Introduction

Minimally-invasive procedures are generally more sought-after due to shorter downtime and costs. These factors have led to further innovation in body contouring, a new form of which are Laser-assisted lipolytic devices.

Mechanism of Action

Unlike traditional liposuction, which uses suctioning of fat to perform contouring, these devices have a two-way mechanism of action. Laser energy not only helps to liquify fat, but also goes on to carry out collagen remodelling, resulting in more firmness and improved contours over time.

A fiber optic cable is inserted into subcutaneous tissue, and delivers focused laser beam into fat.

This brings about the following effects:

1- Thermal damage of fat cells: heat from laser helps to break down adipocyte membranes, resulting in fat liquifaction.

2- Mechanical damage of fat cells: Microtrauma resulting from laser fiber movement, brings about further destruction of adipocytes.

3- Collagen remodelling: application of laser to inner layers of skin gives powerful collagen remodelling, leading to a more organised dermis and hence, improved skin firmness.

Laser specification

Most devices use Nd-yag or Diode lasers, with wavelengths varying from 924nm to 1470nm. Different wavelengths exhibit varying affinities for fat and water. Generally, diode laser offers better fat and water penetration and stronger skin tightening, leading to more favourable outcomes. 980nm tends to be absorb better in high volume fat areas such as abdomen, while 1470 appears more suited to delicate areas like chin. 1470nm, in addition to lipolytic effect, also performs stronger collagen remodelling and skin tightening and allows better coagulation. While many devices work with a single wavelength, newer devices tend to combine two wavelengths to make the device more compatible with various areas of the body and to give safer, better outcomes.

Clinical applications

These devices can be used to bring about contour improvements in mild to moderate skin laxity. Ideal candidates will have BMI lower than 30, in good general health, and have realistic expectations from the treatment. Areas that can be treated include chin, arms, thighs, abdomen, male gynecomastia, lower back, bra roll, as well as improving skin laxity on lateral face, hands, knees, neck and decollette as well as laxity in any other part of the body.

Procedure details

Usually a tumescent anaesthetic is used prior to the procedure. Upon achieving adequate numbing, laser fiber is introduced into the tissues. Usually multiple passes are carried out. A 'pop-corn' sound is heard due to interaction between laser and fat cells, indicating fat lysis. Towards the end, the melted fat can either be suctioned out or left to reabsorb by body's lymphatics.

Post-procedure care

Essential to give best possible outcomes, post-procedure care is important to bring about a favourable results. These include use of compression garments and lymphatic drainage massages for the next few weeks, to help reduce swelling and impact positively on skin tightening.

What does the future hold

With better awareness and knowledge about minimally invasive procedures, laser-assisted lipolysis offers a favourable solution to patients seeking facial and body contouring without having the need to opt for invasive surgery. Future will see more increase in demands and provisions of this device and procedures.