Cold induced lipolysis for spot fat reduction (‘Fat Freezing’).
At present the gold standard treatment for spot fat reduction is liposuction. Liposuction is a surgical technique that often requires admission to hospital, administration of anaesthetic, substantial bruising and swelling, prolonged recovery and a risk of side effects and complications including lumpiness, unevenness and skin indentations. As a result, there has been a strong drive to find less invasive ways of spot fat reduction.
In the past, ‘non-invasive liposuction’ techniques have attempted to use heat generated from laser or ultrasound – delivered through the skin – to destroy fat cells. This technology however has been met with limited success and has never been widely accepted as an effective treatment. In more recent years technology has begum to shift to look at the other end of the thermal energy scale to remove fat, using very cold conditions. Preliminary work in this area is yielding very promising results.
We are currently undertaking a clinical trial of a new ‘fat freezing’ machine. Although the technology is already on the market and widely used, we are undertaking the first formal clinical trial of the machine.
In the first phase of the trial, currently underway, we attempting to accurately quantify how much fat can be removed with a single treatment with current manufacturer recommended settings. In the next phase of the trial we are going to be looking at optimising treatment parameters to maximise the amount of fat that can be treated. This is an exciting clinical trial because it will enable us to more accurately advise patients in the future exactly how much fat they can expect to lose as well as help us to optimise treatments to ensure that each and every patient gets the best possible result.
The use of topical anti-glycation agents and sirtuin stimulators to prevent ageing in the 25-35 year age group.
There is a growing interest from young people, typically only in their 20s or early 30s, in preventing the ageing process. Many clinics are currently advocating that people start having cosmetic treatments as early as their late teens or early 20s to stop wrinkles before they have a chance to appear. I do not believe this to be a wise strategy and believe this will result in a propensity towards long term complications, particularly muscle atrophy and unnatural results.
We are currently trialling various topical agents in combination with lifestyle advice in an effort to delay the ageing process for younger patients as opposed to having cosmetic procedures carried out unnecessarily.
Optimising doses of botulinum toxin.
Botulinum toxin is the most commonly performed cosmetic procedure worldwide. Despite its widespread use however there is currently a great deal of uncertainty and confusion over what is the optimal dose at which to use these drugs, something which is not greatly supported by the medical literature. Although each brand of toxin comes with its own recommended dosing regime, in clinical practice these are often varied. In general, drug companies encourage doctors and practitioners to use higher doses than recommended so that more of their product is used. Clinics and practitioners however will often advocate lower doses, sometimes promoted as ‘baby botox’, to lure in apprehensive patients and keep product costs down.
We are currently undertaking a randomised, double blinded controlled clinical trial to compare standard dose with high dose botulinum toxin to see if there are any differences in efficacy at reducing wrinkles or duration of results. This trial will help us to optimise treatment strategies in the future, so that future patients can be treated – with certainty – at the optimal dose.