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Introduction
CHAPTER 68 Body-Contouring
Devices and Noninvasive Fat Removal
Mark S. Nestor Alexandria B. Glass Michael H. Gold
SUMMARY
Liposuction is now the second most frequently performed cosmetic procedure in
the United States.
Approaches to noninvasive body contouring include cryolipolysis, high-intensity
focused ultrasound (HIFU), low-level laser therapy (LLLT), hyperthermic
lasers, radiofrequency, and infrared lasers.
These approaches to noninvasive fat removal all selectively target components
of adipose tissue.
All minimally invasive body-contouring technologies fall far short of liposuction
in terms of clinical efficacy and rapidity of response.
Beginner Tips
No head-to-head studies have been performed comparing various technologies for
body contouring.
Be sure to closely investigate the various options before purchasing a device, as some
systems require a significant ongoing expenditure on consumables, while others do not.
Expert Tips
Patient selection is critical, as the degree of response seen with body contouring may
be relatively modest.
Most body-contouring approaches should only be used for patients with a BMI in the
normal range.
Combination therapies are a reasonable option for many patients.
Donโt Forget!
Some treatments, such as cryolipolysis, take several months to demonstrate complete
benefit. Therefore, appropriate planning is important for patients aiming to improve their body profile before a major event.
While all treatments are minimally invasive, some lead to more significant
postoperative edema and ecchymosis.
Pitfalls and Cautions
Paradoxical adipose hyperplasia may be rarely seen after cryolipolysis.
If it occurs, spontaneous resolution is not expected; therefore patients should always
be warned of this rare possibility.
While there is a theoretical risk of LFT and lipid changes during the fat resorption
phase, this has not been reported clinically.
Patient Education Points
Multiple treatments may be required.
No minimally invasive treatment can match liposuction in terms of efficacy, flexibility,
and rapidity of response.
Realistic expectations are critical, and patients who expect a dramatic response should
probably be warned against this approach.
CHAPTER 68 Body-Contouring