Laser Lipolysis: Current Practices

Ex vivo laser lipolysis assisted with radially diffusing optical applicator

Laser-assisted lipolysis has been implemented to reduce body fat in light of thermal interactions with adipose tissue. However, using a flat fiber with high irradiance often needs rapid cannula movements and even undesirable thermal injury due to direct tissue contact. The aim of the current study was to explore the feasibility of a radially diffusing optical applicator to liquefy the adipose tissue for effective laser lipolysis. The proposed diffuser was evaluated with a flat fiber in terms of temperature elevation and tissue liquefaction after laser lipolysis with a 980-nm wavelength. Given the same power (20 W), the diffusing applicator generated a 30% slower temperature increase with a 25% lower maximum temperature (84±3.2°C in 1 min; p<0.001) in the tissue, compared with the flat fiber. Under the equivalent temperature development, the diffuser induced up to fivefold larger area of the adipose liquefaction due to radial light emission than the flat fiber. Ex vivo tissue tests for 5-min irradiation demonstrated that the diffuser (1.24±0.15  g) liquefied 66% more adipose tissue than the flat fiber (0.75±0.05  g). The proposed diffusing applicator can be a feasible therapeutic device for laser lipolysis due to low temperature development and wide coverage of thermal treatment.

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.

Preliminary experience in facial and body contouring with 1444 nm micropulsed Nd:YAG laser-assisted lipolysis: A review of 24 cases

BACKGROUND AND AIMS

Near-infrared laser-assisted lipolysis has claimed attention recently as a fast, safe and effective way to remove unwanted fat from various areas of the body. Removal of fat from the face has however proved more difficult. A novel 1444 nm line of the micropulsed Nd:YAG has recently been developed, offering superior duality of absorption in both fat and water. The present preliminary study was designed to assess the efficacy of the 1444 nm wavelength in facial and body contouring.

SUBJECTS AND METHODS

Twenty-four informed and consenting female patients (ages ranging from 23 yr to 59 yr, mean age 32.38 ± 7.26 yrs) were recruited into the study. The laser used was a micropulsed 1444 nm Nd:YAG system. Following tumescent anesthesia, the tip of the optical fiber was placed in the subcutaneous fat via a cannula inserted through a small puncture wound, and lasing was commenced while the tissue over the end of the optical fiber was continuously palpated to check for excessive heat formation. Cold compresses were applied post-lasing. Patients were followed for at least 2 months with clinical photography at baseline, immediately post-treatment and at subsequent assessment points.

RESULTS

All patients successfully completed the study. Patient subjective satisfaction was high, and an objective clinician assessment from the clinical photography showed good efficacy. There were no major adverse side effects. Minor side effects were transitory, all resolved spontaneously and good results were maintained during a 2-3-month follow-up.

CONCLUSIONS

The present study showed high efficacy for the 100 μs micropulsed Nd:YAG laser at 1444 nm for laser-assisted lipolysis of both body and facial areas, with no adverse side effects and virtually no downtime. The high absorption rate of 1444 nm in both fat and water, coupled with the 100 μs pulse, was believed to contribute highly to the success of the study and the satisfaction of the patients. Further larger studies are warranted.

Complications from laser-assisted liposuction performed by noncore practitioners

Liposuction is one of the most commonly performed aesthetic surgery procedures in the United States, and most plastic surgeons perform suction-assisted, ultrasound-assisted, or power-assisted liposuction. The past decade has seen a growing interest in laser-assisted liposuction (LAL) and the proposed advantages of traditional liposuction methods. However, it is performed by a minority of plastic surgeons. In fact, many LAL providers are not trained in aesthetic practice, and many offer LAL as their only body-contouring procedure. When only one method of body contouring is available to a provider, it may lead to inappropriate patient selection with associated poor outcomes. This report discusses the use of laser liposuction in body contouring and the demographics of those performing liposuction, including LAL. Complications from laser-assisted liposuction performed by noncore practitioners are illustrated.

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

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