Health

Elimination of Localized Fat Deposits

The rise in the rate of obesity and the increase in public awareness of the disadvantages of excess adipose tissues have made body sculpting procedures more and more popular. Although diet, exercise, bariatric surgeries may effectively control obesity and lead to dramatic weight loss, oftentimes, cosmetic procedures are still necessary to remove excess fat deposition in selected, more focal areas.

The improvement in the shape and smoothness of the human physique is referred to as body contouring. The traditional method of improving body contour is the removal of fat via liposuction. However as liposuction is an invasive procedure there are inherent risks including postprocedural pain, infection, prolonged recovery, impaired social downtime, and anesthesia-related complications. All these factors have contributed to patients seeking non invasive and non surgical fat removal methods. Currently available non-invasive body sculpting methods including heating, cryo lipolysis, laser, radio frequency, and ultrasound selectively target fat destruction.

Latest Methods and their Features

The selective destruction and non invasive removal of fat are termed cryolypolysis. This noval approach to fat removal is approved by the U.S. Food and Drug Administration ( FDA ) for the treatment of localized fat. This method demonstrates a significant reduction in fat layer thickness with no damage to the skin or associated structures and no systemic elevation of cholesterol or triglyceride levels. A subsequent porcine study confirmed that cryoliplysis led to the decreased thickness of the fat layer as measured by ultrasound and by histology. Histologic analysis showed approximately a 50% reduction in the thickness of the fat layer. Inflammatory response peaks after approximately 2 days following treatment and then declined by clearing fat cells, this process occurs slowly over 90 days post-treatment, with an end result of gradual reduction of fat that is observed clinically. Other mechanisms of action include reperfusion injury, cooling of temperature-sensitive adipocytes, resulting in free radical damage, oxidative stress, and then subsequent cell death.

Ultrasound has been used to selectively target adipocytes through the noninvasive mechanical and thermal mechanism. Ultrasound is a cyclic sound pressure wave with a frequency above the range of human hearing ( >20 kHz). Ultrasound waves are capable of traveling through tissues and in the process, they lose energy and are deflected, scattered, or absorbed by the tissue they pass through. However, if sufficient quantities of ultrasound wave-generated energy reach the target tissue, they can induce the molecular vibrations in the tissue, thus generating thermal heat (thermal-based ultrasound lipolysis). Ultrasound waves are also capable of creating holes ( cavities) when they have sufficient negative pressure. To overcome the adhesion of medium molecules to each other ( nonthermal or cavitation-based ultrasound lipolysis). In the latter case In the latter case, the mechanical energy of ultrasound is used to induce damage to targeted adipocytes. Ultrasound used for body sculpting is divided into two broad categories: cavitation-based lower-frequency nonthermal ultrasound that uses mechanical energy to disrupt adipocyte cells and high-intensity, thermal focused ultrasound ( HIFU ) that uses thermal energy to ablate adipose tissue.

Radio-frequency ( RF ) energy has been used for decades for a variety of health care applications. RF energy is produced by an electric current that can pass through the tissue. Heat is generated by RF through the transfer of energy from the electric field to the charges in the target tissue. Because RF is not produced by the light source, the RF energy is not dependent on chromophores or skin type, and therefore patients of different skin phototypes and ethnicity can safely be treated with RF-based systems. RF energy has different clinical and biological effects depending upon the depth of tissue targeted. The depth of penetration of energy is inversely proportional to the frequency. Therefore at lower frequencies, energy can penetrate deeper.

RF technology can non invasively and selectively heat lard volumes of subcutaneous adipose tissue. By selecting the appropriate electric field, one can obtain greater heating of fat. RF can be delivered using monopolar, bipolar, and unipolar devices. In monopolar devices, a delivery electrode is placed over a target area and a return electrode is applied at a distant site. This allows current to be generated, which passes through the target tissue and returns to the grounding pad somewhere else on the body inducing deeper thermal damage. In general, monopolar devices have more deeply penetrating effects than bipolar or unipolar devices. Pain is related to the duration of the pulse with some devices being painful and some being more lie gentle thermal heating. Monopolar devices can be static and dynamic. Generally, dynamic devices tend to be more like a warm massage. It is utilized for reduction for body contouring around the abdomen, hips, thighs, and other areas of fat.

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