Laser-Assisted Liposuction

Efficacy of 1060 nm Diode Laser for Non-Invasive Subcutaneous Fat Reduction in Mini-Pigs

Purpose

To evaluate the efficacy and safety of abdominal fat reduction in mini-pigs, utilizing at 1060 nm diode laser with a wavelength of 1060 nm.

Patients and Methods

The laser system non-invasively disrupts adipose tissue; its effectiveness and safety were evaluated by ultrasound imaging and histological analysis. Laser irradiation was performed with various powers, and the cooling function was activated to prevent skin surface damage.

Results

The dermal tissue temperature increased to at least 43°C during laser exposure, leading to a decrease in abdominal fat thickness after 30 days. Blood tests revealed no significant changes in kidney and liver function but showed increased blood levels of nonessential free acids (NEFAs), likely due to the release of fatty tissue-derived free fatty acids. Histological evaluation demonstrated rapid transformation of adipose tissue into collagen, muscle fibers, and intracellular fibrous tissue.

Conclusion

The 1060 nm laser showed promise as a non-invasive and safe tool for reducing abdominal fat.

Minimally Invasive Beaded Electrosurgical Dissectors, Basic Science, and Pilot Studies

Background

Minimally invasive beaded electrosurgical dissectors ("BEED devices") provide simultaneous sharp dissection, blunt dissection, and electrosurgical coagulation while performing 100 cm2 porcine tissue plane dissections in 0.8 to 3 min with minimal bleeding and no perforations.

Objectives

The aim of the study was to report the basic science and potential clinical applications and to video document the speed and quality of planar dissections in in vivo and ex vivo porcine models with thermal damage quantified by thermal and histopathologic measurements. Additionally, in vivo porcine specimens were followed for 90 days to show whether adverse events occurred on a gross or macroscopic basis, as evidenced by photography, videography, physical examination, and dual ultrasonography.

Methods

Ex vivo porcine models were subjected to 20, 30, and 50 W in single-stroke passages with BEED dissectors (granted FDA 510(k) clearance (K233002)) with multichannel thermocouple, 3 s delay recordation combined with matching hematoxylin and eosin (H&E) histopathology. In vivo porcine models were subjected to eight 10 × 10 cm dissections in each of 2 subjects at 20, 30, and 50 W and evaluated periodically until 90 days, wherein histopathology for H&E, collagen, and elastin was taken plus standard and Doppler ultrasounds prior to euthanasia.

Results

Five to 8 mm width dissectors were passed at 1 to 2 cm/s in ex vivo models (1-10 cm/s in vivo models) with an average temperature rise of 5°C at 50 W. Clinically evidenced seromas occurred in the undressed, unprotected wounds, and resolved well prior to 90 days, as documented by ultrasounds and histopathology.

Conclusions

In vivo and ex vivo models demonstrated thermal values that were below levels known to damage subcutaneous adipose tissue or skin. Tissue histopathology confirmed healing parameters while Doppler ultrasound demonstrated normal blood flow in posttreatment tissues.

Level of Evidence 4

Safety and Efficacy of Renuvion Helium Plasma to Improve the Appearance of Loose Skin in the Neck and Submental Region

BACKGROUND

Minimally invasive procedures that deliver thermal energy to subcutaneous tissue offer a solution when deciding between excisional and noninvasive options to address face and neck aging-related changes. A minimally invasive helium plasma device, Renuvion, was first utilized for subdermal tissue heating to reduce skin laxity under an FDA general clearance for cutting, coagulation, and ablation of soft tissue.

OBJECTIVES

The purpose of this study was to demonstrate the safety and effectiveness of the helium plasma device for improving the appearance of loose skin in the neck and submental region.

METHODS

Patients undergoing the procedure with the helium plasma device in the neck and submentum were studied. They were seen for 6 months following the procedure. The primary effectiveness endpoint for improvement in lax skin in the treatment area was determined by 2 of 3 blinded photographic reviewers. The primary safety endpoint was the level of pain after treatment.

RESULTS

The primary effectiveness endpoint was met; 82.5% demonstrated improvement at Day 180. The primary safety endpoint was met; 96.9% of patients experienced no pain to moderate pain to Day 7. There were no serious adverse events reported related to the study device or procedure.

CONCLUSIONS

The data demonstrate benefit to patients by improvement of the appearance of lax skin in the neck and submental region. Outcomes resulted in US Food and Drug Administration 510(k) clearance in July 2022, expanding indications for the device to include subcutaneous dermatological and aesthetic procedures to improve the appearance of loose skin in the neck and submental region.

Effectiveness of HIFU Therapy for Nonsurgical Facial and Body Contouring: A Systematic Review of Prospective and Experimental Studies

BACKGROUND

Liposuction, the most common body sculpting surgical procedure known today is associated with the risk of numerous complications. A safer and more noninvasive approach involves the use of high-intensity focused ultrasonography (HIFU) lasers, which work by selectively damaging fat tissue through apoptosis or necrosis induction of fat cells. The authors' systematic review was designed to identify the effectiveness of HIFU for nonsurgical facial and body contouring.

METHODS

An exhaustive literature search was conducted of the PubMed/MEDLINE, Cochrane Central, Scopus, and EBSCO electronic databases for the period from November of 2005 to July of 2020. The full text of selected articles was reviewed for possible study inclusion, and articles fulfilling the inclusion criteria were recruited. Characteristics of the included studies were noted, and outcomes were assessed. Assessment of quality and risk of bias was performed for all the studies using the RevMan tool and the methodological index for nonrandomized studies.

RESULTS

The initial search revealed a total of 4584 citations, of which only 11 were included in the present review: nine used HIFU for recontouring of the abdomen and only two used HIFU over the face and neck. Studies evaluated either the efficacy of HIFU or the safety of its use. The average total energy ranged from 140 to 248 J/cm 2 for the abdominal region and 0.3 to 1.2 J/cm 2 for the face and neck. The focal depth ranged from 1.1 to 1.8 cm. All the studies showed promising results with the use of HIFU.

CONCLUSION

HIFU therapy is safe, effective, and minimally invasive, with predictable results when used for body and facial recontouring.

1470-nm Radial fiber-assisted liposuction for body contouring and facial fat grafting

Background

Laser‐assisted liposuction using 1470‐nm radial fiber emits light energy preferentially absorbed by water, yielding a rapid and localized contouring and tightening effect, with minimal scarring. When collected under appropriate conditions, extracted fat samples can be exploited as autologous filling material in liposculpturing procedures.

Objectives

To assess the 6‐month contouring efficacy of 1470 radial fiber‐assisted liposuction and the volumetric enhancement effect of the harvested tissue in facial fat grafting.

Methods

Twenty subjects underwent liposuction (BeautiFill, Alma Lasers, Inc.) of lower abdominal or outer thigh fat. In seven subjects, harvested samples were grafted into facial regions. Treatment safety, body weight, blinded evaluator‐assessed aesthetic improvements, and subject‐rated satisfaction were monitored for 6 months. Abdominal and facial fat thickness were assessed by magnetic resonance imaging (n = 5) within 3 months of treatment.

Results

One‐month posttreatment, most subjects ranked improvements good/excellent (88%) and skin tightening satisfactory/very satisfactory (92%), with >70% of subjects providing similar scores 6‐month posttreatment. Blinded evaluators noted improved/very much improved aesthetic appearance (87%). Harvested tissue injected as a facial filler (21.0 ± 5.2 ml) led to a 0.63 ± 0.12 mm increase in facial fat thickness, observed by MRI, within 3 months. Six months postfilling, the majority of subjects (83%) were satisfied with the outcome. All procedures were well‐tolerated.

Conclusions

A single 1470 nm radial fiber‐assisted abdominal and thigh liposuction session provided for effective and durable reduction of adipose tissue deposits, with appreciable skin tightening and aesthetic improvements. The gentle harvesting method yielded viable filler material, which was well‐retained in facial regions for up to 6 months.

Preclinical and clinical evaluation on the performance and safety of a novel energy-based device for body shaping: A pilot study

BACKGROUND

The emergence on the market of non-invasive mechanisms aimed at reducing subcutaneous fat achieving a slimming effect arouses great interest in doctors and patients. Several methods for the destruction of adipocytes are today on the market.

AIMS

This is a pilot study on body fat reduction treatment, using a novel energy-based device for body shaping.

METHODS

The study is performed on 42 patients, healthy adults of both sexes, with BMI between 25 and 30 kg/m², indicated for the removal of fatty tissue deposits specifically in the following areas: flanks, abdomen, internal legs, trochanter, buttocks, and arms. A minimum of 5 to a maximum of 6 treatments were performed for each patient, with the device, every two weeks and with a follow-up of 6 weeks. Circumference reduction, side effects, and patient pain were evaluated for all patients.

RESULTS

A set of 42 patients were evaluated. The mean circumference reduction at 6 weeks was 2.42 ± 0.4 cm (p < 0.001). Treatment was well-tolerated (pain score, 3.24 ± 1.03) by all patients. There were no adverse events and patients declared to be satisfied with the aesthetic results obtained with the treatment.

CONCLUSION

The new device emerges as a valid and safe treatment for all patients and shows a higher security profile with no side effects.

Cellulite: A Surgical Treatment Approach

BACKGROUND

Cellulite is one of the most common skin and subcutaneous tissue conditions, affecting predominantly the thighs and hips in postadolescent women. Its etiology is not well defined, and multiple available treatments show variable efficacy.

OBJECTIVES

To describe a technique for treatment of cellulite of the gluteal region, thighs, and hips through superficial liposuction utilizing a special cannula, combined with subcutaneous autologous fat grafting.

METHODS

A retrospective review was performed of patients treated over 26 years at the Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil. Patients underwent pretreatment evaluation as to the extent of their cellulite, and pretreatment and posttreatment photographs were obtained for visual evaluation of the results.

RESULTS

Procedures were performed on 126 patients: 121 (96%) women and 5 (4%) men. The majority considered their results good or excellent. The complication rate was low, with the most common complications being ecchymosis, contour irregularities, partial recurrence of cellulite, seroma, and numbness.

CONCLUSIONS

We describe an effective method for the treatment of cellulite. Whereas subcision techniques utilize a needle or microblade to cut fibrous septa, we utilize a special cannula; larger areas can be treated than with subcision. Fat grafting is utilized to correct depressions and improve skin quality, which are added benefits compared to traditional subcision. Considering the multiple available cellulite treatments and their limitations, and the high patient satisfaction rate we achieved, with a low recurrence and complication rate, this technique can be a safe and effective option for patients with cellulite.

LEVEL OF EVIDENCE 4

Safety and Efficacy of a Noninvasive 1,060-nm Diode Laser for Fat Reduction of the Flanks

BACKGROUND

Preliminary reports indicate a hyperthermic diode laser treatment could be a safe and effective method for noninvasive fat reduction using the 1,060-nm wavelength. This wavelength penetrates the skin to heat subcutaneous adipocytes causing cellular disruption, leaving extracellular lipids, and cellular debris to be evacuated naturally by the body.

OBJECTIVE

To evaluate the safety and effectiveness of this modality for noninvasive fat reduction of the flanks.

MATERIALS AND METHODS

Forty-nine subjects received single laser treatment to 1 flank. Ultrasound images were taken at baseline, follow-up at 6 and 12 weeks after treatment. High-resolution photographs were taken at baseline and 12 weeks after treatment and then evaluated by independent reviewers. Adverse events recorded at all visits. Subjects completed a satisfaction questionnaire at the conclusion of the trial.

RESULTS

Ultrasound images showed statistically significant (p < .001) average fat reduction of 2.6 ± 1.1 mm. Reviewers correctly ordered photographs 90.3% of the time. Ninety-six percentage of subjects rated that they were satisfied. Noted side effects were transient mild to moderate tenderness which subsided within 1 to 3 weeks; no serious adverse events were reported.

CONCLUSION

The hyperthermic 1,060-nm diode laser treatment used in this study was safe and effective for noninvasive fat reduction of the flank.

Laser cellulite treatment and laser-assisted lipoplasty of the thighs and buttocks: Combined modalities for single stage contouring of the lower body

BACKGROUND AND OBJECTIVES

Cellulite and lipodystrophy are often found together, especially in areas of the buttocks and thighs, causing skin surface irregularities. Each of these conditions is currently treated independently as two separate surgical procedures. In our practice, we developed a novel combined approach for the simultaneous treatment of cellulite and lipodystrophy, as a single stage procedure in the same anatomic area. For the treatment of cellulite, we used the Nd:YAG laser at a wavelength of 1,440-nm, along with an innovative 1,000-micron directional side-firing fiber optic laser system. For the treatment of lipodystrophy, the Nd:YAG laser with a 1,440 nm wavelength, along with a fiber optic laser system was used. The objective of this study is to determine the efficacy and safety of a combined approach for the simultaneous treatment of cellulite and lipodystrophy.

STUDY DESIGN, PATIENTS AND METHODS

In 2012, 16 subjects with noticeable cellulite, Grade II and Grade III, accompanied by mild-to-moderate lipodystrophy of the lower body received single treatments of the Nd:YAG laser at a wavelength of 1,440-nm along with the 1,000-micron side-firing fiber optic laser system for simultaneous treatments of both cellulite and lipodystrophy. Patients were assessed at baseline and 3-6 months post-treatment by a modified Nurnberger-Muller scale utilized to quantify the cellulite severity. Additionally, patient satisfaction and a global aesthetic improvement scale were used to measure the improvement in lipodystrophy.

RESULTS

Blinded reviewers identified the correct baseline photographs 97% of the time when presented with a set of photographs. The median modified Nurnberger-Muller scale score at baseline was 4.75 ± 1.2 and the average improvement was 2.0 ± 1.2. Global aesthetic improvement scores ranged from 1 to 3 with an average of 1.58 indicating a much-improved overall appearance. Satisfaction was high for both physicians and patients with scores corresponding to extremely satisfied/satisfied.

CONCLUSION

Precise, effective delivery of laser energy to the dermal-adipose tissue, as well as the deep adipose lipodystrophy is feasible as a safe modality for the simultaneous treatment of cellulite and lipodystrophy in the buttocks and thighs, as a single stage procedure.

Rhabdomyolysis After Cosmetic Laser-Assisted Liposuction

A 34-year-old-female patient visited our emergency room for symptoms of disturbance of urination and shortness of breath. She was diagnosed with rhabdomyolysis with acute kidney injury after laser-assisted liposuction and required hemodialysis. Although laser-assisted liposuction is a well-used procedure, it can cause local complications, such as burns and skin irregularities, as well as systemic complications, such as infection, fever, and emboli. However, laser-assisted, liposuction-induced rhabdomyolysis has not been reported. Repetitive exercises, trauma, and crush injury are the major causes of rhabdomyolysis. In this study, a unique case of rhabdomyolysis that developed after laser-assisted liposuction is reported.

Evaluation of safety and efficacy of 980-nm diode laser-assisted lipolysis versus traditional liposuction for submental rejuvenation: A randomized clinical trial

BACKGROUND

Submental fat accumulation and skin laxity is a frequent concern of cosmetic patients.

OBJECTIVE

The aim of this randomized prospective controlled clinical trial was to compare the efficacy and safety of laser-assisted lipolysis and liposuction in the submental rejuvenation.

MATERIAL AND METHODS

Thirty-six female adults were enrolled in this clinical trial and were categorized into two groups: group 1 underwent 980-nm diode laser with the power of 6-8 W and group 2 underwent traditional liposuction. Patients were evaluated with ultrasonography 2 weeks and 2 months after the procedures.

RESULTS

Ultrasonographic evaluation reported the significant reduction of fat thickness in each group compared with the baseline (p value < 0.001). At the 2 weeks and 2 months follow-up visit, fat thickness reduction was significantly higher in the lipolysis group (p value < 0.05). Overall patients' satisfaction in lipolysis group was higher than liposuction with 11 (61%) of lipolysis patients being very satisfied in contrast to 10 (55.5%) of liposuction patients reporting "dissatisfied or neutral" results.

CONCLUSION

Laser-assisted lipolysis using 980-nm diode is approved to be safe and effective for skin tightening and rejuvenation of the submental area and seems to be a better option than traditional techniques for treatment of this cosmetic problem.

Combining facelift with SmartLipo 1064-nm system, technique overview and retrospective analysis of 56 patients

OBJECTIVE

This study reviews novel approach using SmartLipo 1064-nm system with short-flap facelift treatments focusing on 3 specific facial areas and specific target treatment endpoints. A retrospective review of 56 patients undergoing combined treatment is performed.

METHODS

Fifty-six consecutive patients undergoing SmartLipo with facelift were reviewed using pre-operative photographs as a baseline. The reviewed post-operative photographs were taken at 6 weeks and 6 months. Photographic review was performed by an independent board of physicians on the following scales: Wrinkle Severity Rating Scale, the Global Aesthetic Improvement Scale Assessment, and the Cervicomental Scale.

RESULTS

The 53 primary and 3 revision facelift patients included in this study had a mean body mass index of 24.7, and a mean age of 65 years. These patients received an average of 5,050 joules of energy between three treatment areas which was delivered at 12 Watts and 40 Hz. No major complications were reported, including hematoma and dyspigmentation, even in combined cases with surface lasers. The 6 week and 6 month post-operative photographs showed marked improvements in outcomes in each of the reviewed scales according to the independent board of physicians.

CONCLUSIONS

The SmartLipo 1064 nm is a safe and effective platform to combine with facelifts.

The skin-tightening effects of 1,444-nm Nd:YAG laser on human skin: an in vivo study

BACKGROUND

The 1,444-nm Nd:YAG laser was developed to improve the removal of fat cells and to affect the underlying dermis with the aim of skin tightening. We conducted this study to evaluate whether this laser is effective in tightening the skin and causing histological alterations to dermal collagen fibers, fibroblasts, mucopolysaccharides, and elastin.

METHODS

In a 38-year-old patient who was scheduled to undergo elective abdominoplasty, we subdermally performed laser-assisted treatment with the 1,444-nm Nd:YAG laser using different power settings over periods of 3 months and 1 month and prior to surgery. Postoperatively, we evaluated the skin-tightening effect through histopathologic examination.

RESULTS

On histopathology examination, the thickness of the dermis had gradually increased following the 3-month treatment with laser irradiation. In the treatment groups on the abdomen, the collagen fibers were arranged in a more parallel pattern and became denser than those in the control group. Likewise, fibroblast proliferation and the levels of mucopolysaccharides and elastin were higher in the treatment groups than in the control group.

CONCLUSIONS

The 1,444-nm Nd:YAG laser was effective in promoting the remodeling of the dermis and the regeneration of collagen fibers. As such, the 1,444-nm Nd:YAG laser could be used for skin tightening in addition to its function in lipolysis.

LEVEL OF EVIDENCE II

This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Nonexcisional tissue tightening: creating skin surface area reduction during abdominal liposuction by adding radiofrequency heating

BACKGROUND

Recent publications show that heat-mediated tissue tightening is a promising treatment for the lax abdomen and may provide better long-term outcomes than traditional suction-assisted liposuction (SAL).

OBJECTIVES

The author evaluates the degree and duration of skin surface area contraction, as well as the influence of anatomic location of the treatment region on the degree of tissue tightening, in a study comparing SAL alone vs SAL plus radiofrequency-assisted liposuction (RFAL).

METHODS

In this prospective, randomized, split abdominal study, 12 consecutive patients were treated with SAL alone on 1 side and with SAL plus RFAL on the other side. Each patient had 4 (3 × 3-cm) squares-2 per treatment type-tattooed in the lower abdominal region (2 on the right and 2 on the left). The surface area of these squares was measured with the Vectra computerized measurement system (Canfield, Inc, Fairfield, New Jersey) at pretreatment, at 6 weeks posttreatment, and at 1 year posttreatment. All measurements were subjected to statistical analysis using predictive analytic software and were evaluated for statistical significance.

RESULTS

In regions treated with SAL alone, there was a 10.4% mean skin surface area contraction at 6 weeks and 8.3% at 1 year posttreatment. The mean skin surface area reduction was 25.8% in regions treated with radiofrequency plus SAL at 6 weeks and at 1 year. The anatomic location of each square (medial vs lateral) did not statistically correlate with more or less tissue tightening.

CONCLUSIONS

Radiofrequency-assisted tissue tightening, when applied in conjunction with SAL, is effective in achieving greater skin surface area reduction.

Histological evaluation of dermal tissue remodeling with the 1444-nm neodymium:yttrium-aluminum-garnet laser in in vivo model

Laser lipolysis has a skin tightening effect by heating the deep dermis, in addition to the removal of fat tissues. The 1444-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser has been expected to be more effective and safe for laser lipolysis, due to higher affinity to fat and water, than 1064-nm and 1320-nm wavelengths. The purpose of this study was to evaluate the skin tightening effect of the 1444-nm Nd:YAG laser through in vivo guinea pig models. The 1444-nm Nd:YAG laser was used to irradiate shaved dorsal skin of the guinea pigs and compared with controls (no power, only tunneling). Immediately, 1 week, 1 month and 3 months after laser administration, full-thickness skins were harvested and to evaluate dermal thickness, collagen organization, fibroblast proliferation, and intensity of elastic fibers and mucopolysaccharides, using hematoxylin-eosin, Masson-trichrome, Verhoeff's stain and Alcian blue stain. Dermal thickness showed an increase with time in all groups. In collagen organization, fibroblast proliferation, and intensity of elastic fibers and mucopolysaccharides, the treatment groups were higher than those of the control group, overall. Our study showed that the 1444-nm Nd:YAG laser appeared to be effective for the skin tightening effect in in vivo guinea pig models. The 1444-nm Nd:YAG laser can be used for skin tightening, as well as reduction of fat tissues.

Laser lipolysis using a 924- and 975-nm laser diode in the lower extremities

BACKGROUND

Laser technology provides the desired destruction of adipose tissue, hemostasis, and good skin retraction with a minimum of discomfort and a quick return to normal life for the patient. Here we present our experience with the use of laser-assisted liposuction (LAL) with a 924- and 975-nm laser diode and compare it with traditional liposuction alone.

METHODS

A total of 430 patients were reviewed for this study. Three hundred thirty patients were treated with the 924- and 975-nm laser diode for laser lipolysis and 100 patients were treated with traditional liposuction of the anterior and inner thigh, the knee, the calf, and the trochanter. Patients were assessed by means of ultrasound. Pictures were taken and the degree of satisfaction was assessed. All complications were recorded.

RESULTS

A total of 521 laser lipolysis procedures were performed at different areas: anterior thigh (86), inner thigh (122), trochanter (204), knee (67), and calf (42). The mean energy was area-dependent and evaluated in kJ: anterior thigh (15), inner thigh (14), trochanter (22), knee (5), and calf (4.5). The mean reduction of subcutaneous tissue with LAL in the anterior part of the thigh, the inner thigh, the calf, the knees, and the trochanter was 1.45, 1.9, 1.15, 1.2, and 3.6 cm, respectively. One hundred traditional liposuction procedures were performed for different areas: anterior thigh (27), inner thigh (38), trochanter (72), knee (21), and calf (12). The mean reduction of subcutaneous tissue in the anterior part of the thigh, the inner thigh, the calf, the knees, and the trochanter was 1.2, 1.6, 0.9, 0.6, and 3.2 cm, respectively. All patients who underwent LAL had superior satisfaction compared to those who had liposuction alone.

CONCLUSION

Laser lipolysis with 924- and 975-nm diodes is adequate treatment for removal of adipose deposits and to obtain aesthetically good skin results, with a minimum of recovery time and high patient satisfaction.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Laser, light, and energy devices for cellulite and lipodystrophy

Cellulite affects all races, and it is estimated that 85% of women older than 20 years have some degree of cellulite. Many currently accepted cellulite therapies target deficiencies in lymphatic drainage and microvascular circulation. Devices using radiofrequency, laser, and light-based energies, alone or in combination and coupled frequently with tissue manipulation, are available for improving cellulite. Laser assisted liposuction may improve cellulite appearance. Although improvement using these devices is temporary, it may last several months. Patients who want smoother skin with less visible cellulite can undergo a series of treatments and then return for additional treatments as necessary.

Evaluation of Tissue Tightening by the Subdermal Nd: YAG Laser-Assisted Liposuction Versus Liposuction Alone

BACKGROUND

Skin tightening is a desirable outcome for skin flaccidity.

OBJECTIVE

We evaluated the applicability, safety, capacity and intensity of skin tightening with the subdermal 1,064 nm Nd: YAG laser application to the upper arms, and compared the results with liposuction.

MATERIALS AND METHODS

Patients with lipodystrophy and mild-to-severe skin laxity of the arms were included (n=28). In half of patients, a single treatment with a subcutaneous laser and liposuction was performed, while the other 14 had a regular liposuction. Treatment parameters, adverse effects and photographic documentation were recorded.

RESULTS

Aesthetic improvement and skin retraction was superior by laser lipolysis. The procedure was well tolerated without significant complications.

CONCLUSIONS

The subdermal laser-assisted liposuction using a 1,064 nm Nd: YAG laser achieves improved skin tightening.

High-intensity focused ultrasound effectively reduces waist circumference by ablating adipose tissue from the abdomen and flanks: a retrospective case series

BACKGROUND

Currently available technologies for performing aesthetic body sculpting are either noninvasive but require multiple treatments to achieve relatively superficial effects or very effective but also invasive and sometimes associated with serious complications. A new, noninvasive alternative is to ablate adipose tissue using high-intensity focused ultrasound (HIFU). When focused within subcutaneous adipose tissue, HIFU quickly raises the local temperature, resulting in instantaneous cell death via coagulative necrosis within the targeted area but no damage to the surrounding tissue.

METHODS

A new HIFU device, the LipoSonix system (Medicis Technologies Corporation, Bothell, WA, USA), was used by our clinic staff to reduce waist circumference via removal of excess adipose tissue from the anterior abdomen and flank areas. This report describes the results of a retrospective chart review of patients at one clinic who underwent HIFU treatment of the anterior abdomen and flank areas.

RESULTS

A total of 85 men and women with a mean age of 43.8 years underwent a single HIFU treatment session. The time required to complete treatment was approximately 1 to 1.5 h. Using a mean energy level of 134.8 J/cm(2) and a focal depth of 1.1 to 1.6 cm, the waist circumference was decreased by an average of 4.6 cm after 3 months. Of the 85 patients, 10 (11.8%) reported adverse events including prolonged tenderness (n = 3), ecchymosis (n = 3), hard lumps (n = 2), edema (n = 1), and pain (n = 1), which resolved spontaneously.

CONCLUSIONS

The authors conclude from their experience that HIFU represents a safe and effective means for performing noninvasive body sculpting.

Randomized, blinded split abdomen study evaluating skin shrinkage and skin tightening in laser-assisted liposuction versus liposuction control

BACKGROUND

Laser-assisted liposuction has shown great potential in facilitating fat removal, improving patient recovery time, and decreasing postoperative side effects. Clinical experience has indicated superior skin tightening after laser-assisted liposuction than with liposuction alone.

OBJECTIVES

The aim of the present study was to obtain quantitative, objective data for comparing tissue shrinkage and skin tightening achieved by laser-assisted liposuction versus liposuction alone.

METHODS

Ten female subjects from the author's private practice with unwanted abdominal adiposity and mild to moderate skin laxity were enrolled. On the abdominal skin of each patient, the corners of four rectangular regions (approximately 5 × 5 cm each) were tattooed with India ink and randomly assigned to treatment with laser-assisted liposuction (Smartly MPX laser, Cynosure, Inc., Westford, Massachusetts) or with liposuction alone. The laser system permits individual as well as sequential emission of 1064-nm and 1320-nm wavelengths. Skin shrinkage was quantified by calculating the changes in surface area of the regions. Skin tightening was quantified by changes in the skin stiffness index measured in the treated regions.

RESULTS

One month and three months after treatment, the mean skin shrinkage ratios were significantly higher on the laser-treated side than on the suction side. One month after treatment with or without laser, the mean skin stiffness and skin tightening showed no statistically significant difference from baseline. Three months after treatment, the mean skin stiffness and skin tightening were significantly higher on the laser-treated side.

CONCLUSIONS

Laser-assisted liposuction has a statistically significant effect on skin shrinkage and tightening of the skin in the abdominal area when compared to liposuction alone.