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Liposuction in constant evolution: Laser blends wavelengths for body contouring

Article-Liposuction in constant evolution: Laser blends wavelengths for body contouring

Key iconKey Points

  • SlimLipo uses a blend of wavelengths, enabling high sensitivity.
  • Ideal candidates for selective laser-induced liposuction are those who have steady weight, exercise regularly, but have fat deposits that are refractory to conservative management.

Dr. Weiss
HUNT VALLEY, MD. Darwin surely did not have surgical fat removal in mind when he put forth his theory of evolution, but the principles are nonetheless apropos — the history of liposuction has been one of evolution: adaptation to meet the demands of the environment. In the decades since surgeons first tried vacuuming adipose tissue with a blunt-ended hollow cannula, liposuction has evolved via tumescent anesthesia, internal ultrasound-assisted procedures, external ultrasound-assisted procedures, to laser-assisted liposuction.

The upper arm of a 42-year-old female patient is shown (left) before and (right) six weeks after one SlimLipo treatment. The difference in circumference was 3.5 cm at six weeks.(All photos credit: Robert A. Weiss, M.D.)
It is within that laser-assisted scenario that SlimLipo — selective laser-induced melting — was born. This approach uses different wavelengths (which the surgeon can tailor to patient needs). Robert A. Weiss, M.D., dermatologist with the Maryland Laser, Skin, & Vein Institute, Hunt Valley, Md., president of the American Society of Dermatologic Surgery, and associate professor of dermatology at Johns Hopkins University School of Medicine, Baltimore, has extensive experience with the system.

Upper thigh of a 35-year-old female patient (left) before and (right) six weeks following one SlimLipo treatment. Circumference difference was 3.1 cm at six weeks.
MIXING IT UP He tells Cosmetic Surgery Times that, in his opinion, this is a significant step forward, because SlimLipo (Palomar Medical Technologies) uses a blend of wavelengths, enabling high selectivity. "It uses the 924 nm wavelength, which hasn't been used before in melting fat," Dr. Weiss notes. "The spectrophotometry on human fat shows a peak at around 924 nm in terms of fat absorbing that wavelength more than does water. So, that wavelength becomes selective for fat." He explains that the other wavelengths liposuction typically uses are not selective, "and, in fact, usually water absorbs preferentially over fat. So you're getting a secondary heating event after the heating of water." With the 924 nm wavelength, by contrast, the surgeon has "a direct heating event on fat." One size doesn't fit all, however, and that's where the selectivity comes in. "There's an additional 975 nm wavelength," Dr. Weiss continues, "which is a water-predominant wavelength. There are times when you want to heat up water, particularly if you're trying to get maximum skin tightening," as well as fat removal by heating the subcutaneous fibrous tissue — which has more water than it does fat — he says.

"This way, by blending the wavelengths, you can meld heating of the fat and water when you need to — for instance, at the fat-dermis interface, simultaneously." He adds that other systems he's used sometimes aid in skin tightening, "but, in terms of facilitating the actual lipolysis, in my hands, this has worked the best."

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