Objectives: This study aims to document the structural histologic changes in human subcutaneous tissue induced by the combination of RF treatment with the HIFEM procedure

Introduction: Radiofrequency (RF) is an accepted standalone modality for skin tightening and fat reduction utilizing heat-induced adipocyte apoptosis. HIFEM treatment is an effective tool for body shaping.

Materials / method: Four subjects (51.50±6.35 years, BMI of 22.59±3.21 kg/m2) received three 30-minute abdominal treatments consisting of a combined RF therapy and HIFEM procedure. A 5th subject (57 years, BMI of 23.60 kg/m2) served as a control. Punch biopsies were collected from the treatment area at the baseline, 1-week, and 1-month after treatment to examine treatment induced changes in adipocytes. Samples were sliced and stained with H&E. Waist circumference measurements and digital photographs were also taken at the same time points.

Results: Baseline samples showed normal adipocytes composed of round-shaped unilocular cells of uniform size. At follow-ups, the fat tissue demonstrated an elevated level of apoptosis and consequent fat reduction. Adipocytes were found to be flattened/shrunken and of smaller size (-33.5% at 1 week; -31.7% at 1-month) along with numerous ruptures of the cytoplasmic membrane. In contrast to baseline, the pyknotic nuclei with condensed nuclear chromatin occurred predominantly at 1-week, however, still observable at 1-month. The control samples showed no pyknotic nuclei, nor any clinical improvement.

Conclusion: Histological examination accompanied by circumference measurement and patient satisfaction confirmed the efficacy and safety of this new therapy combining RF and HIFEM treatments. Both treatment induced adipocyte apoptosis and shrinkage lead to overall reduction of fatty tissue.

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Objectives: Objectives: The objectives of this presentation is to review the newest fat reduction devices and how best to use them for the successful treatment of fat reduction.

Introduction: Introduction: Fat reduction is a very popular procedure and many devices have entered into our armamentarium to combat the problem.

Materials / method: Methods: An evidence-based review will show how well these devices work in everyday clinical practice.

Results: Results and Conclusions: Fat reduction with EBDs is real and we have the technology now to successfully reduce fat in appropriate patients.

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Objectives: In the last years, many non-invasive techniques for reducing subcutaneous adipose tissue and skin laxity have been developed. The aim of our experience has been to evaluate the efficacy and safety of Microwaves combined with Flat Electromagnetic Stimulation

Introduction: Among different techniques and procedures, combined treatment with microwaves and Flat Magnetic Stimulation has demonstrated satisfatory results. Microwaves act on the subcutaneous fat, producing localized, controlled heat absorbed by fat through a biophysical process called “dielectric heating”. FMS directly stimulates the muscle-innervating motor neurons, allowing full muscle contraction and remodeling, with a direct action on abdominal laxity and flaccidity, bypassing the central and peripheral nervous system.

Materials / method: Plattforms emitting Microwaves energy and Electromagnetic field have been combined in different session customizing any setting of parameters on the basis of the patient specific characteristics

Results: Accordingly, acting both on muscle cells and adipocytes, in a synergic way, the combined treatments have improved body shaping and, without being invasive, manteined a high safety profile

Conclusion: Our experience, confirming the efficacy and the safety of the sequentially combined treatments in all cases, pointed out the great patient compliance concerning efficay and tolerability

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Objectives: discuss cellulite

Introduction: cellulite tx options

Materials / method: cellulite tx options

Results: cellulite tx options

Conclusion: cellulite tx options

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Objectives: To devise the best approach for body contouring with combination of Multiple non invasive Technologies.

Introduction: Body contouring is defined as modification of body’s appearance through changes in size or shape.Non invasive body contouring devices improve the body’s appearance through the removal of excess adipose tissue and tone and tighten the skin by collagen remodelling.These modalities work effectively in the areas where there is stubborn fat that persists despite optimal diet and exercise routine.Instead of standalone modality, combination of modalities deliver more gratifying results

Materials / method: The shape of the body is determined by Fat,Muscle and Skin.Morphology and Physiology of these layer determine the shape of the body. The health and balance between these three layers is important in determining the body shape. As body shape is depended on multiple layer – fat, skin and muscle.We need multiple modalities to satisfy the patients.Best modalities available are Cryolipolysis.Ultrasound Cavitation,HIFEM and RF( Monopolar in motion, Monopolar Rf, Bipolar ,Tripolar ,, RFCoupled With Suction And Optical Energies,Multipolar With Pulsed Electromagnetic Field )

Results: After thorough body assessment of the patient we customise the treatment plan with combination modalities to deliver gratifying results. We consider Patient’s Physiological condition,expectations ,Age and his budget.Right counseling on diet and physical activity also add to the results

Conclusion: Using a right combination of modalities is the future trend in non invasive body contouring.

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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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