There are several different types of HIFU devices that direct ultrasound energy to a tiny point in the subcutaneous tissue that passes harmlessly through the skin. Using transducers that can deliver different energy levels and focal depths, dermatologists can tailor HIFU treatment for each patient.
HIFU causes very little pain and may cause skin irritation in some patients. Most adverse effects of HIFU treatment resolve spontaneously within 4 weeks and in most cases within 12 weeks after treatment. There have been reports of pain, burning sensation, and mild blisters. There has been one reported case of purpure lesions at the treatment site. HIFU is not known to affect the way serum lipids or liver function tests are performed; in fact, HIFU may cause no abnormalities in these tests.
Lasers
It is becoming increasingly popular to use lasers for noninvasive body contouring. In the last few years, the FDA approved the FDA-cleared laser that uses hyperthermic energy to treat fat in the abdomen and other areas of the body. (39) The device is currently available for use on the upper back, inner and outer thighs, and the submental area. It is a 1060-nm laser that causes a permanent reduction in stubborn fat deposits. The procedure is noninvasive and looks natural. The FDA approved this laser that uses an advanced cooling system that helps minimize discomfort and minimizes the risk of damaging the skin. Initial results can be seen as quickly as 6 weeks posttreatment, and the final result can be achieved in as little as 12 weeks. It was found that the device had excellent safety characteristics and was well tolerated by patients; some patients reported mild discomfort.
Before the advent of this new 1060-nm diode laser, body contouring was done using low-level laser therapy (LLLT). It is a multi-head device that rotates to deliver high-level laser treatment on specific areas of the body. This device has 5 rotating diode laser heads that work at a wavelength of 635 nm. Each treatment session lasts about 30 minutes; it is generally recommended that patients undergo six to eight sessions of HIFU to achieve results that are as good as those obtained with LLLT. Low-level laser therapy is unique because it does not cause a permanent body reshaping by heating tissue; rather, it causes adipose cells to produce a special type of tiny pores that allow lipids to leak out of them, causing fat loss. LLLT causes adipocytes that are targeted to be instantly destroyed, so results are seen as soon as the treatment is completed; however, because of the fact that adipocytes are never killed, it is believed that the recurrence of fat deposits is greater than for other fat reduction modalities. Although LLLT can cause temporary results, long-term or permanent results should not be expected with LLLT. The fact that results are temporary can be either a benefit or a disadvantage, depending on the patient's goals. Some patients prefer immediate results, even if they gradually diminish over time; others prefer results that gradually increase over time and are more permanent, such as with HIFU and RF.
Complications with LLLT are less severe and more frequent than with most other body contouring procedures; in fact, several studies have reported no adverse effects with LLLT. Some patients reported a redness or redness in the treated area, as well as pain or tingling when they were urinating, but these symptoms were temporary and resolved spontaneously. Although lipids released by LLLT are absorbed through the lymphatic system, no studies have shown that LLLT increases serum lipid levels.
Liposuction