Weight Management& Body Contouring
why do it?
It’s natural to want to look great and feel comfortable with your body shape. An attractive body shape looks healthier, is able to fit into clothing better, boosts self-esteem and may even enhance your career prospects.
Unfortunately, even with a healthy, active lifestyle with good eating habits and adequate exercises, there are times when it is difficult to achieve a healthy weight and satisfactory body contour. Ageing, illness, pregnancy or stress may make it even more difficult to fight the flab, leading to insecurities about physical appearance.
Even after working hard to get in shape and shedding the pounds, excess skin or stubborn fatty deposits may remain, producing unsightly bulges. You can’t exercise away loose skin, and sometimes fat clings to problem areas no matter how many squats, lifts and bench presses you do.
Many patients may need assistance to truly achieve a sculpted silhouette.
to manage weight and contour your body safely and effectively
Cryolipolysis uses non-invasive controlled cooling technology to produce sub-zero freezing temperatures, just low enough to freeze fat cells but not skin, muscle and nerves. The frozen fat cells are naturally processed, eliminated and eventually flushed out through the lymphatic system. Once these cells are gone, they shouldn’t reappear or migrate to another body area.
EnCurve Non Contact Radiofrequency
enCurve is a non-contact field radiofrequency (RF) system that generates a constantly oscillating electromagnetic field at a specialised frequency of 27.12 MHz. The high-frequency oscillating field generates heat concentrated mostly in the fatty tissue, but also heats the overlying skin.
This heating causes the fat cells to go into natural and gentle programmed cell death, known as apoptosis, that allows the body to excrete the lipids contained. The heat also stimulates collagen production, tightening the overlying skin.
High Intensity Focused Ultrasound
High-intensity ultrasound energy is focused precisely on the targeted fat layer, creating a rapid rise in local temperature at the targeted area without harming surrounding skin, tissue or organs. HIFU relies on the fact that, above a threshold of 56 degree C (for > 1 second), irreversible cell death occurs. The heat produces a dual tissue response within the treatment area - permanent destruction of targeted fat cells and contraction of surrounding collagen that helps improve tissue laxity. The body naturally removes the destroyed fat from the treatment area, reducing the size of a fat deposit.
Extracorporeal Shockwave Therapy
Extracorporeal Shockwave Therapy uses a hand-held device to transmit focused shockwave energy deep into the tissues, this improves cellulite by:
- disruption of fat, fibrous cords or both
- reduction of lymphedema
- influencing stem cells
Subdermal laser or radiofrequency
A tiny probe inserted under the skin is used to conduct laser energy or radiofrequency energy that is absorbed by the skin and surrounding tissues, stimulating collagen contraction and production to tighten loose skin, reshaping sagging areas.
Weight loss medications
Various prescription medications are available that work by the following mechanisms:
- appetite suppression, reduce the perception of hunger and food craving
- release noradrenaline and adrenaline that cause fat cells to break down stored fat, burn more calories
- stimulation of GLP–1 secretion, increase fullness
- make foods taste less appealing
- delay gastric emptying and promoting a feeling of fullness
- 5-HT2C serotonin receptor activation to reduce appetite
- reduce intestinal fat absorption by inhibiting pancreatic lipase, blocking absorption of about a third of dietary fat
- inhibit α-glucosidase in the small intestine and pancreas, slowing sugar absorption
dr wan's perspective
Medical Obesity and Lifestyle Changes
In Dr Wan’s opinion, it is important to be alert for medical conditions that could be contributing to the excess weight, such as an underactive thyroid gland, medications such as corticosteroids (which may be present in adulterated supplements or traditional medication), or hormonal conditions such as andropause or polycystic ovarian syndrome. Underlying medical causes for obesity should be thoroughly investigated and treated.
Provided there is no underlying medical condition causing weight gain, the correct way to lose weight is a combination of diet and exercise. A healthy, balanced low calorie with reduced fat and sugar intake combined with an appropriate resistance training and cardiovascular exercise regimen helps to promote weight loss and prevent weight gain as well as improve overall health.
Weight Loss Medications
Obesity is a chronic disease that can be difficult to treat. Prescription medications should be considered for suitable patients to help lose weight, especially patients who have not been able to achieve significant weight loss despite putting in adequate effort into diet and exercise. Many patients have already tried diet and exercise before seeking medical help and Dr Wan feels that medical assistance should not be withheld from appropriate patients since weight loss will improve their overall health.
Combination of various weight loss medications with different mechanisms of effect usually yields better effects with lower chances of side effects.
Combining Weight Management and Body Contouring for Better Results
Weight loss medications should not be solely relied upon for weight loss but should be used in conjunction with healthy lifestyle changes. Dr Wan does not advise the long-term usage of weight loss medications as there may be side effects and without making appropriate lifestyle changes, patients tend to regain the lost weight after stopping the medications. Weight-loss drugs aren't the easy answer to weight loss, but a useful tool to help make lifestyle changes needed to lose weight and improve health.
Non-surgical body contouring procedures aren’t intended to be weight loss solutions and should be not used as such. These techniques reduce or remove stubborn pockets of fat and loose skin to contour and shape different areas of the body. Ideal candidates are close to their desired weight and want to eliminate stubborn pockets of fat or loose skin that are resistant to diet and exercise. With most body contouring procedures, your body mass index shouldn’t be over 30.
While they should not be used to achieve weight loss, body contouring and weight management should be concurrent processes that go hand in hand to help achieve the desired body shape. Starting body contouring treatments while using weight management techniques to lose weight allows fat to be preferentially mobilized from problem areas. Conversely, if proper weight management practices are not instituted, body contouring techniques would still work but the overall weight gain may mask the effects leading to unsatisfactory results.
Body Contouring Reduces the Number of Fat Cells
The number of fat cells in our bodies typically becomes a fixed number sometime in our teenage years. Losing or gaining weight generally does not increase or decrease the number of fat cells but instead changes the size of fat cells. When weight is gained, fat cells get bigger. After dieting and weight loss, fat cells get smaller but the number of fat cells stays the same. Body contouring procedures can actually reduce the fat cells in treated areas by about 20% to 25%.
Dr Wan’s opinion on Body Contouring
- Cryolipolysis - Effective for spot reduction of fat bulges. 360 degree cooling cups are more effective than normal dual plate applicators. Unlike spa grade machines, medical grade machines can achieve more consistent, lower temperatures with strong suction to lift the fat away from the heat sink effect of the underlying muscles.
- HIFU - Effective for spot reduction of fat bulges and can be used for tightening of overlying tissues as well but tends to be more expensive.
- Injection Lipolysis - Effective for small areas of fat bulges, harder to use for large areas
- EnCurve - Stimulates skin tightening and treats a large surface area at once. It is able to sustain a targeted temperature increase over the whole treatment area, making it more effective than traditional handheld radiofrequency applicators.
- Subdermal laser - Great for tightening of loose skin
- Shockwave therapy improves the result of other body contouring treatments and should be added on wherever possible.
Customized combination therapy works best
In Dr Wan’s experience, each patient has a unique body shape and it is necessary to customize each treatment course for the most optimal results. It is not possible to fix all problems with a single tool such as cryolipolysis, hence Dr Wan has built an arsenal of multiple body contouring devices using various advanced technologies, so that each patient can receive the most suitable treatment for their specific problem. Combination treatment with different modalities usually produces superior results. For example, Dr Wan may combine weight management using weight loss medications with enCurve for circumferential fat loss and tightening, cryolipolysis for fat bulges and shockwave therapy to smooth out the contours.