Josh Olson, M.D.

Revealing your beauty through science and artistry.

Dr. Olson's Blog

The Skinny on Fat: When Diet and Exercise Don’t Work

I’ll begin by stating the obvious: Getting rid of fat is difficult. Good nutrition, portion control, and working out regularly are great lifestyle habits, but sometimes those are not enough to flatten your tummy, shrink saddlebags, or get rid of that upper arm jiggle. Women and men who come to my Gilbert plastic surgery practice near Chandler, Arizona are looking for ways to lose these stubborn pockets of fat.

But not all fat is created equal. Different types of fat respond to different treatments, and deciding on your best treatment approach involves determining which type of fat is causing your unwanted bulges. In this post, I’ll explain the 4 different types of fat, in what part of the body they typically occur, and the best body contouring treatments for each type.

Fluffy Fat

That soft, jiggly fat that accumulates below the skin, but above the muscle (called subcutaneous fat) tends to develop in women more than men. It shows up on stomachs, hips, thighs, and the back of the arms. Women’s hormones signal the body to keep this lighter weight fat (in case they become pregnant), so it’s often more difficult to get rid of than other types of fat. Putting in extra time at the gym often doesn’t yield the expected results when it comes to fluffy fat.

  • Best Treatment: Liposuction targets stubborn fat. I often use Ultrasound-Assisted Liposuction (UAL), which is gentler than traditional liposuction. UAL uses ultrasound energy to break up the fat, whereas traditional liposuction requires a surgeon to manually break apart fatty tissue using the liposuction wand. In some cases, patients can benefit from nonsurgical fat reduction. CoolSculpting® is completely non-invasive and doesn’t require downtime following the treatment.

Fibrous Fat

This is also subcutaneous fat, but is tougher than fluffy fat. Fibrous fat isn’t easy to shed through dieting and exercise because the fibers that form around and between fat cells make it more difficult for the body to use that fat for energy. This type of fat may begin as fluffy fat, but be compressed by tight clothes and become fibrous. Think of the rolls of fat that develop around bras. That is fibrous fat.

  • Best Treatment: CoolSculpting is an excellent treatment option for fibrous fat. With various applicators specially designed to fit specific areas of the body, CoolSculpting works by lowering the temperature of the fat cells until they begin to die. The cooling process doesn’t damage skin or other tissues because fat cells can be destroyed at temperatures that are safe for other cells.

Cellulite

Contrary to what many people believe, cellulite is a condition that occurs when fat cells get trapped in the skin’s lower layers. It often has nothing to do with a person’s weight, which is why about 90% of women have cellulite. So losing weight doesn’t significantly change the appearance of cellulite. Only by releasing the bands of tissue that pull on the bottom layers of skin can cellulite be reduced.

  • Best Treatment: Cellfina® is a breakthrough, minimally invasive procedure that gets long-lasting results. Supported by clinical studies, Cellfina works by precisely cutting the connective tissue using a microblade. The blade is so small that no sutures are needed.

Firm (Visceral) Fat

This is the only fat of the 4 types described here that isn’t subcutaneous fat. Instead, firm fat accumulates below muscles, surrounding internal organs in the abdominal area. This isn’t the fat you feel when you pinch your waist. Because it’s covered by muscle, liposuction or nonsurgical treatments cannot effectively reduce visceral fat.

  • Best Treatment: Combining exercise and a healthy diet is the best way to reduce firm fat. Unlike subcutaneous fat, visceral fat is relatively quick to respond to lifestyle changes. It represents a significant percentage of the overall weight loss achieved.

The best way to learn how much of your fat is subcutaneous and how much is visceral is by scheduling a consultation with a board-certified plastic surgeon. In most cases, combining a healthy lifestyle with a cosmetic treatment can produce the best results.

Fat Reduction Before-and-After Photos

You can see the results produced by different types of treatments for subcutaneous fat:

CoolSculpting:

Liposuction:

Liposuction:


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