Biomedical Engineering Reference
In-Depth Information
level of pain associated with each treatment, and the time to
fi nal results. Based on patient's needs, the appropriate modality
can be chosen. In choosing the device, the clinical effi cacy
should be reviewed with each patient to set the expectations
correctly. Managing realistic expectations are key to ensuring
satisfaction with results. Although many of the devices reviewed
in this chapter have shown clinical effi cacy in preliminary clini-
cal trials, one should approach the results with healthy skepti-
cism, especially when clinical outcome is measured only by
images or circumferential measurements in small circumfer-
ence areas of the body. Most of these clinical studies were based
on limited number of patients, although once in regular daily
use after FDA clearance, clinical experience accelerates incred-
ibly quickly. Already hundreds of thousands of patients have
been treated worldwide with cryolipolysis, NTFU and TFU,
and rapidly proliferating RF devices. These devices achieve
measurable clinically signifi cant end points for patients with-
out the downtime of invasive procedures, although the effects
of individual treatments and individual devices may be quite
variable and of course less dramatic than invasive fat reduction
and body contouring procedures.
Regardless of the modality chosen for noninvasive fat
removal, there are certain important points that each physi-
cian should discuss with patient before initiating noninvasive
fat removal. First and foremost, patients should understand
that these modalities are not a substitute for weight loss and
healthy living. Second, patients should be thoroughly informed
about the relatively modest nature of fat reduction with these
techniques, which does not compare with the effi cacy or results
seen with liposuction. Maximal reduction for a single treat-
ment is typically in the 20-30% range. Multiple treatments are
typically necessary to obtain the desired results, which also can
take up to 6 months after treatment to be appreciated. The
devices reviewed in this chapter have demonstrated favorable
safety results and when evaluated, they did not lead to liver
function or lipid level abnormalities, with some modalities
achieving better results than others.
8. Dover J, Burns J, Coleman S, et al. A prospective clinical study of
noninvasive cryolipolysis for subcutaneous fat layer reduction—Interim
report of available subject data. In Annual Meeting of the American
Society for Laser Medicine and Surgery. National Harbor, Maryland,
2009.
9. Kaminer M, Weiss R, Newman J, et al. Visible cosmetic improvement with
cryolipolysis: Photographic evidence. In Annual Meeting of the American
Society for Dermatologic Surgery. Phoenix, AZ, 2009.
10. Coleman SR, Sachdeva K, Egbert BM, et al. Clinical effi cacy of noninvasive
cryolipolysis and its effects on peripheral nerves. Aesthetic Plast Surg
2009; 33: 482-8.
11. Klein KB, Zelickson B, Rieopelle JG, et al. Non-invasive cryolipolysis for
subcutaneous fat reduction does not affect serum lipid levels or liver
function tests. Lasers Surg Med 2009; 41: 785-90.
12. Dover J, Saedi N, Kaminer M, Zachary C. Side effects and risks associated
with cryolipolysis. In Annual Meeting of the American Society for Laser
Medicine and Surgery. Grapevine, Texas, 2011.
13. Avram MM, Harry RS. Cryolipolysis for subcutaneous fat layer reduction.
Lasers Surg Med 2009; 41: 703-8.
14. Jewell ML, Solish NJ, Desilets CS. Noninvasive body sculpting technologies
with an emphasis on high-intensity focused ultrasound. Aesthetic Plast
Surg 2011; 35: 901-12.
15. Moreno-Moraga J, Valero-Altés T, Riquelme AM, et al. Body contouring
by non-invasive transdermal focused ultrasound. Lasers Surg Med 2007;
39: 315-23.
16. Teitelbaum SA, Burns JL, Kubota J, et al. Noninvasive body contouring by
focused ultrasound: safety and effi cacy of the Contour I device in a
multicenter, controlled, clinical study. Plast Reconstr Surg 2007; 120:
779-89; discussion 790.
17. Shek S, Yu C, Yeung CK, et al. The use of focused ultrasound for non-
invasive body contouring in Asians. Lasers Surg Med 2009; 41: 751-9.
18. Fatemi A. High-intensity focused ultrasound effectively reduces adipose
tissue. Semin Cutan Med Surg 2009; 28: 257-62.
19. Fatemi A, Kane MA. High-intensity focused ultrasound effectively
reduces waist circumference by ablating adipose tissue from the
abdomen and fl anks: a retrospective case series. Aesthetic Plast Surg
2010; 34: 577-82.
20. Jewell ML, Baxter RA, Cox SE, et al. Randomized sham-controlled trial to
evaluate the safety and effectiveness of a high-intensity focused ultrasound
device for noninvasive body sculpting. Plast Reconstr Surg 2011; 128:
253-62.
21. Neira R, Arroyave J, Ramirez H, et al. Fat liquefaction: effect of low-level
laser energy on adipose tissue. Plast Reconstr Surg 2002; 110: 912-22;
discussion 923-5.
22. Elm CM, Wallander ID, Endrizzi B, et al. Effi cacy of a multiple diode laser
system for body contouring. Lasers Surg Med 2011; 43: 114-21.
23. Jackson RF, Dedo DD, Roche GC, et al. Low-level laser therapy as a non-
invasive approach for body contouring: a randomized, controlled study.
Lasers Surg Med 2009; 41: 799-809.
24. Jackson RF, Stern FA, Neira R, et al. Application of low-level laser therapy
for noninvasive body contouring. Lasers Surg Med 2012; 44: 211-17.
25. Anderson RR, Farinelli W, Laubach H, et al. Selective photothermolysis of
lipid-rich tissues: a free electron laser study. Lasers Surg Med 2006; 38:
913-19.
26. Wanner M, Avram M, Gagnon D, et al. Effects of non-invasive, 1,210 nm
laser exposure on adipose tissue: results of a human pilot study. Lasers
Surg Med 2009; 41: 401-7.
27. Alster TS, Lupton JR. Nonablative cutaneous remodeling using
radiofrequency devices. Clin Dermatol 2007; 25: 487-91.
28. Anolik R, Chapas AM, Brightman LA, et al. Radiofrequency devices for
body shaping: a review and study of 12 patients. Semin Cutan Med Surg
2009; 28: 236-43.
29. Franco W, Kothare A, Ronan SJ, et al. Hyperthermic injury to adipocyte
cells by selective heating of subcutaneous fat with a novel radiofrequency
device: feasibility studies. Lasers Surg Med 2010; 42: 361-70.
references
1. The American society of plastic surgeons: national clearinghouse of plastic
surgery procedural statistics: the American society of plastic surgeons.
[Available from: http://www.asps.org] [accessed November 8, 2011].
2. Matarasso A, Swift RW, Rankin M. Abdominoplasty and abdominal
contour surgery: a national plastic surgery survey. Plastic Reconstruct
Surg 2006; 117: 1797-808.
3. Epstein EH Jr, Oren ME. Popsicle panniculitis. N Engl J Med 1970; 282: 966-7.
4. Beacham BE, Cooper PH, Bushanan CS, et al. Equestrian cold panniculitis
in women. Arch Dermatol 1980; 116: 1025-7.
5. Manstein D, Laubach H, Watanabe K, et al. Selective cryolysis: a
novel method of non-invasive fat removal. Lasers Surg Med 2008; 40:
595-604.
6. Zelickson B, Egbert BM, Preciado J, et al. Cryolipolysis for noninvasive fat
cell destruction: initial results from a pig model. Dermatol Surg 2009;
35:1462-70.
7. Preciado JA, Allison JW. The effect of cold exposure on adipocytes:
Examining a novel method for the non-invasive removal of fat. Cryobiology
2008; 57: 327-7.
