I’ve been going to the gym and eating fairly healthily for over a decade. I tend to get particularly serious for a month or two twice a year. While all other areas of my body have grown, shrunk, or tightened in response to diet and exercise, a bagel-sized deposit of adipose fat encircling my navel and a matching set of love handles have hung on for dear life. Ironically, their presence becomes more conspicuous when my efforts in the gym and my carb cravings are ramped up and tamped down respectively. At these times I tend to look like a relatively fit man who’s tucked two pounds of sausage in the waistband of his pants. This mish-mash of a silhouette tends to sap my enthusiasm for sticking with the healthy choices that will, allegedly, give me the washboard abs I’ve been yearning for.
That’s why, a couple of years back, I got excited about Coolsculpting—a non-invasive procedure in which fat cells are destroyed by the application of cold. A friend of mine told me about about it. He’d had it done three weeks prior and assured me that he was already seeing results. Soon after, I got an assignment and managed to wrangle a Coolsculpting treatment gratis. It worked to a degree that I noticed—even if nobody else did. I would have gone back for a second treatment right away had it not been the single most painful experience of my life. It wasn’t the procedure itself that had me screaming the place down but the part immediately afterward in which the technician kneaded my now slushy belly fat so that I could better resorb and eventually excrete as much of it as possible.
Now, as the memory of the pain became more distant and my stubborn spare tire becomes more maddening, I get back in touch with the technician who’d bore witness to my caterwauling. I ask Rebecca Weston, if I could finally come back in for the second session she’d generously offered. Now working at another company, Center Aesthetic, Rebecca instead offers me treatment with Sculpsure—another fat cell killing procedure that used heat instead of cold. Rebecca explains that Sculpsure—which is made by a company called Cynosure—uses high intensity laser light to heat up adipose tissue to between 42 and 47 degrees celsius (107.6 to 116.6 degrees fahrenheit). As with Coolsculpting, the temperature-damaged cells find their way out of the body over the next several weeks. “Often people start to see results after six weeks but the maximum results can take up to twelve weeks,” she says, adding that two Sculpsure treatments are typically needed to see a difference. (Center charges $1000 dollars for the first treatment, but waived the fee for me to try it for the purposes of this piece.)
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A handful of studies have sought to quantify the sort of blubber reduction that a 25-minute treatment with a 1060 nanometer laser used for laser lipolysis will achieve. One study found that macrophage infiltration begin two weeks after treatment and was complete at six months after treatment. Macrophage infiltration refers to Pac Man-like white blood cells rushing in to chomp up and digest detritus. In this analogy, the game’s ghosts represent all manner of cellular debris, foreign substances, microbes, cancer cells, and, in this case, fat cells that have been subjected to laser beam fuckery.
The same study looked at the average fat thickness two, three, and six months post treatment and found reductions of 14 percent, 18 percent, and 18 percent (i.e. no change) respectively. When researchers used MRI to look at the average fat volume reduction at three and six months, they found that it was was 24 percent and 21 percent, respectively. That study, this study, and others all seemed to conclude that the treatment—as janky as it sounds—was safe, effective, and well-tolerated. But as I learned at various points during the creation of this series, what constitutes “well-tolerated” differs widely from person to person.
When I asked if heating my paunch with a laser beam would be, in her opinion, more or less painful than having chilled into a high-calorie slushie, Rebecca gives a fairly slippery answer.
“Everyone’s different, right?” she says. “Some people can tolerate it [with] no problem and others experience discomfort.” She explains that the applicator surface actually cools the skin and that heating takes place below the dermis. Should clients find the heat intolerable, Rebecca explains, they can ask her to press a button to deliver a “cool blast” that would almost instantly stop any discomfort inadvertently caused by their insides being microwaved. “Any pain from the heat will end within a second or two of you letting me that it’s too much,” she says, adding that pressing the panic button will shorten the length of time that fat cells are being heat damaged and therefore diminish the efficacy of the treatment.
Since being cleared by the FDA in May 2015, discomfort, soreness, bruising and swelling have been the observed side effects that people undergoing a Sculpsure treatment could experience. But that doesn’t necessarily mean that this will always be the case. Coolsculpting was first FDA-cleared in 2012 but in 2014 a study coined the phrase “paradoxical adipose hyperplasia or PAH” to describe a rare side effect in which Coolsculpted wobbly bits actually get bigger rather than smaller after treatment. I take some comfort in the fact that, at the time of writing, Sculpsure’s only connection to PAH is that it’s sometimes used to treat it.
The basic Sculpsure setup consists of four mechanical tentacles attached to a cuboid machine that sports a touch screen. At the end of each of the tentacles is an applicator which has a flat, rectangular face with about the same area as a playing card. These are clicked into a plastic frame so that they remain flush against the skin. The frame is attached to a sort of belt that is strapped around my middle as I lay on a bed in one of Center Aesthetic treatment rooms.
As with my Coolsculpting adventure over two years before, we concentrate on the areas where exercise resistant fat typically hangs out, especially on men’s bodies. The first 25-minute session will be on the bagel, the second will be on my right flank and the third on my left.
Though the face of the metal applicator heads are very cold when Rebecca clicks them into place around my navel, I try to remember that in mere minutes, my paunch will be heated up to point that will likely be unpleasant.
“The first five minutes is just the warm up,” she tells me as she hovers her finger over the start button. “After that, the heat intensity goes in waves so, if it starts to get uncomfortable, you are probably only few seconds away from the heat easing off. Ready?”
Within seconds, I feel a pleasant warming session on my tummy. It’s fine until suddenly it isn’t and I’m sweating and feeling a little queasy from the intense, fat-scorching heat. Thing is, in reality, the heat is not that intense. 106-117 degrees fahrenheit is the difference between the high air temperature record of Massachusetts and Illinois respectively. I mean, coffee is typically served at between 160 and 185 degrees fahrenheit. But all of this furtive number crunching does nothing to stop me from screaming for the cool blast before we’re out of the warm-up phase. It works almost instantly but during this brief period of cold comfort I fret about how I’m going to get through the rest of today and a second treatment in the future. We soon start up again and, just as Rebecca had said, once the temperature started undulating, the heat—while still trying—is just bearable.
When the first 25 minute session is over, Rebecca gingerly tells me that some people feel the so-called “discomfort” more acutely in the flanks than the belly. I almost take her hand off when the Center’s nurse offers me vicodin. I know it won’t help me on the first flank treatment as it takes between 30 minutes and an hour to take effect but, at the very least, it might save some tears on the 2nd go around. Interestingly, however, my first flank wasn’t nearly as sensitive to the heat and I managed to chat to Rebecca throughout. We’d barely gotten started on the second when, via an alarm, the machine told us that it was malfunctioning. This event marked the end of our session but I return without the camera crew a day or two later to ensure symmetry.
I had my second full Sculpsure treatment four weeks after I had the the first which is the earliest it’s offered. That meant that by the time I went through it again, the results for the first treatment were still eight weeks from what would be considered final. It being the week of Thanksgiving, Rebecca advised me to keep my gluttony in check to the best of my abilities. I tried and I failed. Christmas? Same story. The end of January marked 12 weeks since the first treatment and now, the end of February marks 12 weeks since the 2nd. We even snuck in a third treatment just because. That was now about eight weeks ago.
Despite all of my holiday gluttony, it’s had a modest but discernible effect. I think that the difference is more noticeable on the belly than flanks but then, I think there was more adipose tissue there to begin with. Sculpsure hasn’t given me killer abs but no one said that it would. What it has done is thinned the blanket of fat that’s been sitting around my middle since I was around 15. I think that having less of a tire will help me on track when it comes to eating a healthy diet and exercising both regularly and with the intensity needed to provoke results.
And I barely cried at all.
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