e-lipo TM  (Enzyme Liposuction)

Dr Dirk Kremer brings e-lipo to London - efficient fat removal for the discerning patient.

Dr Dirk: "It amazes me how every year, yet another fad fat removal system launches to great fan fare. My e-lipo technique is the most effective yet straight-forward body sculpting technique I have seen in all my years practicing plastic surgery."

e-lipo combines all that is best in current fat removal procedures - infiltration, fat melting and suction removal - whilst avoiding all the pitfalls such as irregular contours, excessive bruising and long duration of procedure.

Body sculpting - the current options

Surgical fat removal has been practiced all over the world for decades and the process has been tried, tested and improved along the way.

Conventional liposuction:

This is still practiced by the majority of plastic surgeons as it involves no major financial investment in new laser systems and gives reasonably predictable and adequate results. The aim of this procedure is to break up stubborn, hard pockets of fat into pieces small enough to pass through the end of a blunt cannula. The target area is filled (known as infiltration) with a salt water solution containing painkillers and adrenaline to reduce bleeding in the area. A large cannula is then passed through small cuts in the skin, the end of which breaks the fat into pieces and the fat particles are then removed using a suction device.

Pros: A well established procedure giving predictable although not perfect results.

Cons: Can leave the area with a lumpy, uneven appearance as not all the fat pads can be broken down by the cannula. A great deal of force is often required which can result in extreme bruising, post operative pain, swelling and in some cases bleeding when blood vessels are damaged. Unless the fat area is tiny, conventional liposuction is usually performed under general anaesthetic as it can be quite a brutal procedure.e-lipo and liposculpture by Dr Kremer

Laser devices for lipolysis (breakdown of fat)

There is no doubt that in order for fat to be adequately removed it firstly needs to be liquefied. The family of laser fat-zapping devices, such as Laserlipo and Vaser Lipo, involve melting the fat before it is removed via suction and offer more predictable results than the conventional procedure. The process takes a lot longer - up to 50% - which is not ideal. Again fat removal can be erratic as the procedure is performed blindly though small cuts in the skin.

Pros: As the fat areas treated with the laser are turned into a liquid, this fat removal process is more efficient than conventional lipo. For the same reason, the procedure is less traumatic resulting in reduced bleeding and pain afterwards.

Cons: The surgeon is unable to see the laser head so can't gauge if the area has been thoroughly treated; subsequently some fat pockets are missed, again resulting in an irregular contour. Laser fat removal takes longer, meaning the patient is exposed to increased anxiety if awake and, if asleep, a significantly longer time under anaesthetic. In the UK, non cosmetic surgeons are allowed to perform these laser procedures, in which case I predict there will be an increasing number of unsatisfied patients. In inexperienced hands, burns can also occur.

e-lipo explained

This innovative technique is a relatively straight forward two step procedure involving infiltration of fat pockets with suction removal. The target area is flooded with a salt solution containing numbing painkillers, adrenaline and the key enzyme cocktail which literally melts the fat within minutes. The enzyme solution moves into the fat cells, causing them to break down into a mush that is very easily removed using suction and tiny cannulae.

The enzyme, hyaluronase, naturally occurs in the body and is responsible for breaking down hyaluronic acid which bonds together collagen and elastin - the beginning of the ageing process. In the field of aesthetics, artificial hyaluronase is commonly used to dissolve injectable fillers after an undesirable result and any lumps or bumps attributed to poor injectable technique. Most temporary fillers have a hyaluronic base, which means they are essentially a mixture of complex sugars and water, products this enzyme identifies and destroys. In the case of fat removal (big and small areas), only a miniscule amount of enzyme is required, diluted in large amounts of sterile salt solution. This liquid mixture is able to thoroughly penetrate the whole area, getting into all the nooks and crannies turning the fat it encounters into mush within minutes, enabling the surgeon to completely suction all of the fat safely and efficiently, without pulling, poking or jabbing inside the body.

Pros: Complete infiltration of the fat pad is guaranteed as the area is thoroughly massaged into the tissues, ensuring the solution diffuses into all the fat cells. Meticulous body sculpting can be performed with the surgeon in complete control of the process resulting in perfect body shaping. Any residual fat products are removed by the body's natural cleaning mechanism. e-lipo also takes less time to perform (up to 50% quicker than the laser options) which is great news for the patient. e-lipo is also a surgical procedure and can only be performed by those on the UK specialist register.

Cons: Surgeons in the UK don't seem to offer it!

What to expect with e-lipo

Pre operatively As with all cosmetic surgery procedures, smokers must stop for at least 3 weeks before and after this procedure. Arnica tablets taken 2 weeks before the procedure can help reduce post operative bruising.

Post operatively e-lipo is termed a 'day case' procedure and, as it is often performed under local anaesthetic, you can go home as soon as you feel able - usually within 2 or 3 hours afterward surgery. If under GA then you might choose to stay a little longer. Expect anything 2 small incisions per area.

You will be advised to wear a surgical support garment for at least two to 6 weeks depending on the amount of removed fat. This helps to mould the shape of the body as it heals.

Return to work can vary according to areas treated but usually a week of reduced activity is advised.

NB: e-lipotmpending