aesthetic plastic surgery procedures

Let Santa Keep the Belly

Posted on December 7th, 2016
Posted by Julene Samuels

“…He had a broad face, and a round little belly, that shook when he laughed like a bowl full of jelly. He was chubby and plump, a right jolly old elf…”


Are you ready for the best present ever for anyone who may be feeling they are beginning to resemble the description of Saint Nicholas in the beloved old tale of ‘Twas the Night Before Christmas’? When it comes to choosing the best way to reduce belly fat or the dreaded “muffin top” (that is, if you don’t wish to give, or undergo, the gift of surgical liposuction), then you may want to consider a gift of UltraShape Power treatments.

In three short, painless, non-surgical office treatments using the new UltraShape Power, with each treatment requiring approximately 35 minutes using no medications or anesthesia, our study patients lost an average of over 3 to 4 inches of stubborn belly fat. UltraShape Power is the most effective non-surgical fat reduction technology on the market today, hands down and by a lot…a lot of fat removal and a lot of power, that is.

So what is UltraShape Power, how does it work, and why is it the most effective fat reducing body contouring tool available? I’m glad you asked.

I am betting that you have heard by now that we can effectively reduce body fat with several different non-surgical devices. All of these devices differ greatly…some work on both skin and fat, some work mostly on skin and to a lesser degree on fat, and some work only on fat leaving the skin to do the best it can to “redrape” itself once the fat below the skin is reduced. All of these devices are patent-protected, therefore one device manufacturer cannot copy another’s technology, which is why they all work so differently. This is also why it can be very confusing for patients to know which device’s technology is best for their target tissue. If you only listen to marketing hype, they all sound miraculous. This is also why I devote large amounts of my time and energy to studying device technology and partnering with manufacturers and their engineers to develop better and more effective technologies. If a patient wishes to choose a non-surgical approach (and increasingly large numbers of patients are doing so, and spending more on non-surgical options), as a surgeon, I believe we owe them a good alternative. I use these non-surgical tools in my surgical body contouring practice as adjuncts to my surgical results and for non-surgical maintenance for surgical patients over time. In my surgical practice, I want the very best tools, otherwise, it is very easy for me to just recommend “one and done” in-office liposuction. The best non-surgical device has to be able to compete fairly well (or at least better than its other non-surgical competitors) with the “Gold Standard” result of surgery itself. Who better than a surgeon can accurately compare results of a non-surgical approach to those of surgery? The questions regarding efficacy of each of these devices boil down to:

• How well does the energy delivered by the device target fat specifically?

• Are the fat cells changed to become just “leaky”, or are they permanently destroyed?

• How much fat is actually affected, and after how many treatments?

• What is the size of the treatment area, and therefore cost, for similar amounts of fat reduction? (i.e., does it take one device 6 treatments to reduce the same amount of fat that another device can reduce in 3 treatments?)

• Is it painful?

• How fast can you see results start to appear?

• Can treatments be repeated?

• How will the skin overlying the reduced fat appear after treatment is completed? Are there other side effects, like skin sensory changes or contour irregularities, shelving or dimpling?

• How much maintenance is required?

• Most non-surgical options require multiple treatments for best results, so does the size of the treatment area cover my entire area of concern each time in a single treatment or will I have to have more than one treatment to cover the area of concern even once? (this is a huge issue to consider when looking at total costs to treat a given body area)

Before we discuss UltraShape Power specifically, let’s evaluate the competition as compared to UltraShape Power, which is the new gold standard amongst non-surgical body contouring options.


CoolSculpt works via “cryolipolysis”, or freezing fat. This is effective in killing only approximately 18% to 20% of fat cells in the treated area, compared to UltraShape Power’s 32%. Disadvantages are that the smaller transducers available cover a much smaller area per session than UltraShape Power, making it necessary to do more treatments to cover the same size area, thereby taking longer to complete the series (and at subsequently more cost), unless the provider uses multiple machines in a single session (which increases costs per treatment even more). Also, CoolSculpt results require 6 to 12 weeks or more to start to be appreciated by the patient, or before the same area can be retreated (and remember that for best results, more than one treatment in each area is necessary). This delays seeing final results even further, since best results usually require a series of 3 or more treatments of any single area to see measurable reductions. An additional disadvantage is that the skin has to be lax enough in the treatment area in order to be able to be suctioned up (thereby stretched) between the vertically positioned cooling plates to be frozen. This makes it harder to treat areas like the outer thighs, arms, or the neck. A corollary of this is also that the treatments can be uncomfortable, the skin may suffer dysaesthesias after treatment, or skin may look looser, dimply or irregular in contour after treatment. In fact, we frequently see patients who come to us for fixing skin contour irregularities that have resulted from CoolSculpt treatments to smooth out the skin with our VASERShape or VelaShape devices.


This is a non-invasive laser treatment that can reduce even smaller amounts of fat (11% to 12%) than CoolSculpt (18% to 20%), and far less than UltraShape (32%), after 2 or more treatments. Lasers are usually the most expensive technologies on the market and are usually not the best energy medium for affecting fat, which requires a broader effect than can be achieved with a narrow beam of light-induced heat. The disadvantage of lasers for fat reduction is that treatments are more expensive, less fat bulk is affected, and therefore more numbers of treatments are necessary to reduce the same amount of fat overall as with UltraShape Power.


There are several radiofrequency body contouring devices on the market today. They go by the names of Venus Concept, Exilis, Protégé, Vanquish, Thermi, VelaSmooth, and Thermage. Radiofrequency is basically electrical current that produces resistive heating to cause a tissue result, and as such, current follows the path of least resistance. The problem is that the human body does not conduct electrical current homogeneously like a wire does, so tissues primarily affected by any radiofrequency device are tissues that are dense, like skin and connective tissue septae (walls) that separate fat compartments. Fat itself is not dense enough to conduct electrical current consistently well in order to be much affected, and therefore, fat is largely spared by radiofrequency. As a result, RF devices can tighten skin fairly well, but can only reach the very top layers of fat, so are not by themselves, good fat reduction tools. These RF devices are best coupled with other devices that target the fat layer better, so that fat reduction and skin tightening or reduction of cellulite can be achieved…

So what devices affect fat the best then?

…ultrasound devices…and here’s the skinny…!

UltraShape Power

UltraShape achieved FDA approval in 2014. In its first prototypic form, UltraShape achieved a fat reduction of 20% in 3 in-office treatments of 45 minutes to one hour. This amount of fat reduction already exceeded that of even today’s competition, but in September of this year, UltraShape Power received FDA approval and can now achieve fat reduction of up to 32% after 3 treatments which are even shorter in duration, averaging about 30 to 35 minutes each. What is the technology behind UltraShape Power? Highly focused mechanical, non-thermal ultrasound.

Ultrasound energy is perfect for affecting fatty tissue, because it can be focused or non-focused to change its depth of effect – to be superficial for skin tightening – or deeper for affecting superficial as well as deep fat. (We can even go really deep with ultrasound and use it to visualize internal organ systems or babies in-utero, right?). Thermal ultrasound can tighten skin and melt fat (VASER Shape), while mechanical ultrasound can permanently destroy fat by essentially imploding the fat cells through exertion of high pressures on their thin walls until the cells explode. Since the ultrasound energy of UltraShape Power is highly focused, it is an important point that it is pulsed to make it non-thermal, otherwise the treatments would be quite painful (i.e., remember a device called Liposonix?, which was totally thermal focused ultrasound…ouch!) Ultrasound is very safe, it is thoroughly studied, and is much cheaper to use than lasers. Additionally, ultrasound waves can be used to deliver energy to affect tissues in very broad treatment areas, so that larger areas can be treated effectively in a single session, and therefore, fewer treatments need to be performed for results. Since there is no true tissue “wound” created by ultrasound as there is with freezing or laser heating which has to heal before results can begin to be seen, UltraShape and VASER Shape results start to be appreciated by patients within days of their first treatments. For these reasons, re-treatments within a series can be spaced as close as 10 to 14 days apart, so that a typical 3 treatment series is completed much faster than with other modalities. Just like with surgical fat reduction – liposuction or tummy tuck – as long as the patient maintains a stable weight, fat does not return, and results are long-lasting.

My office offers 3 different types of ultrasound devices used for body contouring:

Ultrasonic-assisted liposuction by VASER 2.0 for surgically inclined patients to liquefy the fat first and then suction the emulsified fat out (if it isn’t desired for re-injection elsewhere, like to the face or other body parts where it can be used to achieve higher definition, i.e., abdominal muscles or buttock augmentation).

VASER Shape is lightly focused ultrasound, and is one of the few devices on the market that can both tighten skin (the thermal effect of ultrasound) as well as liquefy fat (the mechanical effect of ultrasound), and as such, VASER Shape can affect both skin and fat – and both superficial as well as deeper fat, due to its ability to penetrate all tissue layers in its path. Since the ultrasound energy is only lightly focused, VASER Shape is painless, but more treatments in total number are necessary than its counterpart UltraShape Power, which incorporates highly focused ultrasound, to achieve the same measurement reductions.

UltraShape Power is highly focused ultrasound which is pulsed, so that it is totally non-thermal, and therefore non-painful. Think of it this way…the purely mechanical effect of ultrasound is harnessed so that the ultrasound waves are pulsed through tissues creating oscillating sound waves that create bubbles in the fluid surrounding the fat cells. Fat cells have very thin cell walls, so as the bubbles grow larger, they eventually implode the fat cell membranes, and the fat cells then release their fatty acid contents and are permanently destroyed. The liver, lymphatic system, and intestinal tract eliminate the fat cells and their contents safely and without elevating blood lipid levels, much as these systems would eliminate a fatty meal or fat with weight loss. Patients start to feel smaller within 2 days of their first treatments. Treatments are quicker than with the previous UltraShape, with at least 20% more fat destroyed. All areas of the body can be treated and in fewer treatments than with any other device on the market. What’s not to love?


UltraShape Power is an awesome stand-alone device for body contouring. The skin fares much better after UltraShape Power than after CoolSculpt treatments, as it isn’t stretched during treatments to fit into a transducer as CoolSculpt requires. The existing skin redrapes itself after UltraShape Power just as it would after slower weight loss. However, for patients who also want true skin tightening treatments or cellulite correction in conjunction with volumetric fat reduction, they may choose to combine UltraShape Power treatments with either VASER Shape or Profound for added results.


My office was asked to conduct the first clinical trial testing the improved efficacy of added power to the UltraShape device prior to its subsequent FDA approval in the fall of 2016, and introduction to the market as the new and improved UltraShape Power. The current UltraShape Power is now 20% more powerful than its predecessor, so patients are achieving even more inches of lost fat than before…and just in time for help with all that holiday food and festivity!

Visit our site to learn more,, and then come and see what the best fat reduction tool on the market can do for you or someone you know and let Santa keep the belly…it looks much better on him!

Happy Holidays!

Comments are closed.