Off-face skin scales tailored to each anatomical site can measure laxity and tightening of the neck, chest, arms, hands, abdomen, buttocks, and medial thighs. Although surgery may be indicated for major weight loss patients, other noninvasive modalities may be considered including: CO2 laser, bipolar radiofrequency, monopolar radiofrequency, microfocused ultrasound, and combination therapies. We provide a review of the literature for each modality and relevance to the off-face anatomical sites.
Semin Cutan Med Surg 34:118-128 © 2015 Frontline Medical Communications
Over the past 5 years, there has been a paradigm shift in the treatment of fat. The clear trend is toward noninvasive fat removal technologies over more traditional forms of fat removal such as liposuction. While these devices do not yet approach the results seen with liposuction, noninvasive treatments are gaining popularity due to their ability to safely and effectively reduce fat with little downtime and typically no need for anesthesia. The optimal candidate is relatively fit with localized areas of adiposity, rather than an obese patient. It is important to note that there are numerous noninvasive fat devices including low-level light, radiofrequency, laser, cryolipolysis, and ultrasound. Some of these technologies have more robust data to support their efficacy than others. This review will focus on only 2 noninvasive fat technologies: cryolipolysis and ultrasound.
Semin Cutan Med Surg 34:129-133 © 2015 Frontline Medical Communications
Mesotherapy is an intradermal or subcutaneous injection of therapeutic agents to induce local effects, and was pioneered in Europe during the 1950s. For the past 2 decades, there has been significant interest in the use of mesotherapy for minimally invasive local fat contouring. Based on the theorized lipolytic effects of the agent phosphatidylcholine, initial attempts involved its injection into subcutaneous tissue. With further studies, however, it became apparent that the activity attributed to phosphatidylcholine mesotherapy was due to the adipolytic effects of deoxycholate, a detergent used to solubilize phosphatidylcholine. Since then, clinical trials have surfaced that demonstrate the efficacy of a proprietary formulation of deoxycholate for local fat contouring. Current trials on mesotherapy with salmeterol, a b-adrenergic agonist and lipolysis stimulator, are underway—with promising preliminary results as well.
Semin Cutan Med Surg 34:134-137 © 2015 Frontline Medical Communications
With the recent approval of Kythera Biopharmaceuticals (Westlake Village, California) submental fat injectable treatment Kybella, there comes a lot of excitement—but, also a bit of concern. The idea of having a nonsurgical, nonliposuction treatment for people who have a double chin is certainly exciting. The hope has been that this new treatment will provide opportunities for the many people out there who are focused on the appearance of their submental fullness to have access to a safe, affordable, and reliable treatment.With the approval of this product, there are several misconceptions that the authors herein discuss.
Semin Cutan Med Surg 34:138-139 © 2015 Frontline Medical Communications
Cellulite is a condition that affects the vast majority of women. Although it is of no danger to one’s overall health, cellulite can be psychosocially debilitating. Consequently, much research has been devoted to understanding cellulite and its etiopathogenesis. With additional insights into the underlying causes of its clinical presentation, therapeutic modalities have been developed that offer hope to cellulite sufferers. This review examines evidence for topical treatments, noninvasive energy-based devices, and recently developed minimally invasive interventions that may finally provide a solution.
Semin Cutan Med Surg 34:140-143 © 2015 Frontline Medical Communications