How To Get Rid Of That Stubborn Fat!

How to get rid of that stubborn fat that you just cannot get rid of, even with a perfect diet and exercise program?

Just remember that nothing can really replace a good diet and exercise program to decrease fat percentage and gain lean muscle mass. Keeping that in mind, if all medical causes are excluded, the genetics just can not be overcome yet. But there may be some procedures that may be of value to assist, especially when have worked so hard to get that perfect body or shape.

So, there are different ways to get rid of genetic fat. It is not always necessary to see the Plastic surgeon immediately, unless the offer these services. Liposuction and Lipo-sculpting are invasive procedures, it can be very painful, and it does come with its complications. It may be the last resort, but other options are available. The next procedures or concepts are what is available out there currently.

Fat freeze or better known as CryoLipo or Coolsculpting, is used to freeze the fat, to cause them to die of spontaneously called apoptosis. This technique has its place, but also has its limitations. It will not work for everyone, and the obese patient may not benefit from this procedure. This works for smaller areas like the small abdominal fat or even the underarms. Remember this can decrease the fat layer, but not necessarily will sculpt the area. The recovery period is longer. It does cause some swelling, sometimes severe, and results are mostly seen months after the procedure. What is still important is that a healthy lifestyle still needs to be maintained.

LipoLazer is ultrasound-cavitation that is used therapeutically. It causes formation of tiny bubbles in the fluid around the fat. This will accumulate with time and will cause area to shrink. The fat cell also does not have the structural ability to resist vibrations, therefore the ultrasonic cavitation will break it off easier, whilst sparing the blood vessels, nerves and muscle. After emulsification and breakdown of the fat has happened, it is transported in between the cells. It then gets metabolised to glycerol and free free-fatty acids. The glycerol is water-soluble and is used for energy. The free-fatty acids are excreted via the bile ducts in the liver and excreted via the gut. This is a technique in which lymphatic drainage pathways needs to be well known by the therapist to promote drainage of this inter-cellular fluid. This is also not a technique to sculp.

Lipolysis is a technique that has gone viral

Lipolysis is a technique that has gone viral, besides the different lipo-sculpting techniques. There are only a few molecules approved in South-Africa for Lipolysis. Most molecules used are derivatives of phosphatidylcholine. There is another molecule that is only indicated for the chin in America. Phosphatidylcholine can be used in South-Africa for medicinal purposes, general intravenous fat-loss therapy and sculpting lipolysis. It is of utmost importance that the correct molecule of the phosphatidylcholine is used for the specific indication, otherwise it will not be effective, and the patient might be unsatisfied with the result. If the deep injectable type is used correctly and planned carefully, it can give a good sculpting result. If the intravenous type is used, it needs to be exchanged with blood, thus some of the patient’s blood is mixed with the phosphatidylcholine and then re-injected into the patient. It should not be given as a mixture of a drip.

There are companies that have rights to sell deoxycholic acid that is a derivative of the phosphatidylcholine molecule. The deoxycholic acid is indicated and registered for the sculpting for the whole body. The deoxycholic acid must be repeated a few times but has comparative results to liposuction. It can be used for sculpting if injection is planned carefully and the injector is well trained and experienced.

The best candidate for lipolysis injections are people with small areas of stubborn fat, and best areas to be used are the abdomen, hips, abdominal circumference, chin, arms and even the upper thighs. Certain techniques can be used to improve definition in specific areas. This is however a technique for an advanced injector and good planning is of utmost importance. Remember lipolysis only hastens the process to get rid of stubborn fat, but it still does not replace a good diet and exercise. Important to note, that the patient would rather loose centimetres, or look aesthetically improved and will not necessarily loose weight in kilograms on the scale. This is not a procedure for the obese patient. This is a safe molecule to be used in adults only.

Deoxycholic acid is a more natural product and more accepted by the body. It causes less amount inflammation as seen in phosphatidylcholine which can cause large amount of swelling, pain, redness and warm areas. Deoxycholic acid is a less painful injection and local anaesthetic is very seldom needed. For best results, the procedure needs to be repeated 2 to 4 times to get best results and can be done every 6 weeks. Although deoxycholic acid shows quicker results, it may still take a few months to show the result. Other advantages include the enhancement of bile flow, through which fat is excreted. It can remove sludge and gall stones from the gallbladder and treats a fatty liver and may improve calcified blood vessels as well as the cholesterol.


Although there are various techniques that are conservative or invasive, but I prefer lipolysis with deoxycholic acid, sometimes with other mixtures. Deoxycholic acid is my first choice as studies indicate that it could be equivalent to liposuction, but with less pain and side effects.

Written by Dr. Quinten D. Fourie. MBBCh (Wits), PGPN (Boston)

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