TORONTO – Nonsurgical body contouring technologies are coming down the pipe at a fast and furious pace, with some being more steeped in science and results than others, says W. Grant Stevens, MD, medical director at Marina Plastic Surgery Associates in Marina del Rey, California, at the 45th annual Aesthetic Plastic Surgery Symposium in Toronto.

Stevens has used almost all of the commercially available nonsurgical body contouring devices. He has gotten behind some, based on their efficacy and favorable side effect profile, and abandoned others due to lack of efficacy and patient intolerance to side effects such as pain.

Deciding which nonsurgical technologies to incorporate into a plastic surgery practice should be guided by efficacy, safety, and, of course, economics.  Stevens suggests plastic surgeons trial the technology on themselves, staff, and others before offering it to patients.

“Assess the treatment efficacy on staff, family, and friends,” he says. “Figure out if it makes economic sense for the patient (to undergo the treatment), and figure out if it makes economic sense to the physician (to offer the treatment).”

Apart from clinical experience, plastic surgeons should look to the literature for studies that support the efficacy and safety of a nonsurgical body contouring technology.

Stevens is particularly bullish on Zeltiq’s CoolSculpting™ suite of technologies. The CoolSmooth™ Applicator,  designed to remove “saddlebags” or fat that rests on the outer thighs, is proving popular in  his practice. He published a study of 40 patients who underwent a 2-hour, single treatment where the applicator was applied to the lateral thigh, and the contralateral thigh served as a control. Patients were satisfied with the results after one treatment, and ultrasound imaging showed a 2.6-mm-mean normalized decrease in fat thickness—a reduction that was statistically significant— in the treated thigh compared to the untreated thigh.

Cellfina™, a new US Food and Drug Administration-approved option for treating cellulite, works by cutting the septae in the fat under the skin that connects the skin to muscles, and it has also been well-received in Stevens’ practice. “It appears to be long-lasting (in terms of the effect on cellulite),” he says.

“Surgery may not be the solution for all patients that come to us. Nonsurgical treatment can be an alternative,” says Colin Hong MD, FRCSC, the chief of plastic surgery at Rouge Valley Health System in Toronto.