noninvasive 360 degree body sculpting and cellulite … 360 degree body...noninvasive 360 degree...

Noninvasive 360 degree body sculpting and cellulite treatment

Robert H.Burke, MD,MS,DDS,FACS, FICS Professor of Plastic and Reconstructive Surgery, Michigan State University Professor of Facial Plastic Surgery , Michigan State University Director Michigan Center for Cosmetic Surgery Ann Arbor, Michigan U.S.A.

No Disclosures Level of Evidence II.

Gold Standard for Body Sculpting has been Surgical: liposculpture; surgical

recontouring; or a combination of both.

1. Surgical contouring after major weight loss

2. Combined liposculpture and abdominoplasty after pregnancies and deliveries (mommy makeovers)

3. Liposculpture for treatment of lipodysmorphia

(resistant to diet and exercise)

Best for contouring stubborn fat pockets resistant to diet and exercise: best with BMI <30. Not for weight loss.

Liposculpture

Abdominoplasty

Surgical Body Recontouring : Post Bariatric Surgery after massive weight loss; Skin and underlying tissue excess (gynecomastia; postpartum; following weight gain and loss)

Nonsurgical Body sculpting relies on fat reduction: through adipose cell destruction

or stimulation of cell shrinkage

1. Cryolipolysis(controlled cooling,freezing temperatures)

2. Laser Lypolysis(controlled heating and laser energy)

3. Radiofrequency lipolysis(controlled heating and ultrasound technology)

4. Injection lipolysis(injections target fat cells)

Noninvasive 360 degree body sculpting and cellulite treatment:adipose cell shrinkage

360 Degree Body Sculpting-and Cellulite Treatment

Novel Use of Noncoherent Red Light • Coherent light emitting laser devices (635 nm wavelength)

FDA approved for noninvasive fat reduction.

• Most commonly used device of this category emits 87.5 mW.

• Epidermal penetration of coherent light more efficient than noncoherent light.

• Early study concluded that noncoherent light was not effective for fat reduction due to transdermal inefficiency.

Mechanism of Action: adipose cell releases stored energy: cell size decreases

360 Degree Body Sculpting- Novel Use of Noncoherent Red Light

• Transdermal inefficiency overcome (with a noncoherent

light source) by increasing the power of the light source.

• An LED noncoherent LED light source emitting the same wavelength of light as the initially approved coherent (laser) - (635 nm) has been FDA approved for noninvasive fat reduction.

• This source uses 150 LED lights producing 1600 mW of power each (240,000 mW) .

• Results of the FDA pre approval study indicated accelerated, fat reduction compared to previously approved coherent light source (laser) devices.

360 Degree Body Sculpting- Novel Use of Noncoherent Red Light

• Pre approval FDA study: patients (58) lost an average of 3.5 inches in dimension.

• Pilot study undertaken to determine if significant fat shrinkage occurs in adults treated with the same LED light used in the FDA pre approval study compared to placebo controls.

• Arms of the study included: placebo controls; abdominal treatment; variations in number of treatments.

• 12 subjects enrolled in this 360 Degree Body Sculpting study

• Novel Use of Noncoherent Red Light

• Placebo controls randomly assigned: received 6 treatments at 1 week intervals

• Treatment subjects: 3-10 treatments (treatment were at 1 week intervals)

• 32 minutes treatment duration (8 minutes each of right and left sides, supine and prone positions)

360 Degree Body Sculpting- Novel Use of Noncoherent Red Light

360 Degree Body Sculpting- Novel Use of Noncoherent Red Light

•Weights obtained prior to the first treatment and immediately after the last treatment.

• Circumferential abdominal measurements: 4 areas: upper abdomen; mid abdomen; lower abdomen; hips.

Treatments vs circumferential inches lost

Circumferential abdomen: 10 subjects: 3-10 treatment sessions

• Weights obtained prior to the first treatment and immediately after the last treatment.

• Circumferential abdominal measurements: 4 areas: upper abdomen; mid abdomen; lower abdomen; hips.

Abdominal Results 11.5 inch (29.21 cm) abdominal dimension loss

Upper abd 34.5 32.5 -2.0

Mid abd 37.5 34 -3.5

Lower abd 44 40 -4.0

Hips 45.5 43.5 -2.0

Difference -11.5

Before/after frontal view

360 Degree Body Sculpting- Novel Use of Noncoherent Red Light

• PLACEBO

• Average age: 48

• Number of treatments: 6

• Average dimensional change: +.25 inches (0.623 cm)

• Weight loss: 0

• ABDOMINAL TREATMENTS

• Average age: 44.5

• Number of treatments: 3-10

• Average dimensional change: -7.2 inches(18.288 cm)

• Dimensional loss: -3.75-14 inches(9.525-35.56 cm)

• Average weight loss: -5.26 pounds(2.390 Kg)

Abdomen

0

2

4

6

8

10

12

14

16

1 2 3 4 5 6 7 8 9 10

INC

HE

S L

OS

T

LED LIGHT APPLICATION ABDOMEN

treatment number inches lost

• Ave age: 44.5(21-65)

• 10 Subjects

• 3-10 Treatments

• Average dimensional change: -7.2 inches (18.288 cm)

• Dimensional loss: -3.75-14 inches (9.525-35.56 cm)

• Average weight loss:-5.26 pounds (0.6-14) (2.390 Kg)

3 3

4 4

5 5

6 6 6

10

7

3.75

5 4.75

14

4.5

7.25

5

6.25

13.25

1 2 3 4 5 6 7 8 9 10

Dimensional Loss (inches) vs number of treatments

number of treatments inches lost

3 3 4 4

5 5 6 6 6

10

1

4

4.5 4.5

14

4

7

2

0.6

11

1 2 3 4 5 6 7 8 9 10

Po

un

ds

Number of treatments

Weight loss (pounds) vs number of treatments

number of treatments weight loss lbs.

360 Degree Body Sculpting- Novel Use of Noncoherent Red Light

3 3

4 4

5 5

6 6 6

10

7

3.75

5 4.75

14

4.5

7.25

5

6.25

13.25

1 2 3 4 5 6 7 8 9 10

Dimensional Loss (inches) vs number of treatments

number of treatments inches lost

360 Degree Body Sculpting- Novel Use of Noncoherent Red Light :Frontal

View:Pre and Post Treatment

360 Degree Body Sculpting- Novel Use of Noncoherent Red Light

Frontal:Pre and Post Treatment

Before Treatment After Treatment

360 Degree Body Sculpting- Novel Use of Noncoherent Red Light :Diver’s

View:Pre and Post Treatment:Color + Enhanced

360 Degree Body Sculpting- Novel Use of Noncoherent Red Light Lateral:Pre

and Post Treatment:Color + Enhanced

3 days following one 32 minute red light treatment

What is Cellulite ? • condition in which the skin has

a dimpled, lumpy appearance.

• usually affects the buttocks

and thighs

• can also occur in other areas.

• occurs when fat deposits push

through the connective tissue

beneath the skin.

• High prevalence (80%–90%) in postpubertal

female patients.

• little epidemiologic data published on its exact

prevalence, incidence, and associated factors.

• May worsen during high estrogen states:

pregnancy, nursing, and chronic use of oral

contraceptives.

• Diet, exercise, and lifestyle do not appear to be

associated with its development.

• Weight gain and obesity worsen the appearance of

existing cellulite.

Cellulite

1. Rare in males.

2. Secondary to androgen deficiency

from castration, hypogonadism,

Klinefelter’s syndrome, or estrogen

therapy for prostate cancer.

Cellulite

Nurnberger-Muller Scale-classifies cellulite 1. Stage Zero

No dimpling is seen on the skin when standing naked in front of the mirror. When the skin is pinched no orange peel effect is seen.

2. Stage One No dimpling is seen on the skin when standing, but when you pinch your skin you have bumps and lumps.

3. Stage two See dimpling or the orange peel appearance when standing naked in front of the mirror, but not when lie down.

4. Stage three You can see dimpling both when you are standing and lying down

No single treatment for cellulite is entirely

effective. (Mayo Clinic)

1. Combining modalities

2. Differing mechanisms of action

3. Offers the best current solution.

Cellulite treatment with Green Light

(535nm) LED photobiomodulation

•Improves skin appearance

•Reduces the appearance of cellulite

Upper legs: Results • Average age: 44.3 (40-51)

• 3 subjects

• 2-4 treatments

• Average dimensional change: -2.3 inches(13.436 cm)

• Dimensional loss: -1.75-4.5 inches (4.445-11.43 cm)

• Average weight loss: -2.3 pounds (1-5) (1.045 Kg)

Upper legs: Results Pre Treatment Post Treatment

4 days after 1 led red light treatment

Thank You