Objective
This article is intended to demonstrate efficiency of the IPL device which is designed to provide the highest peak power and shorter pulse duration for treatment of vascular and pigmented lesions.

Methods and materials
The Lumecca IPL device (InMode Ltd.) was used in a pilot study for treatment of vascular and pigmented lesions. The Lumecca IPL device has a peak power of 3.3 kW/cm² and 3 cm² area. That combination allows for a fluence of 10 J/cm² at a pulse duration of only 3 ms. Such pulse durations correspond to the TRT for vessels with diameters of 70 μm. For comparison, a pulse width of 20 msec corresponds to a TRT of a vessel with diameter of 18 μm. In patients a single treatment with fluence of 8-16 J/cm² and filter of 515nm was performed and followed-up after four weeks.

Conclusion
Single treatment with Lumecca provides significant improvement for majority of patients. Exceptionally short pulses provide improvement even for some patients who had previous treatments with other IPL devices. The high peak power of Lumecca makes its effect on vascular lesions comparable to a pulse dye laser.

Published date:

24 September, 2015

Radiofrequency-Assisted Liposuction Compared with Aggressive Superficial, Subdermal Liposuction of the Arms: A Bilateral Quantitative Comparison

Background:
Liposuction of the arms alone may be inadequate for aesthet- ic improvement because of skin laxity. Radiofrequency-assisted liposuction (RFAL) and aggressive super cial liposuction (SupL) have been described to stimulate soft tissue retraction to improve results. We compare the tech- niques and describe a classi cation scheme that factors skin laxity, skin quality, and Fitzpatrick type to provide treatment recommendations.

Methods:
Ten consecutive female patients underwent RFAL of 1 arm and SupL on the contralateral arm. All patients had Fitzpatrick skin types of III, IV, or V with an average body mass index of 26.0. Using uorescent tattooing, key points on the arm skin were measured preoperatively and postoperatively to indicate changes in surface area.

Results:
There were no complications in the group, and all patients re- ported satisfaction with the aesthetic results. All patients showed reduc- tion of measured skin surface areas and skin distances postoperatively. At 1 year, the measured surface area reductions on the anterior arms averaged 15.0% for RFAL and 10.9% for SupL on the anterior arm skin. Posteriorly, RFAL showed 13.1% reduction and SupL 8.1% reduction in the surface areas at 1 year. Linear reduction for RFAL averaged 22.6% and 17.8% for SupL 1 year postoperatively anteriorly.

Conclusion:
Both RFAL and SupL of the arms showed quanti able and sustained reductions in skin surface. Good contour and soft tissue contrac- tion were achieved with both techniques but RFAL with its safety features presents an alternative to SupL, which has a higher complication rate, risk for contour deformities, and steeper learning curve.

Published date:

10 August, 2015

Split-face histological and biochemical evaluation of tightening efficacy using temperature- and impedance-controlled continuous non-invasive radiofrequency energy

Bipolar radiofrequency (RF) is capable of heating dermal collagen fibers and inducing skin tightening by collagen remodeling.

Objective: To substantiate safety and improvement of skin laxity following skin heating with a novel temperature- and impedance-controlled non-invasive radiofrequency (RF) device by histological and biochemical evaluations.

Methods: A split-face study was performed on 4 subjects who underwent 8 weekly RF sessions on one side of their face, leaving the other side an untreated control and then underwent facelift procedure. Clinical evaluation by photographs was done prior to the surgical procedure. Ex vivo fragments were harvested from both sides and compared. Morphometric analysis of dermal collagen fibers, collagen synthesis, and elastin synthesis evaluations were compared in triplicates.

Results: Facial skin tightening was apparent in split-face photographs. A significant increase of 7.9% in dermal collagen content, and a significant increase of 34.7% in collagen synthesis were demonstrated in the treated samples. No statistically significant effect on elastin synthesis was detected.

Conclusions: Skin tightening following treatment with non-invasive RF has proven histologically and biochemically to derive from increase in dermal collagen synthesis and content.

Published date:

01 June, 2015

A novel non-invasive radiofrequency dermal heating device for skin tightening of the face and neck

Background
Loose, lax skin is a common cosmetic complaint. Previous non-invasive skin tightening devices had modest efficacy and were associated with pain or downtime. New technologies may allow for effective skin tightening with a series of no downtime, radiofrequency treatments.

Objective
To evaluate the efficacy and safety of a novel bipolar radiofrequency device for skin tightening.

Methods
15 consecutive female patients were enrolled in the case series; 14 completed the study and were included in the analysis. The device under investigation is a novel, bipolar radiofrequency device allowing for achievement and maintenance of optimal dermal temperatures to stimulate collagen remodeling and skin tightening. Patients underwent a series of 4-6 weekly treatments. Three blinded, experienced cosmetic physicians evaluated paired blinded pre-treatment and post-treatment photographs and determined the associated improvement, if any.

Results
All patients (14/14) were determined to have a clinical improvement, as the pre-treatment and post-treatment photos were correctly identified by the evaluators. 21% (3/14) patients were observed to have significant improvement, 50% (7/14) observed to have moderate improvement, and 29% (4/14) had mild improvement. No pain, side effects or adverse events were observed.

Conclusions
This novel bipolar radiofrequency device represents a safe, effective treatment option for non-invasive skin tightening.

Published date:

15 May, 2015

A Clinical and Biological Evaluation of a Novel, Noninvasive Radiofrequency Device for the Long-Term Reduction of Adipose Tissue

Background and Objective
A novel, noninvasive technology, utilizing suction-coupled radiofrequency (RF) heating and ultra-short pulse duration, high-voltage electrical pulses was studied for its efficacy and safety on adipose tissue reduction.

Method
Twenty-one subjects underwent treatment of their abdominal fat once weekly for 6 weeks. Clinical outcomes including abdominal circumference, adipose tissue thickness (measured by ultrasound), adipose tissue weight, body weight, and clinical photographs were obtained at visits 1 and 3 months after last treatment. Adverse events were recorded. Three subjects, who were undergoing a future elective abdominoplasty, were treated with the same protocol, but on only one side of the abdomen before abdominoplasty. Biopsies from the RF-treated and untreated sides were harvested during abdominoplasty and cultured; measurements of adipocyte size and shape, rate of apoptosis, collagen production, and dermal thickness were determined.

Results
Significant clinical improvements (P < 0.05) were observed for the reduction of abdominal circumference (113.4–110.7 cm). Within the adipose tissue of the treated areas, increased levels of adipocyte apoptosis were observed immediately following the treatment series, with approximately 20% of all adipocyte cells staining positive for APAF-1, a validated marker of apoptosis. In contrast, the control untreated skin only rarely had adipocytes undergoing apoptosis, with less than 1% of adipocytes staining positive for APAF-1. At day 14 of culture, fat cell apoptosis had further increased (30% of adipocytes staining positive for APAF-1) within the RF-treated adipose tissue. Additionally, a significant increase in collagen synthesis (neocollagenesis) representing an average increase of 13.7% was observed after treatment by the RF device, with a mean collagen level of 57.6 mg/mg in the treated zone versus 49.7 mg/mg in the non-treated zone, as determined by the spectrocolorimetric method. Only minor, transient side effects were reported.

Conclusions
This novel, noninvasive RF device was effective for improving subcutaneous fat, reducing abdominal circumference and reducing subcutaneous fat layer thickness. Histologically, these improvements appear to be partly related to increased adipocyte apoptosis.

Published date:

18 February, 2014

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Clinical papers

Peak Power Effect On Skin Rejuvenation Using Ipl: Lumecca Ipl Evaluation

Radiofrequency-Assisted Liposuction Compared with Aggressive Superficial, Subdermal Liposuction of the Arms: A Bilateral Quantitative Comparison

Split-face histological and biochemical evaluation of tightening efficacy using temperature- and impedance-controlled continuous non-invasive radiofrequency energy

A novel non-invasive radiofrequency dermal heating device for skin tightening of the face and neck

A Clinical and Biological Evaluation of a Novel, Noninvasive Radiofrequency Device for the Long-Term Reduction of Adipose Tissue

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