Objectives: Minimally invasive devices that enhance liposuction outcomes have dominated the EBD field for many years. Energy sources such as laser, RF, HIFU and MFU, and cryolipolysis have been found to be effective in the noninvasive fat reduction field, though volumetric reduction is limited. Recently, advances in the noninvasive device field have been shown to increase muscle mass, reduce visceral fat, and potentially increase bone mineral density. In our aging population, enhancement of the entire human framework has strong health benefits which cannot be achieved with minimally invasive devices.
Introduction: For many years, minimally invasive adjuncts plus liposuction have been considered superior to noninvasive EBDs for body contouring. The ability to physically remove liters of fat has sustained the value of the procedure. However, there are some aspects of contouring that cannot be achieved with these devices: reduction of visceral fat, and improvement of muscle contour and bone density. Body composition analysis has rapidly become a new measurement tool for overall wellness. Noninvasive methods are competitive with surgical assist type EBDs, and in some cases can surpass their capabilities.
Materials / method: While no direct comparison of minimally invasive and noninvasive fat reduction devices has been performed, the ability to remove liters of subcutaneous fat with one procedure would indicate a surgical approach is superior here. Four studies show superiority of these EBDs in skin tightening. Over 30 peer reviewed studies show subcutaneous fat reduction, visceral fat reduction, and muscle mass augmentation with noninvasive HIFEM and RF energy. Noninvasive devices devices excel at muscle enhancement and visceral fat loss. Studies regarding bone mineral density are currently underway.
Results: For subcutaneous fat reduction and skin tightening, minimally invasive devices excel.
Nonsurgical diastasis reduction can be achieved with both device types.
Noninvasive devices can address sarcopenia, visceral fat, and osteopenia. These aspects of aging are not treatable using either a surgical or minimally invasive approach.
Conclusion: While surgical tissue excision remains the treatment of choice for many massive weight loss patients, many will choose less invasive procedures with shorter recovery time and less perceived risk. Minimally invasive approaches remain the top choice when large amounts of subcutaneous fat need to be removed. However, the reach of noninvasive devices into new areas will help to further improve wellness and quality of life in our aging population.
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