Photo from via Dan Camacho on Pinterest

Photo from via Dan Camacho on Pinterest

You may still be bundled up in puffy jackets and boots, but now is the perfect time to set your sights on a rockin’ bathing suit season. Even if you’re sticking to your New Year’s pledge to hit the gym – workouts and green smoothies may not be enough to tone problem areas like love handles and saddlebags. Fortunately, new fat removal treatments can tackle those trouble spots without surgery or recovery time. Dr. Gilly Munavalli of DERMATOLOGY, LASER, VEIN SPECIALISTS OF THE CAROLINAS shares the latest on non-invasive fat removal treatments to help us hit the beach with confidence this summer.

Scoop: What are the latest non-surgical fat removal/contouring treatments that DERMATOLOGY, LASER, VEIN SPECIALISTS OF THE CAROLINAS offers? How is it/are they different from Liposuction?

Dr. Munavalli: CoolSculpting® uses non-invasive cooling technology to gradually freeze and remove unwanted areas of fat – resulting in contouring and reduction of these areas. New handpieces allow for fat removal on most parts of the trunk and legs with zero downtime. Exilis uses radiofrequency energy to gradually heat the upper layers of the skin and fat to tighten skin laxity on the abdomen, legs and neck.

What are the most popular areas of the body to perform fat removal? Are there specific areas of the body where CoolSculpting® cannot be used – like the buttocks?
CoolSculpting® can be performed anywhere on the abdomen, on the love handles, muffin-top and upper back. We also treat the back of the arms, inner and outer thighs, and male chest area (otherwise known as man boobs).

Photo from via Benjy Portnoy on Pinterest

Photo from via Benjy Portnoy on Pinterest

Are non-surgical treatments as effective as Liposuction?
Multiple treatments with CoolSculpting® can give you as good or better results as liposculpting. There’s no downtime after CoolSculpting® and you’ll end up with evenness and blending in the treatment areas – avoiding the risk of asymmetry, lumpiness and ridging that can occur in liposuction.

How do I know if I’m a good candidate for a procedure?
The best thing is to come in for a consult with a trained expert. You are likely amenable to CoolSculpting® if you have areas with “jiggly” fat and minimal skin laxity. Areas with mild abdominal skin laxity are targets for Exilis.

I have heard that there can be issues with skin sagging after the fat is reduced via the CoolSculpting® treatment – for overweight and people with mature skin. Can you talk about these concerns?
Further skin laxity can occur in areas where fat is removed – the degree of looseness depends on the starting point and treatment performed. If your goal is to fit and look better in clothes and you are not as concerned with being “beach” ready – CoolSculpting® can still be an excellent option in those areas. If the skin laxity is moderate to severe and the goal is to tighten the skin as well as reduce fat, then liposuction or even a surgical procedure, such as abdominoplasty, may be a better choice.

How many treatments will I need to get the best results?
The treatments are cumulative with most non-invasive fat reduction procedures – so multiple treatments will be necessary. For example with CoolSculpting®, each treatment should improve the result more and more (approximately 20-25% reduction per visit) until you get to the desired endpoint.

Will non-surgical fat removal help if I have a lot of weight to lose?
No. It is best to be within 10-15 lbs of your target weight before a fat removal procedure. If you have more weight to lose, consider a weight reduction program with exercise prior to starting treatment. My patients often use treatments as a reward for losing weight on their own.

Will a doctor oversee my procedure?
Each non-invasive procedure and consult at our office is supervised by a board certified, trained MD. We feel this gives us the opportunity to maximize each treatment for the benefit of our patients and obtain the absolute best results in the safest fashion.

Photo via

Photo via

Is fat removal/contouring painful?
After treatment, there can be transient swelling, tenderness, numbness and tingling – but in almost all cases this resolves in 2 weeks. Exercise can be resumed immediately after the treatment without concern.

Should I plan to take time off for recovery after the procedure?
Typically it isn’t necessary to miss any time from work for recovery after these non-invasive procedures. These are designed for no-downtime and immediate resumption of a normal lifestyle.

What are the risks/side effects?
In some cases, areas can be persistently tender and sensitive, so we would prescribe oral medication to control the discomfort. In a very, very small number of CoolSculpting® cases (less than one hundred cases out of the millions performed worldwide) the treated area of fat can get larger, rather than smaller. This is incredibly rare but is a risk nonetheless and patients in our office are made aware of the possibility. If this occurs, the enlarged area can be corrected with liposuction.

For CoolSculpting®: How much fat reduction should I expect and when will I see results?
Typically 20-25% of fat in a given area is reduced with each treatment. The results are cumulative, so multiple treatments in an area (such as the entire abdomen with multiple cycles in one session) can reduce the whole area and give liposuction-like results. In our office, we can use two machines simultaneously to reduce treatment time by half.

Are the results permanent? Will I need follow up treatments?
The results are permanent in the treated areas. Once fat in an area is gone, it doesn’t return. However if one gains a large amount of weight in the future, it will still show in other areas.

What are the cost ranges for treatments? How do the costs compare to Liposuction?
Cost ranges vary depending on the areas to be treated. The more areas to be treated, the more cycles are needed. Using new treatment methods, entire areas of the body such as the abdomen or the inner and outer thighs can be treated with liposuction-like results, with very reasonable costs.


Dr Munavalli

Gilly Munavalli, MD, MHS, FACMS
Dr. Munavalli, a native of North Carolina, is medical director and founder of DLVSC. He trained in Dermatology at Emory University, Dermatologic Surgery fellowships in Mohs Micrographic Surgery (for the treatment of facial skin cancers), Cutaneous Oncology, Facial Reconstruction, Cosmetic Surgery and Laser Surgery at the University of California-San Francisco.

He also completed a Phlebology and advanced laser surgery fellowship at the Maryland Laser, Skin, and Vein Institute, and Johns Hopkins University. He received his Bachelor of Science from the University of North Carolina-Chapel Hill, Masters of Health Science from the Johns Hopkins University School of Public Health, Doctorate of Medicine from Morehouse Medical School in Atlanta, Georgia, followed by internship training at the Mayo Clinic. Dr. Munavalli received his Board Certification in Dermatology in 2002.

Dr. Munavalli has over 13 years of experience performing the following surgical procedures: tumescent liposuction and liposculpture, blepharoplasty, ablative and non-ablative laser skin resurfacing of the face, facial volume enhancement with fillers, fat transfer, as well as lasers for the removal of small blood vessels, birthmarks, acne, tattoos, fine lines, and wrinkles.

Dr. Munavalli’s medical memberships include the Board certification and member of the American Academy of Dermatology. He is a member and fellow of the American College of Mohs Micrographic and Cutaneous Oncology, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, and the American College of Phlebology. His current affiliations include Assistant Professor of Dermatology at the Wake Forest University Department of Dermatology and Clinical Assistant Professor in the Department of Medicine at UNC School of Medicine, Carolinas Medical Center. Previously , he spent 4 years on the clinical faculty of Dermatology at Johns Hopkins School of Medicine, in Baltimore, MD.