I know I have written on this topic in the past, so I will limit my diatribe and refer you to earlier posts. BUT….the Wall Street Journal personal section had an extensive article on these technologies recently that has brought the topic of non invasive fat removal in the forefront again. Like most articles written about beauty, there was not full disclosure from those in the know! Point being-these technologies are NOT the standard of care for fat removal. Way too many patients are wasting valuable time and money trying to take off inches with these Zerona and Zeltiq devices. What the article did address, which is a valid topic, is that fat is a complex, very functionable part of our body in regards to metabolism, storing and dealing with toxins, and hormonal regulation. Hypothetically, if we can melt large amounts of fat non-invasively (which we cannot) what would the consequences on the body be. My impression is that it would not be the best thing for you. If you have garbage in your backyard- cart it out, don’t melt it down or burn it. The same holds true with fat. Liposuction, particularly Tumescent Liposuction performed solely under local anesthesia is still the safest and most effective method of fat removal hands down. The Zerona and Zeltiq technologies offer very limited amounts of fat removal, if any. Is there a future in these technologies- I do hope so. But for now, in my opinion, it is still science fiction. Unfortunately, 15-20% of my liposuction patients have already spent time and money on these or similar technologies. There were obviously not happy to realize the hard way that Tumescent Liposuction was going to be the only answer for them.

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So what’s new? Well, new is not always better. In this case though, you can teach an old dog new tricks. Laser Hair removal is about 15 years old now. It has certainly come a very long way but it has also had it limitations. Still to date we cannot remove gray hair or very lightly pigmented hair. The target for hair removal laser is pigment. We have improved the manner in which we treat different skin types. We can certainly treat skin of color and we can treat various thicknesses and densities of hair. All this is very good to achieve the overall result of permanent hair reduction in most people. Until recently, laser hair removal, like most forms of hair removal, remained very tedious, time consuming, messy and often painful. This often deterred a large part of the population from getting it done, particularly men who have larger areas to treat such as backs and shoulders. One of the most recent advances in laser hair removal has come from the company that had the gold standard device in the past- The Light Sheer hair Laser. With the ability to treat all skin types with the least number of treatments necessary, this device has proven over the years to be the rolls royce of hair removal lasers. Their most recent prodigy is the Light Sheer Duet Laser. Using similar Diode technology the LightSheer Duet has two treatment heads-the traditional 9×9mm which is still great for small tough to reach areas and the duet HS or high speed hand piece which is almost 10 times the size at 22x 35mm. This allows for dramatically faster, deeper and more efficacious treatments. Backs and legs are done in 15-20 minutes as opposed to 1-1 1/2 hours. The device also uses what is known as pneumatic suction to draw the skin gently into the laser improving penetration of light, efficacy, and a dramatic reduction in pain. The overwhelming majority of patients no longer require anesthesia or treatment gel, making the treatment quick, clean and easy. Thus far i have nothing negative to say about this laser. A dramatic number of patients that would not have done the treatment in the past are coming into the office and leaving very satisfied. A large number of men are also being added to roster. Because of the speed, ease, and minimal discomfort treatment cost becomes more and more attainable as well. I do believe this is the new standard in Laser Hair removal. Feel free to watch a video about how the laser works on our website- www.pfrankmd.com

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Stretch marks or striae are one of the most annoying cosmetic skin problems. The second runner up, cellulite, we will talk about another time. What is generally unknown is that stretch marks are common in men as well as women. They are basically a form of scar tissue where the elastic fibers of the skin are overstretched causing a very signature look with some variation in color and quality. Most popularly they come about during pregnancy. There are also very common during puberty during growth spurts. It is in this circumstance that young men often acquire them. In all cases, one’s susceptibility to them appears to have a strong genetic factor but obviously anyone can get them. The more trauma or stretching action to the skin the more likely one is to acquire them. Some lesser known causes include weight gain, development of muscle hypertrophy with exercise, and as a side effect of oral and topical medications particularly steroids.
Up until recently very little could be done. Billions of dollars have been spent on creams and treatments that basically do nothing. Over the past several years though laser technology has made dramatic improvements in their treatment. In the best-case scenario, stretch marks are detected early and some level of redness or inflammation is present. In this case, a pulsed dye vascular laser (V-Beam) can be used to stop their progression. Once the tissue appears stretched, whitish or dark, other technologies must be used, notably fractional non-ablative lasers such as the Fraxel Restore. In general, I am surprisingly impressed by their efficacy. Now, as expected, nothing will remove them completely and several factors such as skin type, severity, and body location will play a strong role in how much improvement can be achieved. What I could say, is that for many patients that are good candidates we can minimize stretch marks by 80+ %. Universally, several relatively simple, low downtime treatments are necessary. Often a combination of technologies mentioned above must be used in conjunction with topical agents. The good news is that we now have pretty solid protocols that will give patients much greater comfort and hope in the improvement of these common scar-like embarrassments.

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