Zocchi[12] states that the susceptibility of a liquid or biologic tissue to microcavity formation depends upon the molecular cohesion of the material and that the negative pressure required is related to the density of the tissue for its aspiration. Low-density tissues such as fat cells have low molecular cohesion, and this favours micro cavity formation and aspiration.
Connective tissue and muscle are essentially unaffected by this process as they are more dense but an accumulation of secondary thermal energy and micromechanical trauma on sustained application of ultrasound after complete emulsification by microcavitation may result in damage. Thus direct micromechanical trauma and secondary thermal effects of persistent ultrasound energy is the mechanism of action for external UAL.
Nine healthy young males participated in this study, which appears in the journal Nutrients. The researchers asked them to follow a 7-day high fat, low-carbohydrate diet that was similar to the keto diet, consisting of 70 percent fat, 10 percent carbohydrates, and 20 percent protein. They also had to consume a 75-gram glucose drink before and after the diet.
During the ultrasonic tumescent liposuction procedure, fat is liquefied by sound waves prior to removing it with suction. Before surgery, I inject the parts of the body to be treated with a tumescent fluid containing local anesthetic and epinephrine.  In addition to the effects mentioned above with the conventional liposuction procedure, this liquid causes deposits of fat to swell so that they can be removed smoothly, with minimal trauma to the body’s other tissues.  As the sound waves penetrate the fat deposits, the fat melts, easing the removal process.  This is especially useful in patients who have scar from prior liposuction and male patients with more fibrous fatty deposits.  The use of ultrasonic sound waves can also help the skin tighten around the treated area.  Ultrasonic liposuction can lead to more unpredictable results after surgery, increased sensory alterations and increased potential contour abnormalities.  I generally reserve ultrasound liposuction for redo liposuction patients who have more scar tissue and for male patients with more fibrous fat.
Pre-tunnelling (Mladick)[25] increases instrument control as, without suction, it creates desired superficial as well as deep planes of fat removal. It prevents an inadvertent removal in the sub-dermal fat layer that can result in contour irregularities. Similarly, cross tunnelling with at least two port sites at right angles are used to treat an area of adiposity. The use of multiple port sites provides for better contouring and feathering of edges.
I’m following the ketogenic diet and I find it very easy, pleasant and varied. I can even say that my diet today is more varied than the previous one. I do not intend to leave this diet and I cannot really see why. My initial focus was not to lose weight, I’ve always been lean, but to feel better, well disposed. And I got it! I am very pleased, I have read a lot about it (including scientific literature) and I have influenced other people who need to lose weight or improve some aspects of their health. But from the beginning I went on my own way, without the help of a nutritionist because I did not want to suffer the influence of others’ ideas.
Fortunately, since peaking in 2001-2002, the overall prevalence of metabolic syndrome in the United States has fallen, primarily due to decreases in the prevalences of hypertriglyceridemia and hypertension—and in spite of increases in the prevalences of hyperglycemia and obesity/waist circumference. [27]  Data from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) showed that the age-adjusted prevalence of metabolic syndrome had fallen to approximately 24% in men and 22% in women. [28]
Work your core. When many people think of core strengthening, they think of stomach crunches. Crunches are helpful for building abdominal muscles, but contrary to popular belief, crunches won't do much to lose the layer of fat stored in your belly, and can actually cause significant damage to the spine.[34] Instead, try a workout routine that strengthens your whole core, like yoga, or try abdominal presses and planking.[35]
Focus on cardiovascular exercise. Cardiovascular exercise is one of the best ways to lose weight. Studies show that cardiovascular exercise like walking, jogging, and running is highly effective at any degree of intensity.[24] That's because cardio/aerobic exercise works the muscles in your arms, legs, and hips, and increases blood flow to all sets of muscles.[25] Effective cardio exercises include:[26]

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.


• Reducing appetite — Constant hunger can cause you to consume more calories than you can burn, which can eventually lead to weight gain. A ketogenic diet can help you avoid this problem because reducing carbohydrate consumption can reduce hunger symptoms. In one study, participants who were given a low-carbohydrate diet had reduced appetites, helping them lose weight easier.2
People who have metabolic syndrome typically have apple-shaped bodies, meaning they have larger waists and carry a lot of weight around their abdomens. It's thought that having a pear-shaped body — that is, carrying more of your weight around your hips and having a narrower waist — doesn't increase your risk of diabetes, heart disease and other complications of metabolic syndrome.
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