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« What do doctors make? | Main | Funky Arm Slings »

Non-Invasive Fat Melting Devices: Sail or Sink? 

There’s a lot of buzz about the new wave of non-invasive fat melting devices like Zerona (635nm low level laser), Lipo-Ex (radio frequency) and UltraShape® (selective focused ultrasound) who all lack the illustrious FDA clearance desperately needed to make a huge impact in the body sculpting arena.

Sure they possess FDA clearances for safety, but not yet efficacy in the key category of actual fat reduction. What’s the FDA’s hang up? Apparently it has to do with fat metabolism. Specifically, the FDA wants to know what happens to the fat that is expelled from the liposome after treatment, it’s ingestion by macrophages, the transportation to the lymphatic system, and the final excretion by the kidneys. The FDA wants to ensure no harm will come to a patient by this natural process of foreign body elimination. They also want to prove they work as a stand-alone therapy.

I’ve talked with many physicians at ASLMS and The Aesthetic Show and have read posted discussions by fellow MAPA members like, Dr. Lornell Hansen who is extremely proficient in the development of lasers in the U.S. and is highly regarded for his opinions. If I may quote Dr. Hansen, he states every time he asks physicians who have used, specifically the Zerona by Erchonia, over the last few clinical trial years if the device actually works, the answer he receives is they “think it does”. For many physicians that answer doesn’t quite cut the mustard when you're thinking of investing time, money and your reputation on a device. On the other hand, if the technology is proven to be clinically advantageous for your patients, and they finally do receive the FDA’s approval in the next few months as all companies are claiming, are you willing to “miss the boat” and sit idly by on the shore watching everyone else sail into a sea of opportunity? Or, will you get into the boat too early and risk having it sink? It’s a gamble and timing is everything.

Well, our medical spa has thought long and hard on this technology and we have come to the conclusion that if the device is positioned in the right practice and for the right patient, it can be advantageous for both our practice and the patient. Many patients we see during complimentary consultations don’t want to have a minimally invasive surgical procedures, or the multiple injections of lipodissolve. They diet and exercise regularly, but can’t seem to lose those pockets of fat that seem impenetrable by their current regimen. Our practice offers SmartLipo, SlimLipo, VASER® Lipo, lipodissolve and VelaShape. Body contouring is 80% of what we do. We believe this device has a place in our practice either before or after laser lipo, or combined with the lymphatic drainage abilities of the VelaShape. Of course, with all body contouring procedures, optimal patient selection is a must for success.

Our decision was influenced in the faith and belief in technology and also the fact that the Zerona, unlike the UltraShape® and Lipo-Ex, is at least FDA market cleared for laser assisted liposuction. And just think, a few years ago even laser lipolysis was scoffed at. And, who would’ve even dreamed that fractional technology would exists and prove to be beneficial? Technology will continue to advance. Sometimes it works they way you hoped it would, other times your dreams fall a little short.

So, we are very excited to take the leap of faith into the Zerona low level laser and look forward to only positive results for our patients. If it works like we trust it will, we all win and score one more for technology! If it falls short, the worst that could happen is that the technology will need a little more “tweaking” and we’ll sail out boat back to shore.

We’ll keep you all posted on our travels.

Author: Paula D. Young RN runs internal operations and training at Young Medical Spa and is the author of the Medical Spa Aesthetics Course, Study Guide, and Advanced IPL & Laser Training course for medical estheticians and laser technicians.

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Reader Comments (37)

The biggest problem I have with the Zerona is that they do NOT have one study more than 2 weeks after the last treatment. Remember Zerona does not kill the fat cells it only opens up the cell membrane and the fat leaks out. In their own studies they showed that if they did not do more treatments the fat would just re-enter the cells.

What this tells us is that the fat cells are still alive and can re-collect fat. So then my question is whether or not it is worth it for patients to spend $2000 to $3000 dollars for 6 treatments and only get short term benefits. I feel that I want proof that this works and I will not put my reputation on the line for any company. I want my patients trust not just their money.

I have asked the company that manufactures the Zerona for all of their studies including the unpublished articles. They have yet to get those to me. This again makes me question the validity of the technology as a stand alone procedure.

Lornell E. Hansen II, M.D.
LazaDerm Skincare Centre

07.9 | Unregistered CommenterLH

There are a lot of different technologies / treatments that have come out lately and which claim that they burn fat. From my personal research I have concluded that ultrasound technology - used at the frequency that causes the "cavitation" effect - is the most appropriate one that exclusively targets the break of fat cells.

In addition to that, I am expecting for alternative choices other than UltraShape which charges an arm and a leg for features that I doubt are that crucially helpful in the hands of an experienced doctor.

07.12 | Unregistered CommenterAris

Okay. This is what I think about Zerona. At first I was really interested because currently I perform Lipo EX on patients. While I am very happy with the results, the sessions take a LONG TIME to perform if the patients have a high amount of fat in their body (my patients typically have a fat mass of above 40 percent). We had a sales rep. come into our office selling the Lapex 2000 device. She said it would do the same thing but without all the work involved. You just hook the patient up to the cold laser and it does the work for you. We tried it on a patient who measured 44" accross the belly button. After the session he had lost 2 inches. They quoted me $65,000 for the machine. Since I have already paid a great deal of money for the EX, I am not real excited about parting with any additional funds. While researching other machines that might do the same thing, I came across Zerona. From the research I have done on the net, this company has been selling this machine with little success for the last five years. Recently they sold their rights to a sophisticated marketing firm, which named the machine Zerona and is now selling to us unsuspecting medical professionals for five times more than what the machine used to sell for.

I have a few problems with the idea of purchasing a Zerona:

1. The price. We reside in a border town and the price of cosmetic services is lower than anywhere in the US because our patients can skip 2 miles down the road to Mexico and get a five area liposuction for $1000 or radiofrequency for $40/session. The marketing firm leases out the Zerona for a high per usage fee as well as a monthly leasing fee. This seems like a very bad idea to me as an owner of a cosmetic spa because I will be unable to lower my prices if I need to because I will be paying a per usage fee (high overhead). From what I understand the packages are selling for between 2,000 to 3,000 for each package of 6. In our neck of the woods, people have a problem spending $2,000 to $3,000 on LIPOSUCTION so I can only imagine how they would feel if I did happen to find someone interested in shelling out that kind of dough for six treatments.

2. The results: I periodically go on to read patient opinions regarding the "latest and greatest" of what has hit the medical spa market. So far, the patient reviews regarding Zarona have been shitty at best. Patients are complaning of not noticing a difference and the price being so high for not noticing a difference. Also, from their website, ( Zerona states if the patient has a high amount of Viseral fat (pretty much all of my patients down here) they would not be good candidates for Zerona. So basically, if you abdomen measures more than 34", you are screwed.

If anyone is still reading this rambling message at this point and actually has the lapex 2000 machine, can you email me with any opinions. Also, I'm not trying to rat out the Zerona people. I guess I'm just annoyed with the marketing company inflating the price of this machine so that us hard working medical professionals will have a difficult time making a profit and will most likely have to return this piece of junk by the year's end because we can't make a profit with it. It's like some sort of Medical mafia scheme with that per usage bull shit.

just sayin'....

07.13 | Unregistered Commenterwendyh


I'm considering the Lipo-Ex for my med spa and would like to know how many sessions does it take to see results and what are the results in terms of inches or pounds lost? Do they last? Do they need maintence treatments? Can it really be used anywhere on the body like even the face as shown on their video? I was quoted $93,500 for it, which seems rather expensive for something that doesn't even have FDA clearance.

07.16 | Unregistered Commenterlhc

The number of sessions it takes really depends on a few factors. The most important factor is how quickly the patient can process the liquified fat through their lymphatic system. If my patients drink at least 5 regular sized water bottles per day and exercise at least 30 minutes from start to finish per day ( I encourage them to walk as they are more likely to stick with it) , as well as follow a low fat diet, they typically see results within the first two treatments. The first time I did a treatment, I saw results the next morning ( 1 1/2 inch lost!). The cool thing about this machine is that it melts both types of abdominal fat (subq. and visceral). I have used this machine for about 13 months now and my patients that follow the above mentioned guidelines, will lose between 2 to 8 inches after 8 sessions. My patients who do not see results are also the ones who expect the machine to do all the work, then go home and eat more fat than I can melt and then complain that it is not working for them. With this machine, I oftentimes have to do a lot of free diet counseling because many of my patients do not have any concept of what a low-fat diet means. On myself after the christmas hollidays when I had 5 pounds to lose, I did 3 lipotron sessions in seven days, wore a surgical compression device around my abdomen and took the alli fat blocking pill. After the seven days I had lost 4 of the five pounds, and got my flat stomach back. I tell all my patients that want to lose weight as well as inches to do the same thing. If you are trying to lose weight, I've noticed my patients (and myself) will lose at twice the normal rate than not using the machine.

In terms of price, we paid $85,000 so it's possible with a little bargining you should be able to get the same price. I have tried going on to find a price for this machine used, but have been unsucessful. I think the clinics who have this machine are happy with it. As for the FDA clearance, my husband, who is a surgeon, and I both agree this may be a long time coming because this machine is very powerful and if not used correctly, it can cause burns and blistering. Also, if you take the treatment head off the skin without turning the little red button off it will cause a shock to the patient. Actually at our cosmetic center, I am the only one besides my neice that performs the sessions on our patients because everyone else I have spend one whole month trying to train, has failed at learing how to perform sessions correctly.

For the skin tightening and tightening on the face I do a few different things. First I use a machine called the Diamond Medilift for 30 minutes on the face and neck. This makes the muscles contract and relax and when we can train the muscles to tighten, the face and neck will "lift". Machine price is $12,500. After that, I assess the patients face. Sometimes it is just loose skin and sometimes it is both loose skin and fat. I start with the tightening treatment heads on the lipotron for 20 minutes. This will tighten the face and stimultes the skin to produce more collagen. The trick to this, and you just have to learn by experience is to move the head quickly over the skin with hand, while following behind with your other hand to cool the skin because it can feel like a hot iron if not done correctly. If the patient has fat on the neck, I turn the patients head to one side and used the fat melting head, then the other side. The results have been excellent! I have a very high patient satisfaction rate with my method of liftening and tightening. Another neet thing with the machine, is there is a small head that if you rub it over your lips, it will inflate them. All my patients love this.

As for the results lasting, as I tell all my patients, they last as long as you don't gain weight. The tightening part must be maintained at about one maintenence session every few months. (I've noticed this with my own face). One last thing about the machine is this is a great machine to have if you also performing liposuction because if we give the patients a few sessions before their lipo procedure, they lose a few inches before AND it loosens up the fat to where it is a lot easier and quicker to suck out with our power assisted cannula.

I hope I have answered your questions. My husband and I both do a lot of research before we buy and new equipment for our office and its important to know what you are buying before you make a big investment. If you want me to mail you our Radiofrequency/Lipotron brochure that we give to our patients, I can do so. Just give me your mailing address.

-Wendy H.

07.18 | Unregistered Commenterwendyh

I am using radiofrequency device Accent Xl and I could say it works mostly great. It melts realy the fat and the cellulite and at the same it has strong skin tightining effect. The best results you achive by combining the different methods or devices. Recently I have started to combine it with carbotherapy ( the method where you inject CO2 with the needles ) and the resulst become much better.

Dinko, you are FOS! Nothing melts fat "great" except 900 - 990 nm lasers inserted under the skin (laser assisted liposuction).

07.20 | Unregistered CommenterMelFrax

I don t understand what you mean with FOS ? I speak here only about noninvasive methods to remove the fat or celulite !

FOS means full of shit which means that I don't believe you and I think you are either lying or delusional. I have seen all the non-invasive devices and most don't work that well. You seem like a laser rep who is trying to sell the device!

07.21 | Unregistered CommenterPraxZax

BTW, CO2 therapy is wacky and not mainstream. Dinko, are you a doctor? Where do you practice? How long have you been doing this stuff? I really am skeptical of the reporting of your experiences!

07.21 | Unregistered CommenterPraxZax

It does'nt sound like he is a doctor to me.

07.21 | Unregistered CommenterFred

How well does it go over when you tell patients not to gain any weight. Do you really think that they wont.

07.21 | Unregistered CommenterGene

Anyone have any new comments on Reloxin. Are there good results and are patients as happy as they are with Botox?

07.21 | Unregistered CommenterKenneth

Do you always tell your patients the truth when they dont really need to know all the bad stuff?

07.21 | Unregistered CommenterJessica

Has anyone added any aesthetic services to your practice? Has it helped with the financial end of your existing aesthetic practice?

07.21 | Unregistered CommenterStedman

I would like some information about laser technology training for an assistant of mine. Which school has the best training istructors in the Fort Lauderdale area?

07.21 | Unregistered CommenterAnthony

Sounds like a laser rep to me.

07.21 | Unregistered CommenterJackson

what is the difference between the Lipotron and LipoEx?

07.21 | Unregistered Commenterlhc


Suprisingly it goes over really well to be honest with our paitents and explain to them that if they were to gain weight it would ruin their treatment results. This is the same with our liposuction patients. Sometimes they come back to our office in six months saying they are not currently happy with their results, then after we put them on the scale they have gained 10 pounds! It's very important for patients to realise that it's not all about the machine used to melt fat, but they have to maintain their results with a low-fat diet and exercise. And hey, if they don't maintain themselves and gain a few pounds, we can always melt it off again!

Also, I wasn't sure if people were talking about me being a laser rep or not, but I can assure you I am not. My name is Wendy Hovorka and my husband John Hovorka MD FACS, and I have an ambulatory surgery center, vein clinic, and a body slimming center located in McAllen, Texas. My husband is a surgeon who specializes in venous diseases. We started our cosmetic practice in 2007 because most of my husbands high volume of work is during the fall, winter and spring. Due to the Winter Texan population leaving in the summer time, our staff did not have as much work to do. In effort to not lay off anyone during this time, we started doing cosmetic procedures on the side. It would be great to have financial compensation from the medical equipment sales companies (are you listening lipo-ex people?) but this is sadly not the case. I just post what my husband and I have learned in effort for others to make more educated decisions about what they are buying. These are just my opinions based on our own personal trials and experiences and if people dont agree with me, that is fine. We live in a free country and I am taking advantage of that!

07.22 | Unregistered Commenterwendyh

I'm not sure the question you asked was directed to me or not but I'm going to answer it anyway because I am stuck here in Jackson, Mississippi while my husband is doing an externship and I am completely board out of my mind.

You asked if you always tell patients the truth even if they don't really need to know it. My answer is yes I do. Part of being responsible in the medical field is making a patient sign an informed consent document. This is a list of all possible complications that can go wrong with the machine they will be using. Patients need to know the risks so they can make an informed decision if a particular procedure is right for them. It is very irresponsible for a doctor's office to not to tell a patient of the risks involved. All medspas are under a physician's medical license. A physician takes an oath to "first do no harm" to a patient. If a patient was not told about complications, and then suffers one, you are in serious trouble (malpractice!)

In our practice, we turn away lots of people who do not meet the criteria for cosmetic procedures. Often, their BMI is too high to safely do liposuction or they are having problems with lymphadema, high blood pressure, etc... The patients sometimes get upset because they really want to have something cosmetic done, but it's up to the medical spa to say no if they do not meet the criteria. When my husband finished his residency program, his program director wrote each resident a letter about not just doing unnecessary surgery on people to make money. He called it "making piece with the almighty dollar." This was excellent advise that we have lived by over the last decade and even though we probably don't make as much money as the medspa down the street with their false advertising, my husband has an excellent reputation to show for it.

07.22 | Unregistered Commenterwendyh

There is no difference between LipoEX and the Lipotron. When the machine first came out and we purchased it, they called it Lipotron. Later, to my relief, they changed the name to LipoEx. Same machine, but much improved name...

07.22 | Unregistered Commenterwendyh

I have had the Zerona now for 2 months. I have treated several staff members using different types of protocol One being, no diet, no excercise.....only Zerona. Result is loss of 1.5 inches in abdomen only.
The second staff member is watching food intake and walking 30 minutes daily. Result.........1 inch all over.

Although there was some loss, this is not worth the 2-3K it costs in my opinion.

What does everyone think?

07.22 | Unregistered Commentersheri

That is exactly my concern with this technology. Then we still need to ask the question of how long the very modest results last. There are no studies with the Zerona that go more than 2 weeks after the last treatment.

So if a patient gets 1.5 inches of fat loss on their abdomen and it only lasts 2 months, is it worth 2 to 3 thousand dollars to the patient?

I do not feel I can ask that from my patients.

07.23 | Unregistered CommenterLH

My name is Dinko Kaliterna and I m dermatologist located in Europe. This is web site from my clinic and uder the title : video sadržaji you can see treatments which I perform. If you wan to see more videi click under : vise.
I m not not sales rap. At least give my full name but othes hide their namey behid false name. I stand after every my world. If some doesn t belive that his problem. My patients and I we are very hapy with radiofrequency device. I have many other options which also work well. The idea of this blog to exchange the informations not to insult people like did so called prax zax to me. I m using those devices about 5 years. The problem is when you get expensive device you got some parameters and educations which means nothing. Those parameters mostly dont work and the education is bad. You have to find alone the wright parameters and discover many tricks. Example radiofrequency works excelent the abdomen and legs but the results for the knees and inner side of the leg dont are resistent and you have to combine other deviceses. There are many such exampples. The most important think is that we exchange such details and infomations.

I am sure Dinko got the terminology "melting fat" from the Alma rep. who always seem to exaggerate the truth., which in contrary to what the Accent does do. I have also used Radio Frequency (ACCENT) for the past five years and was one of the first to have it in Europe. Whenever I first purchase a new machine I always do clinical trails first on my own patients for six months, at a discounted price just to see what kind of reliable results I can achieve. During the first 2 months relying on what I was recommended from Alma, "no results" at all. Starting to think I has just wasted $60,000 on a machine that would sit in the corner of the room.

It was when I abandoned everything what Alma said and came up with my own protocol. This is when I started to see the results, but then again if you ask an Alma rep what it feels like during treatment I am sure he/she will say " like a warm stone massage " yeah in HELL! Radio Frequency is the only thing I have every experienced to help cellulite, but Dinko was very correct to say all of these machines no matter if it's RF/Laser etc... all have a high learning curve. You yourself have to come up with the best protocol for your patients, and the only way to find out which is the best way to treat is to experiment. This of course in a safe way, in this way you will discover the ''tricks'' as Dinko calls it. I would very much like to correspond with Dinko to compare RF pictures, and to discuss what technique he uses. In case your asking I am now using the Accent XL. which makes the older Accent way outdated. Anyone out there using the PixelRF, as Alma calls it Plasma, LOL?

thanks so much admin. this is a good post. ı have watching you everyday. this are the best netlog sites of and this is the best Chat Sohbet sites of . have a nice days see you later ardour team ! and the last one is one of the famous Chat site on see u later have a nice days.


Can you show any before and afters that you have done on patients when you added the CO injections? My machine (LipoEX) is similar to yours, but I was told the RF penitrates a little deeper. Let me know some of your experiences and I will share what I have learned.


10.2 | Unregistered Commenterwendyh

Hi All,

I am a patient & need some help! Where can I find details of the company that makes Lipo-Ex? Also, are there any places outside of the USA like Eastern Europe/Europe, India, Middle East etc that offer Lipo-Ex?

I take it that since Lipo-Ex is the only treatment that can remove both Visceral & Subcutaeneous Fat, it is much better than others like UltraShape, UltraContour, Zerona, Accent XL, Fusion RF, LipoDissolve etc?

Can Lipo-Ex be either increased in treatment frequency per week and/or combined with any of the above (or others not mentioned) for even better & faster results?

I would also like to learn about the Lapex 2000 system mentioned here as it too sounds quite effective. I really need to lose both visceral & subcutaneous fat. Male, aged 47 & weighing 242lbs with a BMI of 33.7. My fat is entirely localised around my belly and face - my arms, legs, upper torso etc are completely normal with no fat at all. I am based in London, England.

If anyone can help, please kindly respond - Many Thanks!


11.16 | Unregistered CommenterBazzy!

We own a Lipo ex here in the states and was sold by Reveco. I beleive you would have to get intouch with Reveco.

12.15 | Unregistered Commenterwendyh

kitchen range hoods
I was told the RF penitrates a little deeper. Let me know some of your experiences and I will share what I have learned.

The New Yolo Curve is same manufactures as the Lapex it works great and does the job in only 20 min sessions compared to 40 with the other laser.

Show me the science.


07.5 | Unregistered CommenterLH

Why no mention here of Liposonix, the only focused ultrasound device that nonivasively destroys localized fat in a single treatment? Liposonix is FDA cleared, and has a ton of published science to back it up including histology. Unlike UltraShape, which uses frequencies more difficult to focus and control, Liposonix is mostly thermal rather than microcavitation. My impression is that all of the devices that require multiple treatments yield only temporary results if any.

05.1 | Unregistered CommenterDrB

People will believe ANYTHING. Especially if you wear a white coat. There is a whole book called,"Rush Limbaugh is a big fat liar." Written by a member of Congress who used to be a stand up comic. He was not sued by Rush because Rush knows the difference between the truth and a lie which his readers do not understand. Clients want to hear what con men are saying, consequently, they do not check it out and they get stung pretty badly.Purchasers of these devices do not understand how such a machine works and do not want to show their IGNORANCE, soooo, they get just what thy deserve. Remember the EPILADY, the NONO and other devices?

How about "matter can not be created or destroyed. It can be changed to another form (like gas, liquid, or solid). Where does this "melted fat" go? It was not a liquid, or gas before treatment, therefore , it has to be described as a soft solid that retained its state at body temperature. If heated it might be converted to a liquid that could change it's LOCATION where it would cool off and return to the original state and the patient's weight would be the SAME before and after treatment. I do not believe there is a spigot to turn on and drain off the fat. Gravity would make it drain downward like edema in the legs, however, I am of the opinion it would congeal again in another place IF IT MELTED THE FAT ORIGINALLY.

There is another device being tested, at a famous Boston hospital, that FREEZES fat (it was shown on the evening news at 6:00. I do not know how it works yet but I know one of the Docs very well and can find out. I have to know WHERE DOES IT GO? HOW DO YOU REMOVE IF AFTER IT WAS FROZEN? HOW LONG DOES IT STAY FROZEN? CAN YOU GET FROSTBITE FROM THE INSIDE OUT? WHAT ARE THE SIDE EFFECTS (DONT LET ANYBODY FOOL YOU AS EVERYTHING HAS SIDE EFFECTS). DOES THER SKIN ON THE OUTSIDE FREEZE TOO? WHY NOT? THE WHOLE BODY IS MOSTLY WATER, THEREFORE, WHY DON'T ADJACENT ORGANS and vessels FREEZE TOO?

The potential market is tremendous. If the device works they can charge anything they want. The machines will not be made fast enough to satisfy demand. Who can use them? Do you need a separate license to use them? Is this the "practice of medicine"? As yet nobody knows how long the results last IF IT WORKS AT ALL, AND IF FDA ALLOWS IT TO BE MARKETED AS "SAFE AND EFFECTIVE"?.

At room temperature fat is very soft. On a summer day the room is warmer and the fat can easily fall apart as there is very little to hold it together. At body tmp of 98.6 F it is not a liquid. Is that temp too hot to be tolerated? Will the patient be burned from the inside as is possible with other "gadgets"? The operator is working blindly.... what happens to nearby organs and vessels?

05.2 | Unregistered Commenterlefty2g


Correct me if i am wrong, Lipo Ex has received FDA Approval ONLY for medical use on 06/01/2012! I suppose that other non surgical options like liposonix ultrasound that are FDA cleared for weight loss are much better choices!

I would also like to mention that Lipo Ex apart from melting fat also provides skin tightening, so if you would like to combine both features, probably its among the top choices!

Good post ,There is no difference between LipoEX and the Lipotron. When the machine first came out and we purchased it, they called it Lipotron. Later, to my relief, they changed the name to LipoEx. Same machine, but much improved name,.thanks lipo ex

06.1 | Unregistered Commentermedspa

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