOU'RE A KID YOU TAKE A MAGNIFYING GLASS AND THE SUN AND YOU CAN MOVE IT UP AND DOWN AND GET ALL THE LIGHT TO FOCUS ON ONE SPOT AND YOU CAN BURN A HOLE IN A LEAF OR START A FIRE”

He adds about liposuction, “It’s generally a safe procedure and for people who have a lot of volume of fat, it’s a very good procedure to be done… But for people who want a non-invasive approach, where you’re not cutting, it’s one treatment, and a relatively quick procedure, LipoSonix offers a new approach.”

Dr. McGillivray, co-medical director at Pacific Dermaesthetics and another principal investigator of LipoSonix in Canada, cautions that the system is not meant as a replacement for liposuction but rather an alternative body contouring approach. It is also not meant to be used on people with cancer or stomach disease, who are pregnant or suspected to be pregnant, on anticoagulant therapy, or have an implanted electrical device.

As well, LipoSonix should not be used on areas with too little fat, or on those with a body mass index (BMI) of more than 30. Of the latter, McGillivray says, “A lot of their fat might actually be visceral, inside their abdomen. We wouldn’t hope to be able to contour them. Some of those people aren’t even candidates for liposuction, because they’re just too extremely obese, [and] they’re going to have to take measures like diet and exercise.”

The LipoSonix procedure itself is relatively straightforward. The doctor passes the head of the LipoSonix device over the patient’s targeted area, such as the lower abdomen. He or she goes over the entire area, and every time the device shoots, it destroys about a centimetre of fat. At this early stage of Pacific Dermaesthetic’s use of LipoSonix, most of the work has been related to treating the abdomen and the flanks (the sides of the abdomen), though Rivers says they are starting to try other areas.

Patients may experience some discomfort during the procedure, including cold, prickling, tingling, warmth or pain. Those with a higher pain threshold can receive two passes at a high intensity level, which will take about 40 minutes, while those who choose to can do three passes at a medium intensity level, which will take about an hour. The doctor may also give them a painkiller such as Tylenol 3 or Percocet beforehand, though some patients have undergone the procedure with no medication.

After the procedure, some patients may have a slightly bruised or dull feeling in the area that was treated, ranging from a day up to a week. About 10% of people have also experienced a small amount of bruising in the area that was treated. “They probably won’t want to exercise for 24 hours [because] the area can be a little bit sensitive, but there’s otherwise no downtime,” says Solish. “You can get up and go and work.”

The cost of the treatment varies depending on the patient’s specific needs. The most common area currently being treated at Pacific Dermaesthetics is the central abdominal area, which is priced around $2,000. The flanks, or so-called “love handles,” can be treated at a small additional cost. With nine years of research and testing behind its development, LipoSonix became available in Europe in 2008. LipoSonix was approved by Health Canada in June of this year and is being marketed by Medicis Aesthetics Canada. By October, five machines were in use across the country, with five more installs expected by the end of the year. The system is not cleared for sale in the U.S., though its makers have said they hope to launch it there by 2011.

Less than a month after getting the device, McGillivray and Rivers had treated about a dozen patients using LipoSonix, with more on the waiting list. Although eight to 12 weeks are needed to see full results, all indications seem to be positive so far. “[One of my patients], she’s about six weeks out now and she said she’s back into a dress she hasn’t worn in quite a while. That’s a very nice thing to hear,” says McGillivray. •