BACKGROUNDFine lines and rhytides are clinically evident signs of photodamage. Traditionally, ablative and nonablative lasers have been used for nonsurgical facial rejuvenation, but their side effects and downtime have limited their use.OBJECTIVERadiofrequency (RF) is novel nonablative technology or

Radiofrequency in cosmetic dermatology: a review

Treatments for localized adiposities range from topical creams to liposuction. Most treatments lack a substantial proof of efficacy. The unpredictable treatment outcome can be related to the fact that cellulite adipose tissue is physiologically and biochemically different from subcutaneous tissue found elsewhere in the body. Part II of this two-part series on cellulite reviews the various treatment options that are currently available for human adipose tissue including, but not limited to, cellulite. It also focuses on newer techniques that can be potentially useful in the future for the treatment of cellulite.

Treatment of cellulite: Part II. Advances and controversies.

http://files.dermatofuncional.webnode.com.br/200000684-06cc007c5f/Mulholland,%202011.%20Contorno%20corporal-LLLT,%20RF,%20Crio,%20US.pdf

Noninvasive Body Contouring with Radiofrequency, Ultrasound, Cryolipolysis, and Low-Level Laser Therapy

Background
Body-sculpting procedures are becoming increasingly popular in the United States. Although surgical lipoplasty remains the most common body sculpting procedure, a demand exists for noninvasive alternatives capable of reducing focal adiposity without the risks of adverse events (AEs) associated with invasive excisional body-sculpting procedures.

https://www.mikronmed.se/dokument/liposonix-studie-2.pdf

Noninvasive Body Sculpting Technologies with an Emphasis on High-Intensity Focused Ultrasound

Controlled cold exposure has long been reported to be a cause of panniculitis in cases such as popsicle panniculitis. Cryolipolysis is a new technology that uses cold exposure, or energy extraction, to result in localized panniculitis and modulation of fat. Presently, the Zeltiq cryolipolysis device is FDA cleared for skin cooling, as well as various other indications, but not for lipolysis. There is, however, a pending premarket notification for noninvasive fat layer reduction. Initial animal and human studies have demonstrated significant reductions in the superficial fat layer thickness, ranging from 20% to 80%, following a single cryolipolysis treatment. The decrease in fat thickness occurs gradually over the first 3 months following treatment, and is most pronounced in patients with limited, discrete fat bulges. Erythema of the skin, bruising, and temporary numbness at the treatment site are commonly observed following treatment with the device, though these effects largely resolve in approximately 1 week. To date, there have been no reports of scarring, ulceration, or alterations in blood lipid or liver function profiles. Cryolipolysis is a new, noninvasive treatment option that may be of benefit in the treatment of excess adipose tissue.

https://www.bowiemedical.nl/media/wysiwyg/Cryolipolysis_wetenschappelijke_informatie.pdf

Cryolipolysis for reduction of excess adipose tissue.

BACKGROUND Cellulite is seen in more than 85% of postpubertal women. Recent studies show that bipolar radiofrequency and low-level laser devices can produce mild skin tightening of cellulite.



OBJECTIVE The primary objective was to determine if a novel unipolar, more deeply penetrating, radiofrequency device can promote better skin tightening with fewer treatments than is seen with previously described devices. The secondary objective was to determine if such a deeply penetrating device produced undesired effects on lipid metabolism.



METHODS Thirty subjects, with Nurnberger-Muller Scale III–IV upper thigh cellulite, were entered into the study. All were treated, every other week, with a unipolar radiofrequency device for a total of six treatments. Subjects were evaluated before and 6 months after treatment with clinical photographs, clinical measurements, biopsies, MRIs, and blood lipid evaluations.



RESULTS Twenty-seven subjects showed evidence of clinical improvement. The mean decrease in leg circumference was 2.45 cm. Histologic changes showed dermal fibrosis of the upper dermis. No MRI or lipid abnormalities were noted.



CONCLUSION Upper thigh skin cellulite can be improved with a new unipolar radiofrequency device. Histologic changes suggest skin tightening as the method of improvement. No undesired complications of the skin or lipid metabolism were noted.

Amin Fazeli

Papers

Clinical, laboratory, and MRI analysis of cellulite treatment with a unipolar radiofrequency device.