Ultrasound Fat Reduction: Risks of Nerve Damage and Hand Numbness

Cosmetic medicine: Ultrasound fat reduction may cause hand numbness, potentially injuring the nerves?

On April 5th, I underwent "Liposonix" ultrasound fat reduction treatment at a medical aesthetics clinic to slim down my arms.
This treatment is non-invasive and claims not to harm the skin, nerves, or muscles; it only destroys fat cells, which are then metabolized out of the body, with no recovery period required.
The principle of action involves focused ultrasound that uses non-invasive high-frequency energy, bypassing the epidermis and dermis layers to directly target the fat layer.
The high energy can rapidly heat subcutaneous fat within one second, and the generated heat can destroy subcutaneous fat cells.
Additionally, the transmitted heat energy can stimulate collagen production in the dermis, making the treatment area tighter and more contoured.
The necrotic fat cells will be naturally metabolized by the body, resulting in no wounds and no need for post-operative care.
Both the doctor and nurses told me that there would only be pain during the procedure, and it would subside afterward.
The treatment was administered to both arms (upper arms).
During the procedure on my right arm, I initially felt a warm, tolerable sensation similar to a needle prick, but later it felt like an electric shock extending to my fingertips, which was very painful.
However, they assured me this was normal, so I endured it for my left arm as well.
The electric shock sensation was even more intense, causing my fingertips to twitch; I was unsure if this was normal.
After the procedure, my left fingers felt very numb, especially the first three fingers, while the ring and little fingers were less numb but still affected.
That night, I felt very uncomfortable and couldn't sleep, worrying that I might have nerve damage.
On the morning of April 6th, I immediately contacted the clinic to ask if this was normal.
They told me to go home and not to worry too much, so I decided to wait another day to see if it would improve.
On April 7th, the numbness persisted.
During lunch, I went to exercise, but my entire left arm felt like it was being shocked, which was so painful that I was afraid to continue arm exercises.
Consequently, I went to Chang Gung Memorial Hospital to see a neurologist in the afternoon.
The doctor informed me that it would take two to three weeks to determine if there was nerve damage through electromyography, so he scheduled a nerve damage test for three weeks later.
That evening, I returned to the medical aesthetics clinic to hear what the doctor had to say.
He mentioned that I was the first patient to experience this at their clinic, explaining that the fat distribution in both arms is different and that everyone is asymmetrical, which could lead to some nerve damage.
He also remarked that the doctor at Chang Gung is not familiar with this technique.
Later, the clinic administered a B-vitamin IV drip, hoping I would recover quickly.
He mentioned that recovery could take a few weeks to three months, citing a paper that stated this, but it felt like he was uncertain, and that duration seemed excessive.
Wasn't it said that Liposonix has no recovery period? The doctor should have assessed whether my fat thickness was suitable for the procedure.
That night, I still allowed them to administer the B12 drip.
I never expected that an ultrasound treatment would injure my nerves.
Should I consider myself unlucky and continue with their IV drips? The numbness has not improved, making it very inconvenient to perform tasks.
They want me to return daily for IV drips and even mentioned offering me some complimentary treatments.
The clinic is not next to my home, so I am spending time and money on travel and enduring needle pricks, with no idea when I will recover.
The electromyography at Chang Gung is still over two weeks away, and the nurse mentioned that the test would be painful and involve needles.
I wonder if there is any way to expedite the assessment of my nerve damage; I am genuinely worried.
My entire palm feels like it has been burned, and the sensation has spread to my arm.
I am trying to avoid using that hand for tasks, as any contact is uncomfortable.
I kindly ask for your guidance, dear doctor.
Thank you very much!

Li Lili, 30~39 year old female. Ask Date: 2016/04/13

Dr. Gao Chunde reply Neurology

If there is a trend of progression or worsening of the condition, it is advisable to schedule an appointment with a neurologist at Chang Gung Memorial Hospital to inquire whether there are any treatments or medications that can be initiated, as electromyography is primarily a diagnostic tool.

Reply Date: 2016/04/13

More Info

Ultrasound fat reduction, often referred to as "non-invasive body contouring," has gained popularity for its promise of reducing fat without the need for surgical intervention. However, as with any medical procedure, there are potential risks and complications that patients should be aware of, particularly concerning nerve damage and sensations such as hand numbness.

In your case, it appears that you experienced significant discomfort during the procedure, described as a "shock-like" sensation extending to your fingertips. This type of sensation can be indicative of nerve irritation or damage, especially if the treatment area is close to major nerve pathways. The fact that you felt a sharp, electric-like pain during the treatment raises concerns about the possibility of nerve involvement. While the clinic assured you that such sensations were normal, it is crucial to understand that individual responses to treatment can vary widely, and what is considered "normal" for one patient may not be for another.

The prolonged numbness you are experiencing in your left hand, particularly in the first three fingers, is concerning. Nerve damage can manifest as numbness, tingling, or weakness in the affected area. In your case, the symptoms have persisted beyond the immediate post-treatment period, which warrants further investigation. It is essential to monitor these symptoms closely, as they may indicate that the nerve has been compromised during the procedure.

The clinic's response to your concerns, suggesting that you are the first patient to experience such symptoms, is not reassuring. While it is true that individual anatomical differences can lead to varying outcomes, it is the responsibility of the medical professionals to conduct a thorough assessment before proceeding with any treatment. This includes evaluating the thickness of the fat layer and understanding the proximity of nerves to the treatment area.

Regarding your upcoming electromyography (EMG) test, it is a valuable tool for assessing nerve function and determining the extent of any potential damage. While the wait for this test may be frustrating, it is necessary to provide a clear diagnosis. In the meantime, you should avoid activities that exacerbate your symptoms, such as heavy lifting or repetitive motions with your left arm. Resting the affected limb can help minimize further irritation.

As for the B12 injections you received, while vitamin B12 is essential for nerve health, it is unlikely to provide immediate relief for nerve damage. The clinic's suggestion to continue with these injections may be more about providing symptomatic relief rather than addressing the underlying issue.
In summary, while ultrasound fat reduction is marketed as a safe and effective method for body contouring, it is not without risks. Your experience highlights the importance of thorough pre-treatment assessments and clear communication between patients and healthcare providers. If your symptoms do not improve or worsen, it may be prudent to seek a second opinion from a neurologist or a specialist in peripheral nerve injuries. They can provide further evaluation and potential treatment options to address your concerns. Your health and well-being should always be the priority, and you deserve answers and appropriate care for your symptoms.

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