Fat Reduction
Non-surgical body contouring covers three different problems that are often confused: reducing fat, toning muscle, and tightening skin. No single treatment does all three. We no longer offer non-surgical fat reduction for body areas — for a pocket of fat that will not respond to diet and exercise, liposuction is the treatment that works. This page explains which treatment addresses which problem, so you book the one that will actually help.
Which treatment do I need?
| What bothers you | Treatment | What it does |
|---|---|---|
| A pocket of fat on the body that resists diet and exercise | Liposuction | Surgically removes fat. This is now our recommendation for body fat — it removes considerably more than any non-surgical device, in one operation, with a predictable contour |
| Fullness under the chin | Kybella | Injectable deoxycholic acid that dissolves submental fat. Non-surgical, for this area only |
| Lack of muscle tone or definition, not fat | CoolTone | Magnetic muscle stimulation to strengthen and firm |
| Loose or crepey skin over the area | Thermage for Body | Radiofrequency skin tightening |
| Cellulite dimpling | Avéli | Releases the fibrous septa that cause dimpling |
| Loose skin and separated muscle after pregnancy or weight loss | Tummy tuck | Removes excess skin and repairs muscle separation |
Why we now recommend liposuction for body fat
Non-surgical fat reduction devices remove a modest proportion of the fat in a treated area, usually require repeated cycles, and produce results that vary considerably between patients. Liposuction removes substantially more fat in a single operation, treats several areas at once, and gives a far more predictable contour.
For patients who want a real change in shape, the surgical option is more effective and, taken across the number of sessions non-surgical treatment requires, frequently better value. We would rather tell you that at consultation than sell you a course of treatments unlikely to achieve what you want.
Liposuction is performed by Keith Hurvitz, MD, FACS.
Fat reduction is not weight loss
This remains the most important thing to understand. Fat reduction of any kind — surgical or injectable — contours a specific area. It is not a weight loss treatment and will not meaningfully change the number on the scale.
The right candidate is someone near their goal weight with a specific area that has not responded to diet and exercise. Someone hoping to lose a significant amount of weight will be disappointed, and we will say so at consultation.
What about GLP-1 medications?
Patients on semaglutide or tirzepatide often lose fat faster than their skin can retract, and what remains is laxity rather than a fat deposit. If that describes you, skin tightening or surgery is the appropriate next step, not fat reduction. We are seeing this frequently and it changes the recommendation.
Who is a good candidate?
- At or near a stable goal weight
- A discrete area of fullness rather than generalised weight
- Reasonable skin quality — skin needs to retract once fat is removed
- Realistic expectations about the degree of change achievable
Who is not a good candidate?
- Anyone seeking weight loss. These are contouring treatments.
- Significant skin laxity. Removing fat beneath loose skin usually makes the laxity more obvious. Skin tightening or a surgical lift is needed alongside or instead.
- Visceral fat. Firm abdominal fullness that cannot be pinched sits beneath the muscle and cannot be treated by liposuction or by any external device.
- Muscle separation after pregnancy. Diastasis recti requires surgical repair.
Frequently asked questions
Do you still offer CoolSculpting?
No. We no longer offer CoolSculpting. For body fat we recommend liposuction, which removes considerably more in a single procedure with a more predictable result. Kybella remains available for small areas of fullness such as under the chin or localized areas on the body.
Is there a non-surgical option for body fat?
Not one we consider effective enough to offer. Kybella treats small areas of fat only. For the body, liposuction is the treatment that produces a reliable change.
Is the fat gone permanently?
Fat cells removed by liposuction or dissolved by Kybella do not return. Remaining fat cells can still enlarge with weight gain, so the result depends on maintaining a stable weight.
Does liposuction tighten skin?
Only modestly, through the healing response. If loose skin is a significant part of the problem it needs to be addressed separately with skin tightening or with a surgical lift such as a tummy tuck.
Can I combine treatments?
Yes, and it is often the right approach — for example removing fat and then tightening the skin over it, or combining fat removal with muscle toning.
What is the recovery from liposuction?
Considerably more than a non-surgical treatment: compression garments, several days off work depending on the extent, and swelling that settles over weeks to months. That trade-off is the reason to be clear about what you want to achieve. Details are on the liposuction page.
Next steps
The most useful outcome of a consultation is an honest answer about whether fat, muscle, skin or surgery is the real issue.
Schedule a consultation or ask us a question.
Medically reviewed by Sam Naficy, MD, FACS, board-certified facial plastic surgeon and medical director, Naficy Plastic Surgery & Rejuvenation Center, Bellevue, Washington.
