Several lasers are used for lipolysis – a recognized technique for fat reduction. It has been demonstrated that (i) fat liquefaction is induced through a temperature elevation of the adipocyte cells, and (ii) fat volume reduction depends on total cumulative energy delivered at the treatment site. Which wavelength (920nm, 980nm, 1064nm, 1320nm, and 1440nm) is the best?
Studies and substantial anecdotal evidence show that the penetration depth of wavelengths between 900 and 1320nm is very similar – around 1.5mm. The only minor difference is at 1440nm, which is more absorbed by subcutaneous fat. The irreversibly damaged volume of tissue is also similar for wavelengths between 920 and 1320nm. Practitioners obtain the total of about 4cm3 with 3750J delivered to the tissue.
With laser lipolysis, thermal elevation of a given volume can be obtained provided that the penetration depth remains in this nominal range. This explains why similar end results can be obtained using 920nm, 980nm, 1064nm, and 1320nm. Thermal build-up is the main factor behind adipocytolysis and skin contraction. Successful outcomes are dependent primarily on the movement of the optical fiber inside the tissue and even and stable delivery of the laser energy. It’s the hands of the surgeon that truly make a difference!
Final Inches Medical Body Shaping Center in California just announced a new marketing idea. That is in addition to picking a cool name. This practice has two locations specializing solely in Laser Liposculpture, a minimally-invasive procedure that permanently eliminates frustrating fat. This lipo sculpture practice recently announced that they are helping their patients get ready for summer with their custom swimsuit giveaway.
“Certain areas of the body are genetically predisposed to store fat, including the waist, stomach, hips, thighs, and arms. This fat can be very difficult to reduce or eliminate through diet and exercise but at FINAL INCHES we remove this stubborn fat permanently, in about an hour,” states Anh Ngo, MD, Board Certified Surgeon and Medical Director of FINAL INCHES. “With our Laser Liposculpture procedure, we permanently remove stubborn fat, reshaping our patients’ bodies to create a slimmer, sleeker swimsuit-ready body.” This lipo practice performs more Laser Liposculpture procedures than any other Southern California practice.
“We couldn’t be happier designing custom swimsuits for the lipo sculpture patients,” states Jessica Neeper, National Sales Manager of Ginger’s Island, one of the swimsuit companies partnered with the practice in this promotion. “Lipo sculpture patients are some of our most enthusiastic customers because they come to us ready to show off their slimmer bodies. It’s a real thrill working with them to design custom swimsuits that accentuate their curves and get them ready for the beach.”
Qualifying for the free custom swimsuit is simple; patients only need to come in for a consult and have their slimming Laser Liposculpture procedure done before August 31, 2009. After the procedure, patients are then fitted for their free custom swimsuit to show off their new beach-ready body.
This year marks the twentieth anniversary of the FDA’s approval of suction lipoplasty systems, commonly known as liposuction. Although versions of it, like suction-assisted lipectomy, had been recorded in medical literature since the 1970s for non-cosmetic uses such as the removal of fatty tumors, it wasn’t until 1989 that it was officially rubber-stamped for aesthetic body contouring.
Lipo means fat. Liposuction is an established and well researched procedure to liquefy and remove (using vacuum suction) stubborn deposits of fat, which are resistand to strenuous exercise and strict diet.
In the last two decades, liposuction’s popularity has escalated—it’s currently the second most popular surgical cosmetic procedure, according to the American Society for Aesthetic Plastic Surgery (after breast augmentation)—and the same is true of its safety and innovation.
The technology developed over the years has paved the way for versions of liposuction that include ultrasound assisted, laser assisted, and Vaser assisted lipolysis. Laser liposuction is one of the more effective and minimally invasive techniques, which allows physicians to achieve excellent results with topical anesthesia and very minor discomfort for the patient.
Regardless of technique, a certain understanding of body proportions play an enormous role in a successful outcome. If this landmark year is the one in which you choose to undergo liposuction, be sure to choose a board-certified surgeon with extensive experience.
J Cosmet Laser Ther. 2009 Mar;11(1):34-44
Bousquet-Rouaud R, Bazan M, Chaintreuil J, Echague AV.
Dermatological Laser Unit, Millenium Clinic, Montpellier, France.
This article presents the first evaluation of the use of a high-power pulsed Nd:YAG laser for the treatment of cellulite. Three of the four authors are employees of Candela Corporation, the maker of the laser.
The study at first appears to be well-designed. Quantitative endpoints of dermis thickness and ultrasound density were chosen, and preliminary studies were performed to show that measurement methods were not subject to intra-observer or inter-observer error. Twelve patients were treated, with one thigh randomized to treatment and the other randomized to control. In addition to pre-treatment ultrasound measurements, follow-up measurements were performed at 1 month and 3 months after the final treatment of the series of three treatments. Adjunctive photographs were taken before each treatment, and presumably at the follow-up visits. The example photograph appears to be of high quality. The treatments were appropriately standardized to minimize the impact of dosage variation on outcome. Likewise, the patient population appears to be reasonably homogenous in terms of age, body mass index, and pre-treatment evaluation of cellulite severity, to minimize the impact of patient variation on outcome variation.
Given the apparent care taken in the study design, the analysis was extremely disappointing. The analysis presents only the variation in ultrasound measurements of the treated thigh, and completely ignores the control thigh. The authors claim that the mean dermal thickness of treated thighs decreases from the beginning to the end of the study, but this is a flawed claim. Because they do not present data on the control thigh, we cannot know if this result stems from a treatment effect, or from a natural variation in the patient population over time. For all we know, the dermal thickness of the control thigh improved more than the treated leg. This is the whole point of having a control thigh. No other control variables, such as BMI or weight, were presented.
Further, the authors include the raw data for the dermal thickness measurements in all 12 patients, but offer no explanation why some patients have increased thickness at 1 month follow-up which then decreases at 3 months, while other patients show decreased thickness at 1 month with subsequent increases at 3 months. Presumably, the treatment effect would go in generally the same direction in this homogeneous group that recieved the same treatment regime. This variation adds to the concern that something else was going on with these patients during the study that might effect dermal thickness. The same comments apply to the raw data on dermal echogenicity.
The exclusion of measurements of the control thigh from the analysis renders any conclusions moot. The authors further present patient satisfaction data. This type of data is notoriously challenging to interpret, as patients often feel satisfied that they are taking steps towards treating a condition. In this case, on average the patients reported being somewhat satisfied, and no patients reported being very satisfied. Readers of the article should not be satisfied at all.
Cutera will preview its Adjustable Depth Selectivity (ADS) Technology at the 67th Annual Meeting of the American Academy of Dermatology in San Francisco, March 6-10, 2009. ADS is the result of five years of clinical research conducted with in-vitro human fat cells at the Cell Culture Facility at the University of California Medical Center, San Francisco (UCSF).
The research determined fat cell survival rates following thermal exposures, which is necessary to establish treatment parameters and to make the next step in the development of new technologies for non-invasive body contouring. The two key features of this technology are the ability to selectively target and heat fat cells and to vary treatment depths within the fat.
The findings will help physicians develop new protocols for more efficacious treatment of a wide variety of patients and boost new device innovation.