"Focused ultrasound seems to have real promise for noninvasive fat reduction and body contouring, and cryolipolysis may also become an important technique," says William P. Coleman III, M.D., who spoke at the 2010 joint annual meeting of the American Society for Dermatologic Surgery and the American Society of Cosmetic Dermatology & Aesthetic Surgery. Dr. Coleman is clinical professor of dermatology and adjunct professor of surgery (plastic surgery), Tulane Health Science Center, New Orleans.
ULTRASOUND ADVANCES Use of ultrasound for fat reduction has a long history, with a first description found more than 80 years ago, and externally applied ultrasound has been tried more recently as an adjunct for improving liposuction outcomes. Results of randomized, controlled studies, however, found no benefit for these more primitive devices.Currently, the development of focused ultrasound devices offering targeted internal delivery of acoustical energy to disrupt fat cells has renewed interest in ultrasound for fat reduction and body contouring. As of October 2010, there were two focused ultrasound platforms being developed for sale in the United States: LipoSonix (Medicis) and Contour (UltraShape).
The LipoSonix platform has a transducer that focuses energy in an adjustable range to a specific user-selected subcutaneous depth and has a pattern generator to increase treatment efficiency. Clinical trials show the treatment is associated with pain and bruising and results in an average circumferential fat reduction of about 2.8 cm that is appreciable after about three months.
However, "This amount of circumferential fat reduction is modest compared with liposuction, which can achieve up to 10 cm reduction," Dr. Coleman says.
The UltraShape Contour platform is also currently under review by the Food and Drug Administration, but is available in 57 other countries and has been used to treat nearly 200,000 patients, according to its manufacturer. Results from animal trials show that it selectively destroys fat cells, produces significant average circumferential fat reduction (up to 7.6 cm), is comfortable for the patient and has a good safety profile.
The UltraShape protocol involves a series of three treatments performed at two-week intervals and without anesthesia. The platform has a real-time tracking and guidance system for directing the energy to the target site and to prevent the same area from being treated twice.