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Wang Y, Liang J, Chen Y, Xia J, Liu Y, Liu J, Li Y, Yang M, Wang Z, Zeng W. Combined microfocused ultrasound and delicate pulsed light for facial rejuvenation: A prospective, randomized, and split-face study. Lasers Surg Med 2024; 56:346-354. [PMID: 38462706 DOI: 10.1002/lsm.23777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/24/2024] [Accepted: 02/27/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVES Public's interest in noninvasive skin rejuvenation treatments continues to grow. The advantage of combination therapy lies in that it can target different aspects of skin rejuvenation. This study aimed to assess the efficacy and safety of microfocused ultrasound (MFU) combined with delicate pulsed light (DPL) for facial rejuvenation. METHODS Twenty-one patients with facial relaxation were enrolled. All patients received whole-face MFU treatment, and one side of the face was randomly assigned to receive DPL. MFU treatment was performed at Months 0 and 3, while DPL treatment was performed at Months 1, 2, 4, and 5. The length and angle of the nasolabial fold and perioral wrinkles, melanin index (MI), erythema index (EI), transepidermal water loss (TEWL), and follow-up time were recorded at Months 0, 3, and 6. Side effects were recorded during treatment and each follow-up visit. RESULTS Twenty patients successfully completed the study. At the sixth month, the average length of perioral wrinkles and nasolabial folds on the combined side decreased by 11.5% (pwithin < 0.001) and 6.5% (pwithin = 0.011), while 8.3% (pwithin = 0.012) and 3.8% (pwithin = 0.02) on the MFU side. Compared with MFU treatment alone, the combined treatment also showed significant improvements in nasolabial fold angle (from 28.8 ± 3.4° to 32.7 ± 5.0°) and perioral wrinkle angle (from 39.3 ± 5.0° to 43.7 ± 5.1°). In addition, the combined side had greater benefits than the MFU side in improving MI, EI, TEWL, and skin elasticity (pbetween < 0.05). Except for one patient who withdrew due to increased skin sensitivity after MFU treatment, other subjects did not experience permanent or serious side effects. CONCLUSIONS The combination of MFU and DPL for facial rejuvenation treatment is safe and effective. The combined treatment has better efficacy in skin firmness, and improving skin tone.
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Affiliation(s)
- Yawen Wang
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jingchen Liang
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ying Chen
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jun Xia
- Department of Dermatology, The Seventh Affiliated Hospital, SunYat-sen University, Guangzhou, China
| | - Yanting Liu
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jing Liu
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Youbao Li
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Mengyao Yang
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zhao Wang
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Weihui Zeng
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
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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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Zhu J, Han Y, Liu Y, Chang R, Gao W, Gong X, Zhu Y, Shang Y, Shen L, Yu W, Lyu D, Lin X. Evaluation of a Novel Microfocused Ultrasound with Three-Dimensional Digital Imaging for Facial Tightening: A Prospective, Randomized, Controlled Trial. Dermatol Ther (Heidelb) 2024; 14:233-249. [PMID: 38100073 DOI: 10.1007/s13555-023-01078-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 11/24/2023] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND The excellent efficacy is mitigated by the limited safety profile of microfocused ultrasound procedures. OBJECTIVE We sought to assess the safety and tightening efficacy of a novel microfocused ultrasound. METHODS The randomized middle and lower face and submental region of the participants were treated with the novel device using the following transducers: M4.5, D4.5, M3.0, and D3.0. Improvement in paired comparison of pretreatment and posttreatment photographs, three-dimensional (3D) volumetric assessments, skin thickness measured by B-ultrasonography, and skin photoaging parameters were evaluated. Adverse events and patient satisfaction were also recorded. RESULTS A total of 20 participants (20 female) were enrolled. Fourteen of 20 participants (70%) were judged to show clinically significant facial tightening during 3-month follow-up (P < 0.05). The mean volumetric change in the lower face, as quantitatively assessed after 3 months was -0.29 mL compared with +0.42 mL on the control side (P < 0.05). The VAS pain score was 3.00 ± 1.19 without any oral or intramuscular anesthesia. CONCLUSIONS A small sample size, lack of clinical scales, and impersonalized treatment parameters. The novel microfocused ultrasound appears to be a safe and effective modality for lower-face tightening. CLINICAL TRIAL REGISTRATION NUMBER ChiCTR 2200064666.
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Affiliation(s)
- Jiafang Zhu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yue Han
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ying Liu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Rui Chang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Wei Gao
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Xia Gong
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yijia Zhu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ying Shang
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Lingyue Shen
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Wenxin Yu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Dongze Lyu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Xiaoxi Lin
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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Fritz K, Salavastru C, Tiplica GS. [Microfocussed vs. macrofocussed ultrasound for body contouring]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:753-758. [PMID: 37578555 DOI: 10.1007/s00105-023-05199-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/15/2023]
Abstract
Focussed ultrasound is capable of heating tissue in small microscopic areas up to 65-70 °C and is a technique that can be used not only for destruction of superficial tissue but also for fat reduction. The focussing of sound waves according to the principle of a bundling of rays is carried out without injury to the skin. The penetration depth of the coagulation depends on the wavelength. Wavelengths that reach penetration depths of 6mm, 9mm and even 13mm and therefore deeper layers of the dermis and fat tissue are new. These enable fat cells to be eliminated and ultimately lead to girth reduction and also additionally to tightening. The effectiveness has been confirmed by several studies.
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Affiliation(s)
- Klaus Fritz
- Carol Davila University of Medicine and Pharmacy, Bucharest, Rumänien.
- Dermatology and Laser Consultation Center, Landau, Deutschland.
- Zentrum für Dermatologie, Laser und Ästhetische Medizin, Reduitstr. 13, 76829, Landau, Deutschland.
| | - Carmen Salavastru
- Carol Davila University of Medicine and Pharmacy, Bucharest, Rumänien
- Colentina Clinical Hospital, Bucharest, Rumänien
- Pediatric Dermatology Discipline, Dermato-oncology Research Facility, Bukarest, Rumänien
| | - George-Sorin Tiplica
- Carol Davila University of Medicine and Pharmacy, Bucharest, Rumänien
- Colentina Clinical Hospital, Bucharest, Rumänien
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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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Oh S, Kim HM, Batsukh S, Sun HJ, Kim T, Kang D, Son KH, Byun K. High-Intensity Focused Ultrasound Induces Adipogenesis via Control of Cilia in Adipose-Derived Stem Cells in Subcutaneous Adipose Tissue. Int J Mol Sci 2022; 23:ijms23168866. [PMID: 36012125 PMCID: PMC9408610 DOI: 10.3390/ijms23168866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/30/2022] [Accepted: 08/07/2022] [Indexed: 11/16/2022] Open
Abstract
During skin aging, the volume of subcutaneous adipose tissue (sWAT) and the adipogenesis potential of adipose-derived stem cells (ASCs) decrease. It is known that the shortening of cilia length by pro-inflammatory cytokines is related to the decreased adipogenic differentiation of ASCs via increase in Wnt5a/β-catenin. High-intensity focused ultrasound (HIFU) is known to upregulate heat shock proteins (HSP), which decrease levels of pro-inflammatory cytokines. In this study, we evaluated whether HIFU modulates the cilia of ASCs by upregulating HSP70 and decreasing inflammatory cytokines. HIFU was applied at 0.2 J to rat skin, which was harvested at 1, 3, 7, and 28 days. All results for HIFU-applied animals were compared with control animals that were not treated. HIFU increased expression of HSP70 and decreased expression of NF-κB, IL-6, and TNF-α in sWAT. HIFU decreased the expression of cilia disassembly-related factors (AurA and HDAC9) in ASCs. Furthermore, HIFU increased the expression of cilia assembly-related factors (KIF3A and IFT88), decreased that of WNT5A/β-catenin, and increased that of the adipogenesis markers PPARγ and CEBPα in sWAT. HIFU increased the number of adipocytes in the sWAT and the thickness of sWAT. In conclusion, HIFU could selectively increase sWAT levels by modulating the cilia of ASCs and be used for skin rejuvenation.
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Affiliation(s)
- Seyeon Oh
- Functional Cellular Networks Laboratory, Lee Gil Ya Cancer and Diabetes Institute, Gachon University of Medicine, Incheon 21999, Korea
| | - Hyoung Moon Kim
- Functional Cellular Networks Laboratory, Lee Gil Ya Cancer and Diabetes Institute, Gachon University of Medicine, Incheon 21999, Korea
- Department of Anatomy & Cell Biology, Gachon University College of Medicine, Incheon 21936, Korea
| | - Sosorburam Batsukh
- Functional Cellular Networks Laboratory, Lee Gil Ya Cancer and Diabetes Institute, Gachon University of Medicine, Incheon 21999, Korea
- Department of Anatomy & Cell Biology, Gachon University College of Medicine, Incheon 21936, Korea
| | | | | | | | - Kuk Hui Son
- Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University, Incheon 21565, Korea
- Correspondence: (K.H.S.); (K.B.); Tel.: +82-32-460-3666 (K.H.S.); +82-32-899-6511 (K.B.)
| | - Kyunghee Byun
- Functional Cellular Networks Laboratory, Lee Gil Ya Cancer and Diabetes Institute, Gachon University of Medicine, Incheon 21999, Korea
- Department of Anatomy & Cell Biology, Gachon University College of Medicine, Incheon 21936, Korea
- Correspondence: (K.H.S.); (K.B.); Tel.: +82-32-460-3666 (K.H.S.); +82-32-899-6511 (K.B.)
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Lee TJ, Kim D, Kim T, Pak CJ, Suh HP, Hong JP. Rejuvenation of photoaged aged mouse skin using high intensity focused ultrasound. J Plast Reconstr Aesthet Surg 2022; 75:3859-3868. [DOI: 10.1016/j.bjps.2022.06.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022]
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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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Fiala T. Abdominal Laser Lipolysis Using a Microprocessor-Controlled Robotic Arm With Noncontact Heating and Cooling. Aesthet Surg J 2021; 41:NP1951-NP1961. [PMID: 33903903 DOI: 10.1093/asj/sjab206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND A novel FDA-cleared device uses a 1064-nm laser to noninvasively induce apoptosis for lipolysis of subcutaneous abdominal fat while maintaining comfortable skin temperatures with a proprietary jet cooling system (eon; Dominion Aesthetic Technologies, Inc., San Antonio, TX). A programmable articulated robotic arm moves the treatment head without any subject contact, maintaining an appropriate 3-dimensional treatment path, compensating for patient movement. OBJECTIVES The goal of this prospective, single center, open-label study was to demonstrate the safety and effectiveness of this device for reducing subcutaneous abdominal fat when operated with an updated power delivery curve. METHODS Male and female subjects with Fitzpatrick skin types I to VI (N = 26) were treated. Four abdominal zones up to 150 cm2 each, customized in size and location for body habitus, were treated. Each zone underwent a single 20-minute treatment session. Follow-up visits occurred after 6 and 12 weeks. A standardized protocol was used to obtain ultrasound measurement of subcutaneous abdominal fat thickness, abdominal circumference, reported patient satisfaction and digital images. RESULTS The mean treatment area was 378.5 cm2. At Week 12, there was a 21.6% or 6.3 mm mean reduction in abdominal subcutaneous fat thickness and a 4.1-cm (1.6-inch) mean reduction in abdominal circumference. Most subjects (84.6%) were satisfied or very satisfied with their results. The mean pain score was 2.5 on an 11-point ordinal scale. There were no nonresponders. Only 2 adverse events were noted: mild transient erythema (n = 1, 3.8%) and localized subcutaneous firmness (n = 1, 3.8%) which resolved without intervention within 12 weeks. CONCLUSIONS This contact-free device is safe and effective for reducing subcutaneous abdominal fat and represents an improvement on the prior treatment protocol. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Thomas Fiala
- College of Medicine, University of Central Florida, Altamonte Springs, FL,USA
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10
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Verner I. A novel nonfocused pulsed ultrasound technology for noninvasive circumference reduction. Dermatol Ther 2021; 34:e15101. [PMID: 34396647 DOI: 10.1111/dth.15101] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 08/04/2021] [Indexed: 11/29/2022]
Abstract
There is a continuously growing demand for circumference reduction and body shaping technologies, with an overwhelming preference for non-invasive, pain-free procedures. This paper presents a novel body contouring device which uses pulsed, vacuum-assisted non-focused ultrasound. To evaluate the clinical safety and efficacy of the vacuum-assisted acoustic wave technology for circumference reduction of the abdominal region. Eighteen healthy women with a body mass index under 25 underwent four 20-min fat reduction treatments in the abdominal region, at 1-week intervals. Efficacy was evaluated by the change in abdominal circumference up to 12 weeks post treatment relative to baseline and by comparison of before and after photos by two blinded evaluators. Subjects rated their satisfaction with the treatment procedure and outcomes. Safety was evaluated by adverse events, local skin reaction, and pain assessments. 1 week after the final session, the mean reductions in abdominal circumference measured 5.4 ± 2.6 cm. At 1 month after the last session, the cumulative reduction in circumference was 5.8 ± 3.2 cm. Measurements take at 3 months after the last treatment showed abdominal circumferences decrease of an average 5.2 ± 3.1 cm relative to baseline measures. All patients reported a painless procedure and there were no treatment-induced severe adverse events. Most patients reported a positive change in body contour, with all subjects saying they would highly recommend the treatment to others. Assessments performed by blinded evaluators ranked six cases as very to extremely improved and an additional seven cases as somewhat improved. No dramatic weight fluctuations were recorded. This study demonstrates that a four-treatment course with an acoustic wave ultrasound applicator with 1-week intervals, leads to a significant reduction in abdominal circumference, lasting up to at least 3 months with no pain or side effects reported.
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Affiliation(s)
- Ines Verner
- Verner Clinic for Dermatology and Aesthetics, Tel Aviv, Israel.,Department of Dermatology and Regenerative Medicine, University of Rome "Guglielmo Marconi", Rome, Italy
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Atiyeh BS, Chahine F. Evidence-Based Efficacy of High-Intensity Focused Ultrasound (HIFU) in Aesthetic Body Contouring. Aesthetic Plast Surg 2021; 45:570-578. [PMID: 32705441 DOI: 10.1007/s00266-020-01863-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 06/28/2020] [Indexed: 02/06/2023]
Abstract
Being profitable procedures with little disposable costs, a number of noninvasive technologies have gained much popularity in recent years and are permeating the aesthetic marketplace. High-intensity focused ultrasound (HIFU) when focused at a targeted depth of 1.1 to 1.6 cm within subcutaneous tissue raises local tissue temperature at the focal point resulting in almost immediate cell death without damage to the surrounding tissues. Despite having gained popularity, little information is available regarding HIFU use for the treatment of localized fat and aesthetic body sculpturing. The current literature review is intended to investigate evidence-based efficacy of HIFU in aesthetic body contouring. 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 .
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Meyer PF, Sousa JFDS, Rocha RVD, Queiroz Filho J, Ronzio OA, Silva RMVD, Manso ACDM, Almeida ARMD, Andrada CP. Hepathic, biochemical, hematological, and histological effects of the ultracavitation in rabbits livers. Acta Cir Bras 2020; 35:e202000403. [PMID: 32578723 PMCID: PMC7307718 DOI: 10.1590/s0102-865020200040000003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 03/22/2020] [Indexed: 11/22/2022] Open
Abstract
Purpose To collect data capable of pointing out the effects of the ultracavitation treatment on the liver of rabbits after adipose tissue application, by means of histological analyses of the liver and hematological and biochemical exams. Methods This is an experimental study with 12 albino rabbits as sample, which were divided into 3 groups and submitted to a hypercaloric diet for one month. Subsequently, subjects underwent UCV treatment: 3 minutes, 30 W, continuous mode at 100%, every 2 ERAS = 441.02 J/cm2, intensity of 10w/cm2. They were then euthanized and underwent biopsy after 24 hours. Results After 48 hours from the ultracavitation treatment, the animals’ livers presented greater amount of fat infiltration if compared to the amount presented 96 hours after the treatment. However, laboratory tests showed no alterations. Values were maintained within normal parameters of cholesterol, triglycerides, liver enzymes, hemoglobin and hematocrit levels. Conclusions This study has identified that infiltrates may appear on livers after the treatment, despite high hematological and biochemical tests results. The fat infiltrates reduction 96 h after treatment suggests lower risks to animal health, if the period between applications is respected.
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Affiliation(s)
| | | | | | | | - Oscar Ariel Ronzio
- Universidad Maimnides, Argentina; Universidad Nacional Arturo Jauretche F. Varela, Argentina
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High-Intensity Focused Ultrasound Ablation Combined with Electrical Passive Exercise for Fast Removal of Body Fat. Plast Reconstr Surg 2020; 145:1427-1438. [PMID: 32195859 DOI: 10.1097/prs.0000000000006826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND High-intensity focused ultrasound (HIFU) lipolysis still lacks treatment efficacy. The authors hypothesized that electrical stimulation of muscular groups can enhance the metabolism of free lipids released from HIFU-ablated adipocytes. METHODS Five-month-old, male Landrace swine, with an average initial weight of 95 kg, were divided randomly into sham, HIFU only, HIFU plus electrical stimulation I, and HIFU plus electrical stimulation II groups. Subcutaneous adipose tissue of the porcine abdomen was treated once by HIFU on days 1 of weeks 1, 3, and 5, and electrical stimulation of the quadriceps was performed once on the day 1 of weeks 1 through 6. The numbers of ultrasonic sonications were 70 per treatment for the HIFU-only and HIFU plus electrical stimulation I groups and 400 for the HIFU plus electrical stimulation II group. The measured data are expressed as medians (ranges). RESULTS The body weights of all pigs increased gradually with time. The waist circumferences below the sheath decreased from 97.7 ± 6.0 cm in week 1 and 97.9 ± 5.3 cm in week 3 to 96.4 ± 10.0 cm in week 6, and from 105.3 ± 5.1 cm and 101.2 ± 7.4 cm to 100.5 ± 6.1 cm for the HIFU plus electrical stimulation I and II groups, respectively, whereas they increased for the sham and HIFU-only groups. The reductions in the adipose tissue thickness were 0.59, 1.46, and 2.18 mm for the HIFU-only, HIFU plus electrical stimulation I, and HIFU plus electrical stimulation II groups, respectively, when the sham group increased by 1.42 mm. Follow-up blood analyses demonstrated no significant changes in lipid panel parameters from baseline values. CONCLUSION HIFU plus electrical stimulation can induce a substantial reduction in the waist circumference of pigs.
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Jeon HC, Kim DY, Jin SP, Lee DH. A new treatment protocol of microfocused ultrasound for lower eyelid fat bulging. J DERMATOL TREAT 2020; 32:1005-1009. [PMID: 31971035 DOI: 10.1080/09546634.2020.1720581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Microfocused ultrasound (MFU) causes tissue tightening by producing thermal injury zones and is used to treat various age-related changes including lower eyelid fat bulging. OBJECTIVE To investigate the efficacy of a new treatment protocol of MFU for lower eyelid fat bulging. METHODS AND MATERIALS We reviewed the medical records of all patients who began MFU for lower eyelid fat bulging from March 2017 to September 2018. MFU was performed in two steps to tighten the lower eyelid dermis and orbital septum. Data on age, sex, bulging severity, and the number of treatment sessions were obtained. Associations of these variables with treatment response were determined through an ordinal logistic regression analysis. RESULTS Among 191 enrolled patients, 119 (62.3%) and 47 (24.6%) achieved fair and good responses, respectively. In the multivariable analysis, multiple treatment sessions (odds ratio (OR) 6.618; 95% confidence interval (CI) 3.242-13.513; p < .001), moderate bulging (OR 4.328; 95% CI 1.755-10.671; p = .001), and severe bulging (OR 7.570; 95% CI 2.537-22.585; p < .001) were associated with greater treatment response. There were no serious adverse events. CONCLUSIONS The new treatment protocol of MFU is an effective and safe strategy for lower eyelid fat bulging.
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Affiliation(s)
| | - Do-Yeop Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Seon-Pil Jin
- Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Dong Hun Lee
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
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15
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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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16
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Guth F, Bitencourt S, Bedinot C, Sinigaglia G, Tassinary JAF. Immediate effect and safety of HIFU single treatment for male subcutaneous fat reduction. J Cosmet Dermatol 2017; 17:385-389. [DOI: 10.1111/jocd.12466] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Fernanda Guth
- Centro de Ciências Biológicas e da Saúde; Universidade do Vale do Taquari (Univates); Lajeado RS Brazil
| | - Shanna Bitencourt
- Laboratório de Cultura de Células; Programa de Pós-graduação em Biotecnologia; Universidade do Vale do Taquari (Univates); Lajeado RS Brazil
| | | | - Giovana Sinigaglia
- Centro de Ciências Biológicas e da Saúde; Universidade do Vale do Taquari (Univates); Lajeado RS Brazil
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17
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Abstract
Noninvasive body contouring is an attractive therapeutic modality to enhance the ideal male physique. Men place higher value on enhancing a well-defined, strong, masculine jawline and developing a V-shaped taper through the upper body. An understanding of the body contour men strive for allows the treating physician to focus on areas that are of most concern to men, thus enhancing patient experience and satisfaction. This article discusses noninvasive body contouring techniques, taking into account the unique aesthetic concerns of the male patient by combining an analysis of the existing literature with our own clinical experience.
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Lee S, Kim HJ, Park HJ, Kim HM, Lee SH, Cho SB. Morphometric analysis of high-intensity focused ultrasound-induced lipolysis on cadaveric abdominal and thigh skin. Lasers Med Sci 2017; 32:1143-1151. [PMID: 28451817 DOI: 10.1007/s10103-017-2220-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 04/19/2017] [Indexed: 01/20/2023]
Abstract
Non-focused ultrasound and high-intensity focused ultrasound (HIFU) devices induce lipolysis by generating acoustic cavitation and coagulation necrosis in targeted tissues. We aimed to investigate the morphometric characteristics of immediate tissue reactions induced by 2 MHz, 13-mm focused HIFU via two-dimensional ultrasound images and histologic evaluation of cadaveric skin from the abdomen and thigh. Acoustic fields of a 2 MHz, 38-mm HIFU transducer were characterized by reconstruction of the fields using acoustic intensity measurement. Additionally, abdominal and thigh tissues from a fresh cadaver were treated with a HIFU device for a single, two, and three pulses at the pulse energy of 130 J/cm2 and a penetration depth of 13 mm. Acoustic intensity measurement revealed characteristic focal zones of significant thermal injury at the depth of 38 mm. In both the abdomen and thigh tissue, round to oval ablative thermal injury zones (TIZs) were visualized in subcutaneous fat layers upon treatment with a single pulse of HIFU treatment. Two to three HIFU pulses generated larger and more remarkable ablative zones throughout subcutaneous fat layers. Finally, experimental treatment in a tumescent infiltration-like setting induced larger HIFU-induced TIZs of an oval or columnar shape, compared to non-tumescent settings. Although neither acoustic intensity measurement nor cadaveric tissue exactly reflects in vivo HIFU-induced reactions in human tissue, we believe that our data will help guide further in vivo studies in investigating the therapeutic efficacy and safety of HIFU-induced lipolysis.
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Affiliation(s)
- Sugun Lee
- Department of Biomedical Engineering, Jeju National University, Jeju, South Korea
| | - Hee-Jin Kim
- Division of Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Center, Yonsei University College of Dentistry, Seoul, South Korea
| | | | | | - So Hyun Lee
- Miaero Clinic, Lase Center, Seoul, South Korea
| | - Sung Bin Cho
- Kangskin Sillim Dermatology Clinic, Seoul, South Korea. .,Department of Dermatology and Cutaneous Biology Research Center, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Simgok-ro 100gil, 25 Seo-gu, 404-834, Incheon, Republic of Korea.
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19
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Alizadeh Z, Halabchi F, Mazaheri R, Abolhasani M, Tabesh M. Review of the Mechanisms and Effects of Noninvasive Body Contouring Devices on Cellulite and Subcutaneous Fat. Int J Endocrinol Metab 2016; 14:e36727. [PMID: 28123436 PMCID: PMC5236497 DOI: 10.5812/ijem.36727] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 06/08/2016] [Accepted: 06/26/2016] [Indexed: 01/02/2023] Open
Abstract
CONTEXT Today, different kinds of non-invasive body contouring modalities, including cryolipolysis, radiofrequency (RF), low-level laser therapy (LLLT), and high-intensity focused ultrasound (HIFU) are available for reducing the volume of subcutaneous adipose tissue or cellulite. Each procedure has distinct mechanisms for stimulating apoptosis or necrosis adipose tissue. In addition to the mentioned techniques, some investigations are underway for analyzing the efficacy of other techniques such as whole body vibration (WBV) and extracorporeal shockwave therapy (ESWT). In the present review the mechanisms, effects and side effects of the mentioned methods have been discussed. The effect of these devices on cellulite or subcutaneous fat reduction has been assessed. EVIDENCE ACQUISITION We searched pubmed, google scholar and the cochrane databases for systemic reviews, review articles, meta-analysis and randomized clinical trials up to February 2015. The keywords were subcutaneous fat, cellulite, obesity, noninvasive body contouring, cryolipolysis, RF, LLLT, HIFU, ESWT and WBV with full names and abbreviations. RESULTS We included seven reviews and 66 original articles in the present narrative review. Most of them were applied on normal weight or overweight participants (body mass index < 30 kg/m2) in both genders with broad range of ages (18 to 50 years on average). In the original articles, the numbers of included methods were: 10 HIFU, 13 RF, 22 cryolipolysis, 11 LLLT, 5 ESWT and 4 WBV therapies. Six of the articles evaluated combination therapies and seven compared the effects of different devices. CONCLUSIONS Some of the noninvasive body contouring devices in animal and human studies such as cryolipolysis, RF, LLLT and HIFU showed statistical significant effects on body contouring, removing unwanted fat and cellulite in some body areas. However, the clinical effects are mild to moderate, for example 2 - 4 cm circumference reduction as a sign of subcutaneous fat reduction during total treatment sessions. Overall, there is no definitive noninvasive treatment method for cellulite. Additionally, due to the methodological differences in the existing evidence, comparing the techniques is difficult.
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Affiliation(s)
- Zahra Alizadeh
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, IR Iran
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Farzin Halabchi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, IR Iran
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Reza Mazaheri
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, IR Iran
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Maryam Abolhasani
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mastaneh Tabesh
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, IR Iran
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20
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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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21
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Kwon TR, Im S, Jang YJ, Oh CT, Choi EJ, Jung SJ, Hong H, Choi YS, Choi SY, Kim YS, Kim BJ. Improved methods for evaluating pre-clinical and histological effects of subcutaneous fat reduction using high-intensity focused ultrasound in a porcine model. Skin Res Technol 2016; 23:194-201. [DOI: 10.1111/srt.12319] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2016] [Indexed: 11/30/2022]
Affiliation(s)
- T.-R. Kwon
- Department of Dermatology; Chung-Ang University College of Medicine; Seoul Korea
| | - S. Im
- Department of Dermatology; Chung-Ang University College of Medicine; Seoul Korea
- Department of Medicine; Graduate School; Chung-Ang University; Seoul Korea
| | - Y.-J. Jang
- Department of Medicine; Graduate School; Chung-Ang University; Seoul Korea
| | - C. T. Oh
- Department of Dermatology; Chung-Ang University College of Medicine; Seoul Korea
| | - E. J. Choi
- Department of Dermatology; Chung-Ang University College of Medicine; Seoul Korea
| | | | - H. Hong
- Medical IT convergence Research center; Korea Electronics Technology Institute; Gyeonggi-do Korea
| | - Y. S. Choi
- Medical IT convergence Research center; Korea Electronics Technology Institute; Gyeonggi-do Korea
| | - S. Y. Choi
- Department of Dermatology; Chung-Ang University College of Medicine; Seoul Korea
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - Y. S. Kim
- Department of Radiology; Chung-Ang University Hospital; Chung-Ang University College of Medicine; Seoul Korea
| | - B. J. Kim
- Department of Dermatology; Chung-Ang University College of Medicine; Seoul Korea
- Department of Medicine; Graduate School; Chung-Ang University; Seoul Korea
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22
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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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23
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24
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Shek SY, Yeung CK, Chan JC, Chan HHL. Efficacy of high-intensity focused ultrasonography for noninvasive body sculpting in Chinese patients. Lasers Surg Med 2014; 46:263-9. [DOI: 10.1002/lsm.22232] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2014] [Indexed: 11/07/2022]
Affiliation(s)
- Samantha Y.N. Shek
- Division of Dermatology; Department of Medicine; The University of Hong Kong; Hong Kong SAR China
| | - Chi K. Yeung
- Division of Dermatology; Department of Medicine; The University of Hong Kong; Hong Kong SAR China
| | - Johnny C.Y. Chan
- Division of Dermatology; Department of Medicine; The University of Hong Kong; Hong Kong SAR China
| | - Henry H. L. Chan
- Division of Dermatology; Department of Medicine; The University of Hong Kong; Hong Kong SAR China
- Wellman Center for Photomedicine; Massachusetts General Hospital; Boston Massachusetts
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25
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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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26
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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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27
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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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28
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Jalian HR, Avram MM. Body contouring: the skinny on noninvasive fat removal. ACTA ACUST UNITED AC 2013; 31:121-5. [PMID: 22640432 DOI: 10.1016/j.sder.2012.02.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Accepted: 02/16/2012] [Indexed: 11/17/2022]
Abstract
Historically, the approach to body contouring has largely involved invasive procedures, such as liposuction. Recently, several new devices for noninvasive fat removal have received clearance by the Food and Drug Administration for the treatment of focal adiposity. Modalities are aimed primarily at targeting the physical properties of fat that differentiate it from the overlying epidermis and dermis, thus selectively resulting in removal. This review will focus on 3 novel approaches to noninvasive selective destruction of fat.
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Affiliation(s)
- H Ray Jalian
- Laser and Cosmetic Center and Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA
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29
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Ersek RA. Evaluation of new ultrasound technologies should include assessments of peripheral nerve function. Aesthet Surg J 2011; 31:837; author reply 838. [PMID: 21908817 DOI: 10.1177/1090820x11416455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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30
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Gadsden E, Aguilar MT, Smoller BR, Jewell ML. Evaluation of a novel high-intensity focused ultrasound device for ablating subcutaneous adipose tissue for noninvasive body contouring: safety studies in human volunteers. Aesthet Surg J 2011; 31:401-10. [PMID: 21551431 DOI: 10.1177/1090820x11405027] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND High-intensity focused ultrasound (HIFU) is an energy-based medical technology with many clinical applications. A device under clinical investigation in the United States (LipoSonix; Medicis Technologies Corporation, Bothell, Washington) uses HIFU to reduce localized deposits of abdominal adipose tissue. OBJECTIVES The authors describe the results from their clinical trial investigating the safety of this HIFU device in human patients. METHODS Over the course of three studies evaluating the safety of the HIFU device for ablating human subcutaneous adipose tissue (SAT), 152 healthy patients were treated with total HIFU energy doses of 47 to 331 J/cm(2)), including patients who presented for elective abdominoplasty and underwent treatment to areas identified for subsequent excision. The safety of each treatment regimen was confirmed before the energy levels were raised. Abdominoplasty was performed up to 14 weeks following the HIFU procedure, and a pathologist performed histopathological analyses of excised tissues. Safety evaluations included an assessment of clinical chemistry and hematology profiles, physical examinations, and adverse events. RESULTS Posttreatment ultrasound confirmed that the HIFU effects were limited to targeted SAT layers. Histopathology revealed well-demarcated disruption of adipocytes within the targeted SAT. Phagocytosis of released lipids and cellular debris occurred after 14 to 28 days. Phagocytized lipids underwent normal hepatic metabolism. Healing progressed normally and was 95% complete after eight to 14 weeks. Adverse events consisted primarily of temporary treatment discomfort, edema, erythema, dysesthesia, and ecchymosis. There were no changes in clinical laboratory parameters, and no serious device-related adverse events occurred. Optimal clinical outcomes were achieved with lower energy levels, which provided beneficial effects with the least amount of discomfort. CONCLUSIONS HIFU appears to provide a safe means for removing and remodeling unwanted deposits of abdominal SAT.
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