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Objectives: The current ultrasound case study was aimed to validate the results observed in previous studies after application of HIFEM field technology.

Introduction: Several recent studies claimed High-Intensity Focused Electromagnetic (HIFEM) field technology to be effective for body contouring through simultaneous muscle thickening and far layer reduction. However, more evidence is necessary to validate these results.

Materials / method: In this case study seven patients were enrolled and received 4 abdominal treatments using a novel device (30 minutes each) utilizing non-thermal HIFEM technology. Primary outcome of the study was to assess changes in the thickness of subcutaneous tissue. We performed four measurements at the predefined locations (lateral left/lateral right/subumbilical/epiumbilical region) at a distance 2 inches from the umbilicus. Data were obtained by an ultrasound system at the baseline and 1-month follow-up appointment. Wilcoxon signed-rank test was performed to determine the significance of the results.

Results: We observed a reduced thickness of the subcutaneous layer in all subjects at the 1-month follow-up and the average improvement over the measured abdominal areas reached 24.33±2.74% (-4.94±0.68 mm). The most visible reduction was observed epi-umbilicaly (26.82%, -5.7 mm), followed by right lateral (25.44%, -5.1 mm), sub-umbilical (24.59%, -4.9 mm) and left lateral (20.45%, -4.0mm) region. Statistical analysis revealed the significance of all results at P<0.05. Treatments were tolerated well and we observed no side effect or adverse event related to HIFEM procedure.

Conclusion: Presented results obtained on the small patient sample correlate with the results observed in previous research and indicate that HIFEM technology is able to safely reduce subcutaneous tissue layer in the abdominal area during the course of 4 treatments.

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Objectives: 1. To educate regarding the use of hyaluronic acid injectable fillers for medical and reconstructive use.

2. To learn about a non surgical technique that can be easily implemented into practise to treat soft tissue, fat and bony defects.

3. To discern which patients would be candidates for the medical and reconstructive use of hyaluronic acid injectable fillers.

Introduction: The use of hyaluronic acid as an injectable filler for cosmetic enhancement has been well described. It is efficacious for cosmetic use to contour, enhance and replace volume in the face and hands. This abstract describes a novel use of hyaluronic acid injectable fillers for medical and reconstructive use in patients who have soft tissue, fat and bony deficits as a result of congenital deformities, trauma or surgical procedures. This procedure has been used on the face, neck as well as areas on the body including the legs.

Materials / method: The technique involves first injecting the area to be treated with a 1% xylocaine with epinephrine for anesthesia. Subcision of scar tissue is then performed using an 18 gauge needle in order to release scarring and adhesions. Following the subcision, tissue expansion with normal saline is done by injecting normal saline into the area of subcision. The use of normal saline injection results in tissue expansion which produces a potential space. Into this space a hyaluronic acid filler is injected. After placement, the area is gently massaged. More specific details will be discussed.

Results: Post surgical and post traumatic patients with significant bony and soft tissue deficits were treated with hyaluronic acid injectable filler using the technique as described above in Method. All patients achieved an improvement in contouring and filling of these soft tissue and fat deficits. In addition, patients with bony deficits also saw an improvement in volume. Patients maintained these improvements up to 24 months post treatment. Indeed, even 3 years later they were better than their baseline examination.

Conclusion: Prior to the use of this technique, treatment options for patients with soft tissue, fat and bony defects were limited to fat grafting and surgical implants. This abstract describes the implementation of hyaluronic acid injectable fillers to treat these patients. This is a novel treatment that can be easily implemented into clinical practise as it is a practical, non-surgical, in office procedure with instantaneous results.

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Objectives: The objective of this study was to analyze the safety and compare the outcomes of the leading thermal and non-thermal technologies for body shaping.

Introduction: Noninvasive body shaping has for long been represented by thermal modalities such as cryolipolysis, low-level laser therapy (LLLT), radiofrequency (RF) and high-intensity focused ultrasound (HIFU). Lately, there has been an outbreak of studies describing non-thermal high-intensity focused electromagnetic (HIFEM) technology for body shaping.

Materials / method: To review and compare the leading techniques in body shaping and its outcomes, the terms ‘non-invasive’, ‘cryolipolysis’, ‘radio frequency’, ‘ultrasound’, ‘low-level laser’, ‘HIFEM’ and ‘electromagnetic’ were used along with ‘fat reduction’ and ‘body contour’ during the search in the PubMed database. We identified 42 prospective studies investigating thermal and non-thermal modalities for body contouring which used quantitative assessment such as circumferential, fat thickness or muscle thickness measurements.

Results: In fat reduction, HIFEM technology yields competitive results when compared to the thermal modalities, but does not outstrip the results of RF or cryolipolysis. Although HIFEM technology does not surpass the thermal technologies in fat reduction, it has a benefit of simultaneous thickening of the underlying muscles. The circumferential reduction by HIFEM is comparable to the non-thermal modalities, due to fat reduction and muscle tightening effect. In addition, treatments by thermal modalities are often accompanied by adverse events, while the HIFEM studies did not report any.

Conclusion: Thermal devices appear to be more effective for fat reduction, but non-thermal technology makes it up by its simultaneous effect on fat and muscle. The non-thermal technology may extend the scope of instruments for the doctors to more successfully fulfill the goals of their patients.

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Objectives: Recently published Global Consensus Guidelines for dilute and hyperdilute calcium hydroxylapatite (CaHA) contain detailed protocols for body and face areas. The objective of this technique is to provide a specific approach to the upper arms and elbows.

Introduction: CaHA can be used to improve both laxity and skin quality by promoting dermal remodeling through stimulation of collagen and elastin for a skin-tightening effect and improve superficial wrinkles, elasticity and skin thickness.

Materials / method: Approximately 3 mL CaHA per arm (diluted 1:2 or 1:3) is generally effective for treating the medial surface of the upper arms and elbows. For the upper arm fanning injection technique (cannula) or retrograde threading technique (needle) can be effectively used. CaHA can be used in combination with MFU-V to improve both laxity and skin quality in the arms; often MFU-V is used initially to strengthen tissue in thin or weak skin before filler. Same-day treatments involving CaHA and MFU-V should begin with MFU-V to avoid visualization difficulties and inadvertently delivering energy into filler.

Results: Results often last up to 18 months when using CaHA, given its ability to stimulate collagen production and improve the skin’s structure.

Conclusion: Individualized approaches involving both MFU-V and dilute CaHA are often most effective for simultaneously addressing laxity, skin quality, and lines/wrinkles for upper body tightening and shaping of multiple body areas, including the upper arms and elbows.

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Objectives: To evaluate the efficacy of radio frequency ultrasound and ultracavitation
In combination with primary Cryolipolysis in the Indian fat reduction scene

Introduction: The Indians speciallyales are prone to central obesity and fat deposits in the anterior abdominal wall and flanks
This study evaluates the use of various energy based devices to reduce the fat deposits without surgery

Materials / method: Cryolipolysis
Ultrasound
Bipolar RF
MONOPOLAR RF
ULTRACAVITATION

Results: Reduction in waistline
Reduction in cellulite
Reduction in stretch marks
Reduction in fat on flanks (love handles )
In 80 percent cases

Conclusion: In the modern area of body shaping and fat reduction we aim to provide the Indian perspective with different protocols of treaent and challanged the lots to get the desired results

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