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Objectives: Cellulite is a dimpled, lumpy skin appearance in the gluteofemoral
body area, occurring almost exclusively in females. This chronic skin
condition is widespread and affects more than 85% of females
over 20. Cellulite does not necessarily correlate with
BMI's onset can be seen as early as during puberty. It does not demonstrate a significant association with lipedema, another GF-related disorder. Still, its manifestations are much more severe, with a reduced incidence rate and unknown pathophysiology, apparent mostly as a dramatic expansion of the subcutaneous white adipose tissue.

Introduction: Various pathophysiologies of cellulite have been proposed in the past. However, none of these proposed mechanisms can explain the most pronounced morphological alterations observed in the cellulite skin, namely, the distinct protrusions of the underlying adipose tissue into the dermis.

Materials / method: Pronounced protrusions of adipose tissue into the dermis can be caused either by reduced levels of adhesion between skin and WAT on the dermal–hypodermal junctions or by special properties of the superficial adipose tissue in cellulite skin, allowing its higher invasiveness. Here, we analyze recent results concerning the superficial adipose tissue in humans and the new morphological findings in
cellulite skin and underlying adipose tissue. We propose a new pathophysiology of this skin condition, which can explain the appearance of WAT protrusions in the dermis.

Results: Metabolic endotoxemia is a widely accepted pathophysiological factor in generalized adiposity and diabetes. However, the accumulation of LPS within a specific WAT depot has so far not been considered as a possible pathophysiological mechanism triggering localized WAT modifications. Still, it may very well be involved in such conditions as lipedema or cellulite. Here, we propose that the gfWAT depot provides conditions for local activation of TLR4 receptors. This makes this tissue more sensitive to low doses of LPS in gfWAT and will induce low-grade inflammation and promote fibrosis.

Conclusion: Whereas such low-grade gfWAT-specific endotoxemia should be a common effect leading to its low-grade inflammation accompanied by fibrosis and enhanced protrusions into the dermis, further increase of endotoxemia level in gfWAT must lead to the uncontrollable expansion of this tissue observed by lipedema. Also, I propose a new scheme of treatments based on the new physiopathology.

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Objectives: The field of non-invasive aesthetic and medical procedures has witnessed a paradigm shift with the advent of Patented High Intensity Focused Electromagnetic (HIFEM) technology. The learning outcome should result in knowledge and awareness of this groundbreaking innovation in addressing both aesthetic and medical concerns related to body contouring and pelvic health.

Introduction: Aesthetic patients now seek not only fat reduction but also enhanced muscle tone. Weakness in pelvic and back muscles can lead to a myriad of medical issues, such as back pain, diastasis recti, incontinence, urinary and fecal, and prolapse of the uterus. The core muscles, including abdominal and pelvic floor muscles, play a crucial role in overall body strength, stability, and aesthetic appearance.Traditional approaches to strengthen core muscles involve exercises in fitness studios, manual therapy by physical therapists, and exercises to relax or contract pelvic floor muscles.

Materials / method: HIFEM employs electromagnetic pulsed energy to induce supramaximal muscle contractions, targeting neuromuscular tissue and triggering rapid metabolic reactions in fat cells. The technology overcomes the limitations of voluntary workouts by achieving intensities not possible through traditional exercise.Several studies were performed .

Results: Patients undergoing HIFEM procedures report a 16% increase in muscle mass and an impressive 95% satisfaction rate. The therapy selectively interacts with motor neurons, creating intense pelvic floor muscle contractions that lead to increased strength, improved balance, posture, and potential relief from back discomfort.
Application in Female Sexual Dysfunction: Postpartum and postmenopausal women, the largest demographic of female sexual dysfunction patients, benefit significantly from HIFEM therapy. Studies show a 95% improvement in quality of life, and sustained results during follow-ups

Conclusion: The revolutionary HIFEM technology, introduces the Core to Floor Therapy, offering a non-invasive and effective solution in strengthening and tightening the pelvic and core muscles for bodycontourim´g as well as improving muscle functions to avoid incontinence, back pain and other medical disorders

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

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

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

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请注明名称（个人，公司，学会等等）: Venus Concept, InMode, Allergan Aesthetics, Cynosure, Cutera, Lightfective, SofWave, Solta

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请注明名称（个人，公司，学会等等）: Venus Concept, InMode, Allergan Aesthetics, Cynosure, Cutera, Lightfective, SofWave, Solta

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