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Ramot Y, Karakuz V, Willenz EP, Alon T, Barzilai DZ, Beer O, Nyska A. Comprehensive Evaluation of the BeShape One Device: Assessing Thermal Safety in Noninvasive Body Contouring Using Advanced Techniques. Lasers Surg Med 2024; 56:581-591. [PMID: 38888133 DOI: 10.1002/lsm.23818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 06/05/2024] [Accepted: 06/05/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVES This study aims to assess the thermal safety profile of the BeShape One Device, a noninvasive, high-intensity, non-focused ultrasound device designed for reducing waist circumference. This device possesses several features that distinguish it from other commercial ultrasound-based fat reduction devices. The study focuses on evaluating temperature-related physiological changes through thermal safety analysis and histopathology in a swine model. MATERIALS AND METHODS The study utilized three types of applicators-active, demo, and modified-to comprehensively assess the device's impact on various skin layers. Five female Large White X Landrace swine were involved in the study, and the BeShape One Device was applied to designated treatment sites using a specific treatment protocol. The assessment included clinical observations, skin reaction evaluations, gross pathology, histopathological analyses, and advanced temperature measurement techniques, including needle thermocouples, thermal cameras, COMSOL modeling, and CEM43 analysis. RESULTS Clinical observations indicated the animals' overall well-being throughout the study. Skin reactions, including erythema, edema, bruising, and crust formation, were temporary and resolved over time. Gross pathology revealed no treatment-related pathologies, except for a discoloration related to a tattoo procedure. Histopathological analyses at 30 and 90 days posttreatment demonstrated an absence of heat-related lesions in skin layers. Needle thermocouples and thermal camera measurements supported the device's ability to maintain consistent thermal homogeneity. COMSOL modeling and CEM43 analysis predicted no thermal damage to the skin, confirming the safety of the BeShape One Device. CONCLUSIONS Under the experimental conditions, the BeShape One Device demonstrated a favorable safety profile. Clinically and histopathologically, no adverse effects were observed. The device's ability to achieve thermal homogeneity in skin layers was validated through advanced temperature measurement techniques. COMSOL modeling and CEM43 analysis further supported the conclusion that the device is safe, making it a promising option for noninvasive body contouring procedures.
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Affiliation(s)
- Yuval Ramot
- Department of Dermatology, Hadassah Medical Center, Jerusalem, Israel
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Ehud P Willenz
- Pre-Clinical R&D Department, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel
| | - Tal Alon
- Pre-Clinical R&D Department, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel
| | | | - Oren Beer
- Pre-Clinical R&D Department, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel
| | - Abraham Nyska
- Consultant in Toxicologic Pathology, Tel Aviv University, Tel Aviv, Israel
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2
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Al-Jumaily AM, Liaquat H, Paul S. Focused Ultrasound for Dermal Applications. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:8-17. [PMID: 37806924 DOI: 10.1016/j.ultrasmedbio.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/03/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023]
Abstract
Focused ultrasound (FUS) is emerging as one of the most promising, non-invasive treatment techniques. The advancement of transducer technology has paved the way for dermatological applications. A comprehensive review is presented for healthcare practitioners and researchers, summarizing the effect of various operational parameters on the injury zone produced by ultrasound beams for various dermatological applications, which include skin tightening, fat reduction, hyperpigmentation and cancer treatment. In this article, we aim to highlight the efficient operational parameters of FUS to enhance pain relief during surgery and its affordability for skin treatment. Finally, a prospective future technique for efficient FUS is discussed.
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Affiliation(s)
- Ahmed M Al-Jumaily
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand.
| | - Hassan Liaquat
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand
| | - Sharad Paul
- University of Auckland, Auckland, New Zealand
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Filippou A, Damianou C. Experimental evaluation of high intensity focused ultrasound for fat reduction of ex vivo porcine adipose tissue. J Ultrasound 2022; 25:815-825. [PMID: 35106735 PMCID: PMC9705658 DOI: 10.1007/s40477-022-00663-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/12/2022] [Indexed: 10/19/2022] Open
Abstract
PURPOSE The present study was stimulated by the continuous growth of commercially available high intensity focused ultrasound (HIFU) systems for fat reduction. Herein, HIFU was utilised for fat ablation using a single-element ultrasonic transducer operating in thermal mode. METHODS The custom-made concave transducer that operates at 1.1 MHz was assessed on excised porcine adipose tissue for its ability to reduce fat. Ultrasonic sonications were executed on the adipose tissue utilising acoustical power between 14 and 75 W and sonication time in the range of 1-10 min. The mass of the adipose tissue sample was weighed afore and after ultrasonic sonications and the effect of the sonication on the mass change was recorded. RESULTS Mass change was linearly dependent with either increasing acoustical power or sonication time and was in the range of 0.46-1.9 g. High acoustical power of 62.5 W for a sonication time of 1 min and a power of 75 W for a sonication time of 5 min, respectively resulted in the formation of a lesion or possible cavitation on the piece of excised adipose tissue. CONCLUSION The study demonstrated the efficacy of the proposed transducer in achieving a reduction of excised fat tissue. The present findings indicate the potential use of the transducer in a HIFU system indicated for the reduction of subcutaneous adipose tissue where increased values of acoustical power can result in increased amounts of fat reduction.
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Affiliation(s)
- Antria Filippou
- Department of Electrical Engineering, Computer Engineering and Informatics, Cyprus University of Technology, 30 Archbishop Kyprianou Street, 3036, Limassol, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering and Informatics, Cyprus University of Technology, 30 Archbishop Kyprianou Street, 3036, Limassol, Cyprus.
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Siddique Z, Malik AU. Fruits and vegetables are the major source of food safety issues need to overcome at household level (traditional vs. green technologies): A comparative review. J Food Saf 2022. [DOI: 10.1111/jfs.13003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Zarghona Siddique
- Postharvest Research and Training Centre, Institute of Horticultural Sciences University of Agriculture Faisalabad Pakistan
| | - Aman Ullah Malik
- Postharvest Research and Training Centre, Institute of Horticultural Sciences University of Agriculture Faisalabad Pakistan
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5
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Bader KB, Makin IRS, Abramowicz JS. Ultrasound for Aesthetic Applications: A Review of Biophysical Mechanisms and Safety. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:1597-1607. [PMID: 34709673 DOI: 10.1002/jum.15856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/28/2021] [Accepted: 10/02/2021] [Indexed: 06/13/2023]
Abstract
Aesthetic ultrasound is used for fat reduction and to improve skin appearance. In this review, the fundamental mechanisms by which ultrasound can alter tissue are outlined. The technologies that are commercially available or under development are discussed. Finally, recommendations are made for safe and effective use of aesthetic ultrasound.
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Affiliation(s)
- Kenneth B Bader
- Department of Radiology, University of Chicago, Chicago, Illinois, USA
| | - Inder Raj S Makin
- School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, Arizona, USA
| | - Jacques S Abramowicz
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, USA
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Har-Shai L, Ofek SE, Cohen S, Cohen KH, Yaacobi DS, Olshinka A, Dibbs RP, Ad-El DD. Israeli Innovations in the Field of Plastic Surgery. Semin Plast Surg 2022; 36:55-65. [DOI: 10.1055/s-0042-1748916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractNumerous innovations within the field of plastic surgery have been developed in Israel over the last few decades. Many of these therapeutic devices and techniques have been established globally with demonstrable efficacy and respectable safety profiles. This article offers an overview of recent Israeli cutting-edge medical therapeutic solutions contributing to the global practice of plastic surgery.
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Affiliation(s)
- Lior Har-Shai
- Department of Reconstructive Plastic Surgery & Burns, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sar-El Ofek
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Stav Cohen
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Keren H. Cohen
- Department of Reconstructive Plastic Surgery & Burns, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dafna Shilo Yaacobi
- Department of Reconstructive Plastic Surgery & Burns, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Asaf Olshinka
- Department of Reconstructive Plastic Surgery & Burns, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rami P. Dibbs
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine. Houston, Texas
| | - Dean D. Ad-El
- Department of Reconstructive Plastic Surgery & Burns, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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7
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Abdel-Aal NM, Mostafa MSEM, Saweres JW, Ghait RS. Cavitation and radiofrequency versus cryolipolysis on leptin regulation in central obese subjects: A randomized controlled study. Lasers Surg Med 2022; 54:955-963. [PMID: 35481595 DOI: 10.1002/lsm.23555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 03/18/2022] [Accepted: 04/11/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVE To investigate the efficacy of adding ultrasound cavitation and radiofrequency versus cryolipolysis to weight reduction program on leptin, insulin, waist circumference, skinfold, body weight in central obese subjects. MATERIAL AND METHODS Sixty centrally obese participants were randomly allocated into three equal groups. Subjects in the study group (I) received cavitation and radiofrequency plus dietary regimen, subjects in the second study group (II) received cryolipolysis in conjunction with the same diet program, and subjects in the control group (III) received the same dietary regimen only. Leptin, insulin level, waist circumference, skinfold, body weight, and body mass index were measured shortly before intervention techniques and 3 months afterward. RESULTS There were no statistically significant differences between cavitation plus radiofrequency and cryolipolysis on leptin and insulin levels after 3 months of intervention. However, statistically significant differences were found in waist circumference, skinfold, weight reduction, and body mass index in favor of the cavitation group (p < 0.05). In addition, both cavitation-radiofrequency and cryolipolysis were statistically significantly different than the diet alone in favor of the study groups (p < 0.05) in all the outcome measures. Furthermore, there were statistically significant differences in all outcome measures (p < 0.05) when comparing the baseline and postintervention results in each group except for leptin level in the diet group (p = 0.14). CONCLUSION Subjects who underwent cavitation plus radiofrequency had better improvement on waist circumference, skinfold, and body mass index than subjects who received cryolipolysis. However, no differences were found between cavitation plus radiofrequency and cryolipolysis on leptin and insulin levels.
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Affiliation(s)
- Nabil M Abdel-Aal
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Dokki, Giza, Egypt
| | - Mohamed S E M Mostafa
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Dokki, Giza, Egypt.,Basic Science Department, Faculty of Physical Therapy, Heliopolis University, Cairo, Egypt
| | - Joseph W Saweres
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Dokki, Giza, Egypt
| | - Ramy S Ghait
- Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Murgia RD, Noell C, Weiss M, Weiss R. Body contouring for fat and muscle in aesthetics: Review and debate. Clin Dermatol 2022; 40:29-34. [DOI: 10.1016/j.clindermatol.2021.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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9
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Kwon HH, Yang SH, Choi M, Jung JY, Park GH. Tightening and Reduction of Unwanted Submental Fat Using Triple-Layer High-Intensity Focused Ultrasound: Clinical and 3-Dimensional Imaging Analysis. Dermatol Surg 2021; 47:1595-1600. [PMID: 34608087 DOI: 10.1097/dss.0000000000003241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Unwanted submental fat (SMF) is aesthetically unappealing, but methods of reduction are either invasive or lack evidence of their use. OBJECTIVE The authors sought to evaluate the safety and efficacy of a novel triple-layer high-intensity focused ultrasound (HIFU) regimen for SMF reduction. METHODS Forty Korean subjects with moderate/severe SMF were evaluated after receiving a session of triple-layer HIFU treatments (using 3.0-, 4.5-, and 6.0-mm focusing transducers). The objective evaluation based on the 5-point Clinician-Reported Submental Fat Rating Scale (CR-SMFRS) and patients' satisfaction based on the 7-point Subject Self-Rating Scale (SSRS) were determined 8 weeks after treatment. Three-dimensional image analysis was also performed. RESULTS At the follow-up visit, the proportion of treatment responders defined as subjects with ≥1-point improvement in CR-SMFRS was 62.5%, and the proportion of patients satisfied with appearance of their face and chin (score ≥4 on the SSRS) was 67.5% of the total patients. The results of 3-dimensional analysis were consistent with clinical observations. Only mild and transient side effects were observed for some patients with no serious adverse effects. CONCLUSION The triple-layer HIFU regimen including the novel 6.0-mm transducer has benefits for tightening and rejuvenation of the area with unwanted SMF, showing reasonable safety profiles.
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Affiliation(s)
| | | | - Mira Choi
- Department of Dermatology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | | | - Gyeong-Hun Park
- Department of Dermatology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
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Taha MM, Aneis YM, Mohamady HM, S. A. A, Elsayed SH. Effect of focused ultrasound cavitation augmented with aerobic exercise on abdominal and intrahepatic fat in patients with non-alcoholic fatty liver disease: A randomized controlled trial. PLoS One 2021; 16:e0250337. [PMID: 33909662 PMCID: PMC8081198 DOI: 10.1371/journal.pone.0250337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 04/02/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES The study aimed to examine the effect of focused ultrasound cavitation augmented with aerobic exercise on localized abdominal and intrahepatic fat in fatty liver patients. METHODS 34 fatty liver patients aged 30-45 with a body mass index (BMI) of 30-40 kg/m2 were randomly assigned into two equally numbered groups. Group A received focused ultrasound cavitation and moderate aerobic exercise for three months, while Group B (control group) received moderate aerobic exercise only. Abdominal subcutaneous fat volume, visceral fat volume, liver-to-spleen ratio (L/S ratio), body weight, BMI, and waist circumference were measured both before and after the study period. RESULTS Both groups showed significant improvements in subcutaneous fat volume, visceral fat volume, body weight, BMI, and waist circumference relative to baseline where (P < 0.001), with a higher percentage in group A. L/S ratio only showed a significant improvement in group A. Between-group differences were noteworthy regarding L/S ratio and waist circumference where (P < 0.0001). CONCLUSION While substantial risky measures in non-alcoholic fatty liver disease have been modified by aerobic exercise, its combination with focused ultrasound cavitation causes more notable effects on the reduction of abdominal and intrahepatic fat, making it a superior option. TRIAL REGISTRATION ClinicalTrials.gov: NCT04161703.
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Affiliation(s)
- Mona Mohamed Taha
- Department of Rehabilitation, College Of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
- Department of Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Yasser M. Aneis
- Department of Basic Science, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | | | - Alrasheedy S. A.
- Department of Internal Medicine, EL Sahel Teaching Hospital, Giza, Egypt
| | - Shereen Hamed Elsayed
- Department of Rehabilitation, College Of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
- Department of Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Hausswirth C, Marquet LA, Nesi X, Slattery K. Two Weeks of High-Intensity Interval Training in Combination With a Non-thermal Diffuse Ultrasound Device Improves Lipid Profile and Reduces Body Fat Percentage in Overweight Women. Front Physiol 2019; 10:1307. [PMID: 31695621 PMCID: PMC6818470 DOI: 10.3389/fphys.2019.01307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/30/2019] [Indexed: 02/06/2023] Open
Abstract
This study evaluated the effectiveness of an innovative strategy which combined low-frequency ultra sound (LOFU) with high-intensity interval training (HIIT) to improve physical fitness and promote body fat loss in overweight sedentary women. A placebo controlled, parallel group randomized experimental design was used to investigate the efficacy of a 2-week combined LOFU and HIIT program (3 sessions per week). Participants were allocated into either the Experimental HIIT group (HIITEXP, n = 10) or Placebo HIIT group (HIITPLA, n = 10). Baseline exercise testing (maximal oxygen uptake, lower limb strength and substrate oxidation test), dietary assessment, anthropometric measures and blood sampling were completed in week 1 and repeated in week 4 to determine changes following the program (Post-HIIT). During each training session, the HIITEXP and HIITPLA groups wore a non-thermal diffuse ultrasound belt. However, the belt was only switched on for the HIITEXP group. Delta change scores were calculated for body weight, body fat percentage (Fat%), muscle mass, V.O2max, hip and waist circumferences, and all lipid variables from Baseline to Post-HIIT. Statistical analysis was completed using a repeated-measures factorial analysis of variance by group (HIITPLA and HIITEXP) and time (Baseline and Post-HIIT). Results showed significant improvements in maximal oxygen uptake (HIITEXP; Baseline 24.7 ± 5.4 mL kg–1 min–1, Post-HIIT 28.1 ± 5.5 mL kg–1 min–1 and HIITPLA; Baseline 28.4 ± 5.9 mL kg–1 min–1, Post-HIIT 31.4 ± 5.5 mL kg–1 min–1) for both groups. Significant decreases in Fat% (HIITEXP; Baseline 32.7 ± 3.2%, Post-HIIT 28.9 ± 3.5% and HIITPLA; Baseline 28.9 ± 3.5%, Post-HIIT 28.9 ± 3.4% kg), waist circumference (HIITEXP; Baseline 95.8 ± 9.6 cm, Post-HIIT 89.3 ± 8.9 cm and HIITPLA; Baseline 104.3 ± 3.5 cm, Post-HIIT 103.6 ± 3.4 cm) and triglycerides (HIITEXP; −29.2%, HIITPLA; −6.7%) were observed in the HIITEXP group only. These results show that HIIT combined with LOFU was an effective intervention to improve body composition, lipid profile, and fitness. This combined strategy allowed overweight, sedentary women to achieve positive health outcomes in as little as 2 weeks.
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Affiliation(s)
- Christophe Hausswirth
- Laboratoire Motricité Humaine Expertise Sport Santé, University of Côte d'Azur, Nice, France.,BeScored Institute, Sophia Antipolis, France.,Human Performance Research Centre, University of Technology Sydney, Ultimo, NSW, Australia
| | | | - Xavier Nesi
- BeScored Institute, Sophia Antipolis, France
| | - Katie Slattery
- Human Performance Research Centre, University of Technology Sydney, Ultimo, NSW, Australia
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12
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A Review of the Use of Ultrasound for Skin Tightening, Body Contouring, and Cellulite Reduction in Dermatology. Dermatol Surg 2018; 44:949-963. [DOI: 10.1097/dss.0000000000001551] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Canela VC, Crivelaro CN, Ferla LZ, Pelozo GM, Azevedo J, Liebano RE, Nogueira C, Guidi RM, Grecco C, Sant’Ana E. Synergistic effects of Combined Therapy: nonfocused ultrasound plus Aussie current for noninvasive body contouring. Clin Cosmet Investig Dermatol 2018; 11:203-212. [PMID: 29731654 PMCID: PMC5927144 DOI: 10.2147/ccid.s157782] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Nowadays, there are several noninvasive technologies being used for improving of body contouring. The objectives of this pilot study were to verify the effectiveness of the Heccus® device, emphasizing the synergism between nonfocused ultrasound plus Aussie current in the improvement of body contour, and to determine if the association of this therapy with whole-body vibration exercises can have additional positive effects in the results of the treatments. SUBJECTS AND METHODS Twenty healthy women aged 20-40 years participated in the study. Ten patients received Combined Therapy treatment (G1) and the other 10 participants received Combined Therapy with additional vibratory platform treatment (G2). Anthropometric and standardized photography analysis, ultrasonography, cutometry and self-adminestered questionnaires of tolerance and satisfaction levels with the treatment were used. RESULTS Compared with baseline values, reduction of fat thickness was observed by ultrasonography in the posterior thigh area in the G1 group (P<0.05) and in the buttocks (P<0.05) and the posterior thigh areas (P<0.05) in the G2. All the treated areas in both groups showed reduction in cellulite degree in the buttocks, G1 (P<0.05) and G2 (P<0.05), and in posterior thigh areas, G1 (P<0.05) and G2 (P<0.05). Optimal improvement of skin firmness (G1, P<0.0001; G2, P=0.0034) in the treated areas was observed in both groups. CONCLUSION We conclude that the synergistic effects of the Combined Therapy (nonfocused ultrasound plus Aussie current) might be a good option with noninvasive body contouring treatment for improving the aspect of the cellulite, skin firmness and localized fat. If used in association with the whole-body vibratory platform, the results can be better, especially in the treatment of localized fat. Further studies with larger sample size should be performed to confirm these results.
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Affiliation(s)
| | | | | | | | - Juliana Azevedo
- CDE Medical Imaging Department, Brazilian College of Radiology (CBR), Amparo, SP, Brazil
| | - Richard Eloin Liebano
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Caroline Nogueira
- Research, Development and Innovation Department, Ibramed Research Group (IRG), IBRAMED, Amparo, SP, Brazil
- Biomedical Engineering Department, Faculty of Electrical Engineering and Computing, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Renata Michelini Guidi
- Research, Development and Innovation Department, Ibramed Research Group (IRG), IBRAMED, Amparo, SP, Brazil
- Biomedical Engineering Department, Faculty of Electrical Engineering and Computing, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Clóvis Grecco
- Research, Development and Innovation Department, Ibramed Research Group (IRG), IBRAMED, Amparo, SP, Brazil
| | - Estela Sant’Ana
- Research, Development and Innovation Department, Ibramed Research Group (IRG), IBRAMED, Amparo, SP, Brazil
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Gold MH, Coleman WP, Coleman W, Weiss R. A randomized, controlled multicenter study evaluating focused ultrasound treatment for fat reduction in the flanks. J COSMET LASER THER 2018. [PMID: 29533112 DOI: 10.1080/14764172.2018.1444778] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Energy-based cosmetic devices offer an in-office treatment option, with minimal downtime, to non-invasively remove unwanted fat. We evaluated focused, pulsed ultrasound treatment to randomized flanks, compared to corresponding non-treated contralateral flanks. MATERIAL AND METHODS Subjects were enrolled at three sites for a series of focused ultrasound treatments to a single flank, with the contralateral flank remaining untreated throughout the study. Success criteria included measureable fat thickness reduction on ultrasound imaging in the treated areas at 16 weeks after the final treatment session, and correct identification of the post-treatment photo and treated flank in at least 80% of evaluated images, as assessed by two blinded evaluators. RESULTS The post-treatment flank photo and treated flank side were correctly identified in 82% and 93% of cases, respectively. All study subjects demonstrated significant fat reduction in their treated area, as measured by ultrasound and skin caliper. Subjects expressed a high satisfaction from treatment outcomes. There were no complications with treatment. CONCLUSION A series of three ultrasound treatments resulted in significant fat reduction in treated flanks. Although treatment results are more modest than with liposuction, non-invasive ultrasound treatment may provide an attractive alternative for patients seeking an in-office, nonsurgical procedure for fat reduction.
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Affiliation(s)
- Michael H Gold
- a Tennessee Clinical Research Center , Nashville , TN , USA
| | - W Patrick Coleman
- b Coleman Center for Cosmetic Dermatologic Surgery , Metairie , LA , USA
| | - William Coleman
- b Coleman Center for Cosmetic Dermatologic Surgery , Metairie , LA , USA
| | - Robert Weiss
- c Maryland Dermatology Laser, Skin, & Vein Institute , Hunt Valley , MD , USA
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15
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Ferrando G. Safety, tolerability, and efficacy evaluation of the SlimME device for circumference reduction. Lasers Surg Med 2018; 50:745-754. [PMID: 29411402 PMCID: PMC6120542 DOI: 10.1002/lsm.22796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the short- and long-term thermal impact of subclinical and clinical regimens of a single, non-invasive uniform ultrasound treatment session on subcutaneous adipose tissue (SAT). STUDY DESIGN Prospective, open-label, single-arm, split-side study. METHODS Patients (n = 17) were subjected to uniform ultrasound treatment, delivered in a single session with the SlimME device. The device was set to one of four treatment regimens, which differed in their durations and energy fluences during the raise and maintenance phases. Up to six abdominal regions were treated, with six patients receiving a different treatment on each side of the abdomen. Safety was assessed by measuring skin surface temperature, evaluating expected skin responses immediately and 30 min after treatment and via patient ratings of pain and discomfort. Efficacy of raising and then maintaining SAT temperatures at 48°C, was determined by routinely measuring SAT temperatures during the treatment session and by histological analysis of samples collected 7 (n = 13) or 90 (n = 4) days after treatment. RESULTS Trace to mild erythema was observed in up to 48% of the treated zones, which, in most cases, resolved within 30 minutes. No significant rise in mean skin surface temperature (≤26.5°C) was recorded following any of the four tested regimens. Overall, patients reported tolerability to treatment, with the highest mean pain score registered for the moderate and high intensity regimens (4.4 ± 1.5 and 4.9 ± 1.4, respectively). Mean SAT temperatures did not exceed 48.4 ± 2.5°C and were effectively maintained throughout the maintenance phase of the treatment session. Low-energy fluence led to localized fat coagulative necrotic lesions, surrounded by subacute rim of inflammation, while high-energy fluence induced fat coagulative necrosis alongside granulomatous panniculitis, which resolved within 90 days. CONCLUSION The tested uniform ultrasound regimens elicited SAT temperature elevations, with a subsequent energy-dependent increase in degree of fat necrosis. At the same time, the unique design spared the surrounding tissue from thermal damage and was associated with minimal discomfort. Taken together, the SlimME device constitutes an effective tool for destruction of stubborn hypodermal fat deposits. Lasers Surg. Med. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Giovanni Ferrando
- Queen Anne Street Medical Centre18‐22 Queen Anne StMarylebone W1G 8HULondon
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Development of an Omnidirectional-Capable Electromagnetic Shock Wave Generator for Lipolysis. JOURNAL OF HEALTHCARE ENGINEERING 2017; 2017:9258512. [PMID: 29065664 PMCID: PMC5463193 DOI: 10.1155/2017/9258512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 03/18/2017] [Accepted: 04/09/2017] [Indexed: 11/17/2022]
Abstract
Traditional methods for adipose tissue removal have progressed from invasive methods such as liposuction to more modern methods of noninvasive lipolysis. This research entails the development and evaluation of an omnidirectional-capable flat-coil electromagnetic shock wave generator (EMSWG) for lipolysis. The developed EMSWG has the advantage of omnidirectional-capable operation. This capability increases the eventual clinical usability by adding three designed supports to the aluminum disk of the EMSWG to allow omnidirectional operation. The focal pressures of the developed EMSWG for different operating voltages were measured, and its corresponding energy intensities were calculated. The developed EMSWG was mounted in a downward orientation for lipolysis and evaluated as proof of concept. In vitro tests on porcine fatty tissues have been carried out. It is found that at a 6 kV operating voltage with 1500 shock wave exposures, a 2 cm thick subcutaneous hypodermis of porcine fatty tissue can be ruptured, resulting in a damaged area of 1.39 mm2. At a 6.5 kV operating voltage with 2000 shock wave exposures, the damaged area is increased to about 5.20 mm2, which can be enlarged by changing the focal point location, resulting in significant lipolysis for use in clinical applications.
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Pereira JX, Cavalcante Y, Wanzeler de Oliveira R. The role of inflammation in adipocytolytic nonsurgical esthetic procedures for body contouring. Clin Cosmet Investig Dermatol 2017; 10:57-66. [PMID: 28260937 PMCID: PMC5327851 DOI: 10.2147/ccid.s125580] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background The adipocytolytic non-surgical esthetic procedures are indicated for the reduction of localized fat and are effective in reducing local adiposity through the ablation of adipocytes with fast and lasting results, besides causing local inflammation. Objective This study aimed to characterize the adipocytolytic procedures and correlate the phases of the inflammatory process with the results obtained from such procedures, in order to clarify the role of inflammation triggered by the adipocytolytic procedures and its relation with the lipolytic process, with a focus on body shaping. Methods This work is an integrative literature review that presents a total of 72 articles published between 1998 and 2015, derived from the PubMed database, in order to establish a relationship between clinical and basic science research, assuming an important role in medical practice based on evidence. Results The results show that the adipocytolytic procedures are characterized by triggering inflammation arising from the disruption of adipocytes by interfering with the lipolytic signaling pathways in both acute and chronic phases of inflammation through the direct action of proinflammatory cytokines or catecholamines. Therefore, inflammation plays an important role in modulating the lipolytic process, influencing body shaping. Conclusion The inflammatory process assists the adipolytic process in all stages of inflammation, contributing to the reduction of body contouring.
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Coleman WP, Coleman W, Weiss RA, Kenkel JM, Ad-El DD, Amir R. A Multicenter Controlled Study to Evaluate Multiple Treatments With Nonthermal Focused Ultrasound for Noninvasive Fat Reduction. Dermatol Surg 2017; 43:50-57. [PMID: 28009680 DOI: 10.1097/dss.0000000000000918] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Demand for nonsurgical esthetic body procedures has led to the development of noninvasive techniques for reducing localized subcutaneous adipose tissue. OBJECTIVE This study assessed multiple treatments with nonthermal focused ultrasound for noninvasive abdominal treatment of excess fat deposits. MATERIALS AND METHODS Subjects were randomly assigned to Group 1 for a 4-week control phase before undergoing 3 abdominal fat reduction treatments, at 2-week intervals, or to Group 2 for immediate treatment. Weight, abdominal circumference, tolerability to treatment, subject satisfaction, and adverse events were recorded. RESULTS Weight remained stable in the 126 participants. Mean reduction in midline circumference was 2.5 ± 2.1 cm in the Group 1 and 3.5 ± 2.7 cm in the Group 2 at Week 22. The effect of multiple treatments was cumulative with a steady decrease in abdominal circumferences during the study. Erythema was observed in 28% of treatments but was mild and transient in nature. Subjects tolerated the treatments well and were satisfied with treatment outcome. CONCLUSION The study demonstrated the efficacy and safety of multiple nonthermal focused ultrasound treatments of excess abdominal fat deposits. Although the remodeling effect is minor compared with traditional surgical procedures, successive focused ultrasound treatments significantly reduced treatment area circumference, while avoiding invasive techniques and their associated disadvantages.
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Affiliation(s)
- William P Coleman
- *Coleman Center for Cosmetic Dermatologic Surgery, Metairie, Louisiana; †Maryland Laser Skin and Vein Institute, Hunt Valley, Maryland; ‡Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, Texas; §Department of Plastic Surgery and Burns, Beilinson Hospital, Petah Tikva, Israel; ‖Syneron Medical Ltd., Yokneam, Israel
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Intralipotherapy, the State of the Art. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e1085. [PMID: 27826479 PMCID: PMC5096534 DOI: 10.1097/gox.0000000000001085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 08/23/2016] [Indexed: 11/25/2022]
Abstract
Background: Reconstruction intralipotherapy is a term commonly used in the field of aesthetic medicine, above all in Europe, which defines a specific injection technique developed for the treatment of localized fat with substances that provoke the lysis of adipocytes by means of an injection directly into the adipose tissue with a long needle. The aim of this study is to define the technique in detail and everything that is associated with it, on the basis of years of multicenter experience by doctors who perform it. Materials and Methods: From January 2010 to December 2014, 3,080 European physicians were trained in intralipotherapy technique, and approximately 152,500 patients were treated. The adipocytolytic agent used is a Conformité Européene-certified device. The technique, equipment, protocol, posology, postoperative management, and adverse events are described below. Results: The intralipotherapy technique combined with the appropriate adipocytolytic agent has been shown to be effective in every zone on the average of 76.7% of the cases. The variability is due to the area treated and the patient. The standardization of the technique, homogeneity of the protocol, and the posttreatment management have been essential for standardizing the results and minimizing any adverse events. The latter occurred only in a small percentage of the cases, while those more serious have been extremely rare. Conclusion: This study shows how the intralipotherapic technique, when performed properly with an appropriate adipocytolytic device and when proper precautions are taken, can be effective and safe for reducing undesirable subcutaneous fat deposits.
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Lee HJ, Lee MH, Lee SG, Yeo UC, Chang SE. Evaluation of a novel device, high-intensity focused ultrasound with a contact cooling for subcutaneous fat reduction. Lasers Surg Med 2016; 48:878-886. [DOI: 10.1002/lsm.22576] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2016] [Indexed: 12/25/2022]
Affiliation(s)
- Heun Joo Lee
- Department of Dermatology, Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - Mi-Hye Lee
- Department of Dermatology, Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - Su Gun Lee
- Department of Biomedical Engineering; Jeju National University; Jeju Korea
| | | | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
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Long-term follow-up for noninvasive body contouring treatment in Asians. Lasers Med Sci 2015; 31:283-7. [PMID: 26714982 DOI: 10.1007/s10103-015-1852-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 12/08/2015] [Indexed: 10/22/2022]
Abstract
There are versatile modalities to achieve noninvasive fat reduction, and most of them have proven to be effective for circumferential reduction of local fat tissue, without any serious or permanent adverse effects. However, the follow-up time is short, ranging from 1 to 24 weeks. Most of the patients would like to know how long will its effect last and whether there is long-term side effect or not. The aim of this study was to assess the long-term efficacy and safety of combination therapy of focused ultrasound and radio frequency for noninvasive body contouring. Thirty-two Asian subjects received three sequential combination therapies of focused ultrasound and radio-frequency treatments every 2 weeks in the abdominal region and were followed up 1 month and 1 year after the last treatment. After a year, 5 patients were loss follow-up and 2 were pregnant. Finally, 25 healthy Asian subjects (18 females and 7 males) were enrolled in this study. Safety parameters and adverse events were recorded. The mean body weight change remained constant without a significant change 1 year after treatment and was 0.1 ± 1.2 kg (p = 0.513). The mean abdominal circumference change between 1 month and 1 year after the last treatment was 0.4 ± 1.2 cm and was not significant (p = 0.169). The relationships between weight change and circumference change of the 23 patients were tested using Spearman's rho correlation coefficient. There was a correlation between weight change and circumference change (0.73; p = 0.000). The procedure was safe without a recordable long-term adverse event. The combination therapies of nonthermally focused ultrasound and radio-frequency treatments for body contouring in the abdominal region are effective and may show positive results for at least a year if patients can maintain their body weight. The procedure is safe without recordable long-term adverse events in this study.
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Abstract
In our contemporary postmodern society, a modified perception of the human body is accompanied by an increasing demand for body shaping procedures. The treatment needs to be effective but it is just as important that they are safe and can be easily integrated into the daily working and routine schedule. While the options for minimally invasive volume addition are largely limited to injectable implants based on hyaluronic acid or autologous fat, a multitude of options are available for volume reduction. Before deciding on the method of choice, the following needs to be considered: which indications need to be treated, the extent of the reduction in volume and how much pain and possible undesired reactions the patient is prepared to accept.
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Affiliation(s)
- N Krüger
- Rosenpark Research, Wilhelminenstraße 13, 64283, Darmstadt, Deutschland.
| | - S Lübberding
- Rosenpark Research, Wilhelminenstraße 13, 64283, Darmstadt, Deutschland
| | - G Sattler
- Rosenpark Research, Wilhelminenstraße 13, 64283, Darmstadt, Deutschland
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The efficacy of a combination non-thermal focused ultrasound and radiofrequency device for noninvasive body contouring in Asians. Lasers Surg Med 2015; 48:203-7. [DOI: 10.1002/lsm.22406] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2015] [Indexed: 11/07/2022]
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Mahmoud ELdesoky MT, Mohamed Abutaleb EEL, Mohamed Mousa GS. Ultrasound cavitation versus cryolipolysis for non-invasive body contouring. Australas J Dermatol 2015; 57:288-293. [DOI: 10.1111/ajd.12386] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 07/23/2015] [Indexed: 01/09/2023]
Affiliation(s)
| | | | - Gihan Samir Mohamed Mousa
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics; Faculty of Physical Therapy; Cairo University; Cairo Egypt
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Moravvej H, Akbari Z, Mohammadian S, Razzaghi Z. Focused Ultrasound Lipolysis in the Treatment of Abdominal Cellulite: An Open-Label Study. J Lasers Med Sci 2015; 6:102-5. [PMID: 26464776 DOI: 10.15171/jlms.2015.02] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Despite a growing popularity of noninvasive ultrasonic lipolysis procedure, there is a lack of evidence about the efficacy of this method. This study was performed to evaluate the efficacy of focused ultrasonic lipolysis on abdominal cellulite treatment. METHODS Twenty-eight consecutive subjects (age: 37.8 ± 8 years) underwent weekly transdermal focused ultrasonic lipolysis (Med Contour, General Project Ltd., Florence, Italy) and vacuum drainage for a maximum of eight sessions. Largest abdominal girth and 2 lines at 4 cm to 7 cm distance above and under it were located as fixed points of measurements. The mean value of the three fixed lines was considered as the abdominal circumference. Subjects were evaluated using measurements of circumference, immediately after and 3 weeks after the final treatment and compared using paired t test. RESULTS One hundred ninety-four ultrasonic lipolysis procedures were performed on 28 subjects. A statistically significant (P < .001) average of 1.89 cm (95% CI: 1.63-2.02 cm) decrease of circumference value was observed in each session of ultrasonic lipolysis. The mean pretreatment to posttreatment circumference reduction was 8.21 cm (95% CI: 6.38-10.04, P < .001) that declined to 7 cm (95% CI: 3.2-10.8, P < .001) at the 3-month follow-up visit. CONCLUSION Focused ultrasonic lipolysis appears to be an effective method for reduction of abdominal cellulite, although some amount of circumference reduction reversal may be observed in long term follow-up visit.
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Affiliation(s)
- Hamideh Moravvej
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Akbari
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahrzad Mohammadian
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Razzaghi
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Abstract
The demand for body contouring is rapidly increasing, and interest in noninvasive approaches has also grown. The author reviewed the evidence base behind the currently available devices and methods for nonsurgical body contouring. There is little high-level evidence in the present literature to support the effectiveness of any of these devices.
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Affiliation(s)
- Reza Nassab
- Dr Nassab is a Locum Consultant in Plastic Surgery, Countess of Chester Hospital, Chester, United Kingdom
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Tonucci LB, Mourão DM, Ribeiro AQ, Bressan J. Noninvasive body contouring: biological and aesthetic effects of low-frequency, low-intensity ultrasound device. Aesthetic Plast Surg 2014; 38:959-67. [PMID: 25192747 DOI: 10.1007/s00266-014-0391-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 07/18/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recent advancements in body-contouring techniques have prompted the investigation of ultrasound (US) technology as a potential noninvasive alternative for nonobese subjects for lifting, tightening, and reducing small areas of unwanted fat. This prospective study aimed to evaluate the biological and aesthetic effects of a low-frequency, low-intensity US device in reducing localized fat deposits for improving the body contours. METHODS A total of 20 female subjects included in this study were subjected to low-frequency US in the abdomen area. The effectiveness of this technique was determined by measuring changes in the anthropometric measurements and body composition, photographs, and a Client Satisfaction Questionnaire. The safety of the technique for application was determined by assessing the clinical features and biochemical tests results. RESULTS After five US sessions, a significant mean reduction of 1.5, 2.1, and 1.9 cm was noted in the waist, abdominal, and umbilical circumferences, respectively. No significant changes were noted in the levels of free fatty acids, insulin, liver enzymes, or lipid profile. However, a significant increase in the fasting glucose level was noted. However, four adverse side effects were reported: mild burning or discomfort, tingling or unilateral numbness in the lower limbs, pain around the bony areas, and soreness in the abdomen. CONCLUSION The low-frequency, low-intensity US device provides reduction in the abdominal region with a moderate level of satisfaction. However, more studies are required to assess the effectiveness of US for body contouring and its effect on glucose metabolism.
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Affiliation(s)
- Livia Bordalo Tonucci
- Department of Nutrition and Health, Federal University of Viçosa, Av. PH Rolfs, s/n, Campus UVF, CCB II, Viçosa, Minas Gerais, 36.570-000, Brazil,
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Milanese C, Cavedon V, Piscitelli F, Zancanaro C. Effect of low-intensity, low-frequency ultrasound treatment on anthropometry, subcutaneous adipose tissue, and body composition of young normal weight females. J Cosmet Dermatol 2014; 13:202-7. [DOI: 10.1111/jocd.12101] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Chiara Milanese
- Laboratory of Anthropometry and Body Composition; Department of Neurological and Movement Sciences; University of Verona; Verona Italy
| | - Valentina Cavedon
- Laboratory of Anthropometry and Body Composition; Department of Neurological and Movement Sciences; University of Verona; Verona Italy
| | - Francesco Piscitelli
- Laboratory of Anthropometry and Body Composition; Department of Neurological and Movement Sciences; University of Verona; Verona Italy
| | - Carlo Zancanaro
- Laboratory of Anthropometry and Body Composition; Department of Neurological and Movement Sciences; University of Verona; Verona Italy
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Use of transcutaneous ultrasound for lipolysis and skin tightening: a review. Aesthetic Plast Surg 2014; 38:429-41. [PMID: 24567045 DOI: 10.1007/s00266-014-0286-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 01/19/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED Several ultrasonic devices have recently been investigated for their ability to decrease areas of focal adiposity and tighten small areas of the skin. Studies show that ultrasound technology offers a safe, reliable, and predictable means to sculpt the body of nonobese patients, but its efficacy remains uncertain. Although most studies claim statistically significant results, the clinical significance of ultrasound technology has yet to be determined. Most studies use waist circumference measurements to determine statistical significance and efficacy. The majority of the current studies also have a relatively a short follow-up period of 3 months. More studies are needed to assess the true efficacy of ultrasound technology using more reliable measurements such as diagnostic ultrasound and computed tomography (CT) imaging and to include a follow-up period longer than 6 months to obtain more valid results. LEVEL OF EVIDENCE III 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 .
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Histological and Ultrastructural Effects of Ultrasound-induced Cavitation on Human Skin Adipose Tissue. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2013; 1:e41. [PMID: 25289235 PMCID: PMC4174158 DOI: 10.1097/gox.0b013e3182a7f222] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 07/17/2013] [Indexed: 11/26/2022]
Abstract
Background: In aesthetic medicine, the most promising techniques for noninvasive body sculpturing purposes are based on ultrasound-induced fat cavitation. Liporeductive ultrasound devices afford clinically relevant subcutaneous fat pad reduction without significant adverse reactions. This study aims at evaluating the histological and ultrastructural changes induced by ultrasound cavitation on the different cell components of human skin. Methods: Control and ultrasound-treated ex vivo abdominal full-thickness skin samples and skin biopsies from patients pretreated with or without ultrasound cavitation were studied histologically, morphometrically, and ultrastructurally to evaluate possible changes in adipocyte size and morphology. Adipocyte apoptosis and triglyceride release were also assayed. Clinical evaluation of the effects of 4 weekly ultrasound vs sham treatments was performed by plicometry. Results: Compared with the sham-treated control samples, ultrasound cavitation induced a statistically significant reduction in the size of the adipocytes (P < 0.001), the appearance of micropores and triglyceride leakage and release in the conditioned medium (P < 0.05 at 15 min), or adipose tissue interstitium, without appreciable changes in microvascular, stromal, and epidermal components and in the number of apoptotic adipocytes. Clinically, the ultrasound treatment caused a significant reduction of abdominal fat. Conclusions: This study further strengthens the current notion that noninvasive transcutaneous ultrasound cavitation is a promising and safe technology for localized reduction of fat and provides experimental evidence for its specific mechanism of action on the adipocytes.
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Friedmann DP, Mahoney L, Fabi S, Goldman MP. A Pilot Prospective Comparative Trial of High-Intensity Focused Ultrasound versus Cryolipolysis for Flank Subcutaneous Adipose Tissue and Review of the Literature. ACTA ACUST UNITED AC 2013. [DOI: 10.5992/ajcs-d-13-00001.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Introduction: Multiple treatment modalities exist for noninvasive body sculpting and reduction of focal adipose deposits, including high-intensity focused ultrasound (HIFU) and cryolipolysis. The focus of this study was to compare the efficacy of HIFU and cryolipolysis in the reduction of localized subcutaneous adipose tissue in the flank region. Materials and Methods: Eight female patients with subcutaneous adipose tissue localized to the bilateral flanks were randomized to a single treatment with either HIFU or cryolipolysis to each flank. Weight and widest-point waist circumference were recorded at baseline and at 4 monthly follow-up visits, with no significant change in weight over the study period. Two blinded investigators graded baseline and 4-month follow-up photographs for improvement using a 5-point global aesthetic improvement scale. Results and Discussion: Although both HIFU and cryolipolysis led to modest reductions in localized flank subcutaneous adipose tissue, there was a trend toward greater improvement in the HIFU treatment group.
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Halachmi S, Lapidoth M. Commentary: safety and tolerability of a focused ultrasound device for treatment of adipose tissue in subjects undergoing abdominoplasty, a placebo control pilot study. Dermatol Surg 2013; 39:752-4. [PMID: 23627808 DOI: 10.1111/dsu.12085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pugliese D, Maiorano E, Pascone M. Histopathological Features of Tissue Alterations Induced by Low Frequency Ultrasound with Cavitational Effects on Human Adipose Tissue. Int J Immunopathol Pharmacol 2013; 26:541-7. [DOI: 10.1177/039463201302600230] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Low frequency, high energy level ultrasound (US) induces physical effects on tissues called ultrasonic cavitation (UC). Endermic US therapy has recently been proposed as a method to reduce non-invasively the amount of adipose tissue. Very few published studies have dealt with the biological effects of such therapies on human adipose tissue. The aim of this study is to evaluate, through histopathological examination, the effects of various levels of ultrasonic radiation on supravital human adipose tissue. Four ex vivo human tissue samples were treated as follows: sample 1: no US radiation; sample 2: US radiation 2,5 W/cm2 for 15 minutes; sample 3: US radiation 5 W/cm2for 15 minutes; sample 4: infiltration of 30 ml physiological saline and US radiation, 5 W/cm2 for 15 minutes. For lower levels of ultrasonic energy, interruption of the adipocytic membranes was evident both in the surface and in the deeper cutaneous and subcutaneous layers, with focal dissolution and homogenization of the surface dermal fascia. For higher levels of ultrasonic energy, alterations of the adipocytes and of the collagen fibers were greater, resulting in the dissolution of the cells and of the interlobular fibrous septa. Both effects were amplified by tumescent saline infiltration. The histological lesions demonstrated in adipocytes confirm the theoretical premises of a possible usefulness in the treatment of localized adiposis. The alterations observed in the connective stroma could have positive effects on the structural re—organization and consequently on the in vivo external appearance of the treated areas.
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Affiliation(s)
- D. Pugliese
- Internal Medicine Unit, Policlinico Universitario di Bari, Bari, Italy
| | - E. Maiorano
- Department of Pathology, University of Bari, Policlinico Universitario di Bari, Bari, Italy
| | - M. Pascone
- Institute of Plastic, Aesthetic and Reconstructive Surgery, University of Bari, Policlinico Universitario di Bari, Bari, Italy
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Chang SL, Huang YL, Lee MC, Chang CH, Chung WH, Wu EH, Hu S. Combination therapy of focused ultrasound and radio-frequency for noninvasive body contouring in Asians with MRI photographic documentation. Lasers Med Sci 2013; 29:165-72. [DOI: 10.1007/s10103-013-1301-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 03/05/2013] [Indexed: 10/27/2022]
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Wassef C, Rao BK. The science of cellulite treatment and its long-term effectiveness. J COSMET LASER THER 2012; 14:50-8. [DOI: 10.3109/14764172.2012.670706] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bengtson BP, Eaves FF. High-resolution ultrasound in the detection of silicone gel breast implant shell failure: background, in vitro studies, and early clinical results. Aesthet Surg J 2012; 32:157-74. [PMID: 22328687 DOI: 10.1177/1090820x11434507] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Magnetic resonance imaging (MRI) has historically been considered the "gold standard" for imaging silicone gel breast implants and is currently recommended by the US Food and Drug Administration for device surveillance. Recent studies, however, have questioned its accuracy as the best screening test for implant failure. In addition, the high cost of MRI is a significant deterrent to follow-up, especially among asymptomatic patients. Recent advancements in ultrasound technology have led to the development of high-resolution devices with the potential to accurately image breast implants and breast tissues. OBJECTIVES The authors evaluate the feasibility of portable, high-resolution ultrasound (HRUS) for imaging of silicone gel breast implants and perform preliminary comparisons of HRUS to MRI in the assessment of both intact and failed implants in a clinical setting by both radiologists and plastic surgeons. METHODS Phase 1 was composed of in vitro and ex vivo scanning model assessments in a variety of implant models utilizing multiple HRUS hardware platforms (GE LOGIQ-9, LOGIQ-e, LOGIQ-i, and Venue-40 devices) and transducer heads (range, 8-16 MHz, mainly GE12ML transducer). In Phase 2, these technologies were applied clinically to provide imaging experience in three patients previously diagnosed with unilateral implant failure. Phase 3 was a preliminary prospective evaluation of HRUS of 29 implants in 15 consecutive patients for whom MRI and independent surgeon-performed and radiologist-performed HRUS scans were compared to subsequent surgical findings. RESULTS In Phase 1, all hardware models easily detected both intact and intentionally damaged shells in currently marketed fourth-generation responsive gel implants and in investigational, fifth-generation highly-cohesive gel devices. Although multiple transducers were able to detect shell failure, the 12-MHz head produced the best images at the normal clinical depth range. In Phase 2, confirmatory HRUS scans correctly identified the side of rupture and were consistent with MRI and surgical findings in all patients. In Phase 3, MRI, surgeon-performed HRUS, and radiologist-performed HRUS scans were all accurate in predicting implant shell integrity in 29 of 29 imaged breasts (100%) as confirmed at the time of surgery in both symptomatic and asymptomatic patients. CONCLUSIONS Preliminary results with a variety of base and transducer systems demonstrated that HRUS provides excellent visualization of current fourth- and fifth-generation silicone gel implants both in the in vitro and ex vivo scanning models. In vivo surgeon-performed HRUS accurately identified implant status and correlated with radiologist-performed HRUS, MRI, and surgical findings. An ongoing Phase 4 prospective study is under way to help define the sensitivity and specificity of HRUS technologies in the evaluation of current implant designs. However, the relative affordability, accessibility, availability, and dynamic real-time visualization provided by HRUS represent significant potential advantages of HRUS over MRI in both the screening and future diagnosis of breast implant shell failure.
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Sobanko JF, Imadojemu S, Miller CJ. Epidemiology of Cosmetic Procedures: An Update for Dermatologists. CURRENT DERMATOLOGY REPORTS 2012. [DOI: 10.1007/s13671-011-0006-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Gao Y, Gao S, Zhao B, Zhao Y, Hua X, Tan K, Liu Z. Vascular effects of microbubble-enhanced, pulsed, focused ultrasound on liver blood perfusion. ULTRASOUND IN MEDICINE & BIOLOGY 2012; 38:91-98. [PMID: 22104531 DOI: 10.1016/j.ultrasmedbio.2011.09.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Revised: 09/23/2011] [Accepted: 09/29/2011] [Indexed: 05/31/2023]
Abstract
The purpose of this study was to investigate the vascular effects of microbubble-enhanced pulsed high-pressure ultrasound on liver blood perfusion. In the presence of circulating lipid-shell microbubbles, a focused ultrasound transducer was used to transcutaneously treat eight livers of healthy rabbits for perfusion analysis and to treat three livers with the abdomen open for histologic analysis. Twenty-two livers treated with the ultrasound only (n = 11) or microbubbles only (n = 11) served as the controls. The focused ultrasound was operated at a frequency of 1.22 MHz with a peak negative pressure of 4.6 MPa. The liver blood perfusion was estimated by performing contrast-enhanced ultrasound and gray-scale quantification on the livers before and after treatment. A temporary, nonenhanced region occurred in all of the experimental livers. The regional contrast gray-scale values of the experimental group dropped significantly from 88.4 before treatment to 2.7 after treatment. The liver perfusion also demonstrated a gradual recovery over a 60-min period. The liver perfusion of the control groups remained the same after treatment. We found microvascular rupture, hemorrhage and swelling hepatocytes upon histologic examination of the experimental group. Regional liver blood perfusion can be temporarily blocked by microbubble-enhanced focused ultrasound with high-pressure amplitude. These vascular effects can be explained as acute microvascular injury of the liver and may have clinical implications.
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Affiliation(s)
- Yuejuan Gao
- Department of Ultrasound, Xinqiao Hospital, The Third Military Medical University, Chongqing, China
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Noninvasive body sculpting technologies with an emphasis on high-intensity focused ultrasound. Aesthetic Plast Surg 2011; 35:901-12. [PMID: 21461627 DOI: 10.1007/s00266-011-9700-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 03/03/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Body-sculpting procedures are becoming increasingly popular in the United States. Although surgical lipoplasty remains the most common body sculpting procedure, a demand exists for noninvasive alternatives capable of reducing focal adiposity without the risks of adverse events (AEs) associated with invasive excisional body-sculpting procedures. METHODS This report describes the mechanism of action, efficacy, safety, and tolerability of cryolipolysis, radiofrequency ablation, low-level external laser therapy, injection lipolysis, low-intensity nonthermal ultrasound, and high-intensity focused ultrasound (HIFU), with an emphasis on thermal HIFU. The articles cited were identified via a PubMed search, with additional article citations identified by manual searching of the reference lists of articles identified through the literature search. RESULTS Each of the noninvasive treatments reviewed can be administered on an outpatient basis. These treatments generally have fewer complications than lipoplasty and require little or no anesthesia or analgesia. However, HIFU is the only treatment that can produce significant results in a single treatment, and only radiofrequency, low-level laser therapy, and cryolipolysis have been approved for use in the United States. Early clinical data on HIFU support its efficacy and safety for body sculpting. In contrast, radiofrequency, laser therapy, and injection lipolysis have been associated with significant AEs. CONCLUSIONS The published literature suggests that noninvasive body-sculpting techniques such as radiofrequency ablation, cryolipolysis, external low-level lasers, laser ablation, nonthermal ultrasound, and HIFU may be appropriate options for nonobese patients requiring modest reduction of adipose tissue.
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Noninvasive Body Contouring with Radiofrequency, Ultrasound, Cryolipolysis, and Low-Level Laser Therapy. Clin Plast Surg 2011; 38:503-20, vii-iii. [DOI: 10.1016/j.cps.2011.05.002] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
Liposuction has evolved tremendously over the past three decades. Since its introduction by Illouz it has progressed into one of the most popular procedures in plastic surgery. The objective of this CME is to provide a foundation of knowledge with respect to anatomy, physiology, preoperative, intraoperative, and postoperative management of patients scheduled to undergo liposuction. A review of both the immediate and delayed complications related to liposuction is addressed, as well as relevant surgical site-specific pearls for patients undergoing liposuction. Finally a summary of the various operative techniques available for surgeons is discussed along with information related to relevant emerging technology in body contouring.
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Affiliation(s)
- Phillip J Stephan
- Department of Plastic Surgery, University of Texas Southwestern Medical Center Dallas, TX, USA
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Coleman KM, Coleman WP, Benchetrit A. Non-Invasive, External Ultrasonic Lipolysis. ACTA ACUST UNITED AC 2009; 28:263-7. [PMID: 20123426 DOI: 10.1016/j.sder.2009.10.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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