Blasting Fat with Ultrasound


By Amy Tsao Medical advances have increased the options for changing body contours. But whether one chooses liposuction -- in which unwanted fat cells are removed from the body -- or a procedure like a tummy tuck -- in which loose skin and fat are removed from the stomach area -- there's no getting around going under the knife.

That could change, however. Research is now being done on using high-intensity ultrasound to take the surgery out of these kinds of plastic surgery. "This technology could be revolutionary," says Peter Fodor, president of the American Society for Aesthetic Plastic Surgery (ASAPS). "In a noninvasive manner, you will accomplish what we do with liposuction." (Fodor is on the advisory board at LipoSonix, a startup based in Bothell, Wash., that's developing a fat-busting ultrasound device. He says he receives no financial compensation for his services.)

LOOSEN THE LARD. The prospect of noninvasive fat removal is certainly intriguing -- and not just to doctors and prospective patients. Liposuction is the second-most popular of all cosmetic-surgery procedures (breast augmentation is first), according to ASAPS. In 2003, Americans spent $711 million on liposuction. Little wonder that LipoSonix raised $27 million from venture capitalists last month.

The idea that ultrasound can break down fat cells has its merits. With the LipoSonix approach, ultrasound would be delivered through the skin using a wand-like device. The ultrasound would break down fat, and the busted-up fat cells would be metabolized and excreted by the body instead of suctioned out, as it is in liposuction.

Some plastic surgeons use ultrasound during liposuction to help loosen up fat cells before they're suctioned. And experts agree that high-intensity ultrasound has become advanced enough that it would allow doctors to target fat tissue at the cellular level. "They can be very precise," says Larry Crum, director of the University of Washington's Center for Industrial and Medical Ultrasound. "It can be focused down to a grain of rice."

LOW-RISK. Still, for all of its potential appeal, ultrasound fat reduction has to be put into perspective. Intense ultrasound won't likely achieve the same level of fat reduction as liposuction. "You could take out a few ounces with each [ultrasound] treatment," Crum figures. "But in conventional liposuction, you are taking kilograms at a time." The technology would probably be most beneficial to people looking to sculpt an inch or two.

Jens Quistgaard, CEO of LipoSonix, nevertheless believes a significant market will develop for such procedures. "This is not going to replace liposuction," he says. "It may well provide an alternative for some people, who wouldn't choose surgery. They perhaps would have our procedure."

Far more testing will be needed before the treatment is available on the market. LipoSonix says it has tested its device, which it calls SonoSculpt, on 30 patients in Mexico. "Safety data came back really good," says Quistgaard.

PROBLEM SOLVED? The biggest question is: Can the body safely get rid of the broken-down fat cells? "If you had a lot of fat passing through the body, that probably wouldn't be a good thing," Crum says. "It's very unnatural to remove two to three ounces of material that has suddenly died." If the technology is approved for fat removal, the Food & Drug Administration will likely recommend a limit on how much fat can be removed in a single treatment, Crum predicts.

LipoSonix claims to have developed a way to address the issue of the zapped fat cells being metabolized, though for competitive reasons, Quistgaard would not elaborate. "We agree that having the body eliminate this tissue would be difficult to do," he says. "But I think we have solved it." Quistgaard figures a person could safely metabolize fat cells treated in one SonoSculpt session in four to six weeks. New data in humans will be available a year from now, he says.

Regardless of high-frequency ultrasound's efficacy for removing fat, researchers think it will ultimately have therapeutic and medical applications. "It's unfortunate that some of the early uses of this tremendous technology are for body sculpturing rather than solving bigger problems like cancer," says Crum.

COMBO TREATMENT. Researchers are now testing ultrasound's ability to remove tumors. In June, an FDA panel recommended approval of a device combining magnetic resonance imaging (MRI) and ultrasound for treatment of uterine fibroids -- an often-painful condition in which benign tumors grow on the lining of the uterus. The device's manufacturer, InSightec, is also testing the MRI-ultrasound device in destroying breast-cancer tumors.

Utrasound is already commonly used in diagnosing various conditions. Now, the hope is that high-intensity ultrasound can have an even bigger impact. If that proves to be the case, companies like LipoSonix and InSightec could end up in fat city. Tsao is a reporter of BusinessWeek Online in New York


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