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The rising popularity of non-invasive treatments in aesthetic medicine is undeniable. Body contouring procedures that do not require surgery are perfect for many patients who fear potential complications and a lengthy recovery.

For further information on this topic, you may be interested to learn more about the HealthCert Professional Diploma program in Aesthetic Medicine.

The four most effective and sought-after modalities for non-surgical body contouring are:

• Cryolipolysis
• Radiofrequency
• High-Intensity Focused Ultrasound (HIFU), and
• Laser Therapy

Overview

These procedures are non-invasive. That means a medical professional in primary care can achieve favourable outcomes with proper training. The devices in use are safe and effective, and there is no need for anesthaesia or hospital stay.

All body contouring procedures have the same goal. That is to decrease the abdominal circumference by reducing fat tissue in the area.

It is up to the practitioner to choose the optimal non-invasive modality and ensure the best outcome. The important decision-making factors are:

• Treatment (session) duration
• Number of sessions
• Treatment frequency
• Time until visible results
• Time until optimal results
• Decrease of abdominal circumference

Cryolipolysis

Cryolipolysis relies on the fact that adipocytes (fat cells) freeze easier than surrounding cells. The process leads to cell death (apoptosis) in fat cells. Other structures around them remain intact. When macrophages digest these apoptotic cells, the overall reduction of fat tissue occurs in the treatment area.

The cryolipolysis device vacuums the tissue between two cooling panels for thirty to sixty minutes. Side effects are minimal. Potential complications in the treatment area include:

• Sensitivity
• Bruising
• Swelling
• Pain
• Erythema

Radiofrequency

Radiofrequency uses the variations in the electrical resistance (impedance) between different tissues to destroy fat cells. That’s possible because fat tissue has a higher impedance than the skin, for example. So, it heats up much faster.

Monopolar radiofrequency devices provide a visible reduction of abdominal circumference. They require fewer sessions than bipolar devices.

There are no significant side effects. Complications may include short-lasting edema or erythema at the treatment site.

High-Intensity Focused Ultrasound (HIFU)

HIFU also uses thermal energy to provoke cell death in adipocytes. However, this technology relies on acoustic energy.

A HIFU device delivers energy deep into the dermis without causing damage to the epidermis and other structures. It heats fat cells to more than 65°C and causes both necrosis and apoptosis.

HIFU also promotes new collagen synthesis. Therefore, it also has a skin-tightening effect.

Side effects may include pain, erythema, and ecchymosis. Rare complications are blisters, subcutaneous nodules, purpuric lesions, and burning sensation.

Laser therapy

As a popular non-invasive modality in aesthetic medicine, laser therapy is the most versatile body contouring treatment. A laser device uses thermal energy to destroy fat cells. Each session causes a permanent reduction of fat. Although, at least six sessions over two weeks are necessary for visible results.

Laser therapy is the safest of all non-invasive body contouring modalities. Except for the mild discomfort during treatment, there are no other side effects. Rare complications may include swelling and erythema.

The bottom line

Doctors in primary care need to understand the patients’ aesthetic goals and manage their expectations. That way, they can help them choose the optimal body contouring procedure and maximise their satisfaction.

– Dr Rosmy Barrios

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References

1. Ingargiola MJ, Motakef S, Chung MT, et al. Cryolipolysis for fat reduction and body contouring: safety and efficacy of current treatment paradigms. Plast Reconstr Surg. 2015;135:1581-1590.
2. Beasley KL, Weiss RA. Radiofrequency in cosmetic dermatology. Dermatol Clin. 2014;32:79-90.
3. Ko EJ, Hong JY, Kwon TR, et al. Efficacy and safety of non-invasive body tightening with high-intensity focused ultrasound (HIFU). Skin Res Technol. 2017;23:558-562.
4. Decorato JW, Chen B, Sierra R. Subcutaneous adipose tissue response to a non-invasive hyperthermic treatment using a 1,060 nm laser. Lasers Surg Med. 2017;49:480-489.
5. Sorisky A, Magun R, Gagnon AM. Adipose cell apoptosis: death in the energy depot. Int J Obes Relat Metab Disord. 2000;24(suppl 4):S3-S7.