|J Cosmet Laser Ther. 2008 Dec;10(4):202-9.
Reduction of subcutaneous fat and improvement in cellulite appearance by dual-wavelength, low-level laser energy combined with vacuum and massage.
Boston Surgical Group, Southborough, MA 01772, USA. Lach@alum.mit.edu
BACKGROUND: This study compares the efficacy and safety of low-level, dual-wavelength laser energy and massage with massage alone for the reduction of subcutaneous fat in the thighs of normal women. The device was an early prototype of the FDA-cleared SmoothShapes system (Elemé Medical, Merrimack, NH, USA).
METHODS: The thighs of each individual (n=102) were randomized to either laser light (dual wavelength of 650+/-20 nm and 915+/-10 nm) and massage or to massage alone (control). Individuals who completed the study (n=74) received a mean of 14.3 treatments over 4-6 weeks. Magnetic resonance imaging (MRI) scans quantified fat pad dimensions before and after the final treatment.
RESULTS: Fat thickness decreased for the leg treated with laser-massage by 1.19 cm(2) (mean) and increased by 3.82 cm(2) (mean) for the control leg over time. The difference was statistically significant (p<0.001). Among those who completed the study, 82.26% responded to treatment. Individuals reported looser-fitting clothing and satisfaction with the procedure and results. Adverse effects were limited to occasional increases in urinary frequency.
CONCLUSION: Low-level, dual-beam laser energy with massage appears to be safe and more efficacious than massage alone for reducing subcutaneous fat in the thighs of normal women.
Lasers Med Sci. 2006 Apr;21(1):19-23. Epub 2006 Mar 25.
Action of low-level laser therapy on living fatty tissue of rats.
Medrado AP, Trindade E, Reis SR, Andrade ZA.
Laboratory of Experimental Pathology, Oswaldo Cruz Foundation, Rua Waldemar, Falcao, 121 Brotas, CEP: 40295-001, Salvador, Bahia, Brazil. firstname.lastname@example.org
Little is known about the action of laser rays on normal adipose cells. The present study attempts to observe the behavior of fatty cells submitted to laser therapy. Dorsal fat pads of normal adult rats were submitted to low-level laser irradiation applied locally through intact skin, with four different dose schedules (4, 8, 12, and 16 J/cm(2)), with a further group being sham-irradiated. Histology, morphometry, immunofluorescence, and electron microscopy were all used to analyze irradiated tissues. Changes were restricted to the brown fatty tissue, in which a tendency was shown for multivacuolar cells to be transformed into the unilocular type. The number of cells which exhibited enlargement and fusion of small vacuoles was greater in the 4- and 16-J/cm(2) groups (p<0.05). Increased vascular proliferation and congestion was another more evident finding in laser-treated animals compared to nontreated animals. Low-level laser rays cause brown adipose fat droplets to coalesce and fuse. Additionally, they stimulated proliferation and congestion of capillaries in the extracellular matrix.
Clin Plast Surg. 2006 Jan;33(1):117-27, vii.
Low-level laser-assisted liposuction: the Neira 4 L technique.
Neira R, Toledo L, Arroyave J, Solarte E, Isaza C, Gutierrez O, Criollo W, Ramirez H, Gutierrez MI, Ortiz-Neira CL.
Department of Plastic Surgery, Maxillofacial and Hand Surgery, Pontificia Universidad Javeriana, Cali, Colombia. email@example.com
Low-level laser-assisted liposuction (LLLL), known as the Neira 4 L technique, is an excellent adjuvant tool for the surgeon practicing liposculpture. A low-level laser is used to create a transitory pore in the cell membrane of the adipocyte to move fat from inside the cell to the interstitial space outside without killing the cell. LLLL has been performed successfully in in-vitro and human adipose tissue cultures. It protects the patient from the surgical trauma of liposuction by protecting and preparing tissues for the surgical trauma; modulating the inflammatory response to prevent short and long-term side effects of surgery; and improving the quality and quantity of the healing process by accelerating recovery time, modulating secondary cicatrization, and preventing postoperative neuralgias.
Plast Reconstr Surg. 2004 May;113(6):1796-804; discussion 1805-6.
Effect of low-level laser therapy on abdominal adipocytes before lipoplasty procedures.
Brown SA, Rohrich RJ, Kenkel J, Young VL, Hoopman J, Coimbra M.
Nancy Lee and Perry Bass Advanced Wound Healing and Tissue Regeneration Laboratory, Department of Plastic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9132, USA. firstname.lastname@example.org
Low-level laser therapy is a new subspecialty for the medical application of lasers that provides therapeutic rather than surgical outcomes for many medical indications. Recently, low-level laser therapy was reported to “liquefy” or release stored fat in adipocytes by the opening of specialized yet not identified cell membrane-associated pores after a brief treatment. Currently, low-level laser therapy is a U.S. Food and Drug Administration-approved technology for improving pain alleviation. To explore these data further, a series of in vitro studies on human preadipocytes and institutional animal care and use committee-approved protocols in a porcine Yucatan model and an institutional review board-approved clinical study were performed. Using a 635-nm low-level laser of 1.0 J/cm supplied to the authors by the vendor, these studies were designed to determine whether alteration in adipocyte structure or function was modulated after low-level laser therapy. Cultured human preadipocytes after 60 minutes of laser therapy did not change appearance compared with nonirradiated control cells. In the porcine model, low-level laser therapy (30 minutes) was compared with traditional lipoplasty (suction-assisted lipoplasty) and ultrasound-assisted lipoplasty. From histologic and scanning electron microscopic evaluations of the lipoaspirates, no differences were observed between low-level laser therapy-derived and suction-assisted lipoplasty-derived specimens. Using exposure times of 0, 15, 30, and 60 minutes in the presence or absence of superwet wetting solution and in the absence of lipoplasty, total energy values of 0.9 mW were delivered to tissue samples at three increasing depths from each experimental site. No histologic tissue changes or specifically in adipocyte structure were observed at any depth with the longest low-level laser therapy (60 minutes with superwet fluid). Three subjects undergoing large-volume lipoplasty were exposed to superwet wetting fluid infiltration 14 minutes before and 12 minutes after, according to vendor instructions. Tissue samples from infiltrated areas were collected before suction-assisted lipoplasty and lipoaspirates from suction-assisted lipoplasty. No consistent observations of adipocyte disruptions were observed in the histologic or scanning electron microscopy photographs. These data do not support the belief that low-level laser therapy treatment before lipoplasty procedures disrupts tissue adipocyte structure.
Plast Reconstr Surg. 2002 Sep 1;110(3):912-22; discussion 923-5.
Fat liquefaction: effect of low-level laser energy on adipose tissue.
Neira R, Arroyave J, Ramirez H, Ortiz CL, Solarte E, Sequeda F, Gutierrez MI.
Department of Plastic Surgery, Centro Medico Imbanaco, Avenida 4-Oeste #5-274, Apto 301 B, Edificia Bosque Valladares, Cali, Colombia. email@example.com
Low-level laser energy has been increasingly used in the treatment of a broad range of conditions and has improved wound healing, reduced edema, and relieved pain of various etiologies. This study examined whether 635-nm low-level lasers had an effect on adipose tissue in vivo and the procedural implementation of lipoplasty/liposuction techniques. The experiment investigated the effect of 635-nm, 10-mW diode laser radiation with exclusive energy dispersing optics. Total energy values of 1.2 J/cm(2), 2.4 J/cm(2), and 3.6 J/cm(2) were applied on human adipose tissue taken from lipectomy samples of 12 healthy women. The tissue samples were irradiated for 0, 2, 4, and 6 minutes with and without tumescent solution and were studied using the protocols of transmission electron microscopy and scanning electron microscopy. Nonirradiated tissue samples were taken for reference. More than 180 images were recorded and professionally evaluated. All microscopic results showed that without laser exposure the normal adipose tissue appeared as a grape-shaped node. After 4 minutes of laser exposure, 80 percent of the fat was released from the adipose cells; at 6 minutes of laser exposure, 99 percent of the fat was released from the adipocyte. The released fat was collected in the interstitial space. Transmission electron microscopic images of the adipose tissue taken at x60,000 showed a transitory pore and complete deflation of the adipocytes. The low-level laser energy affected the adipose cell by causing a transitory pore in the cell membrane to open, which permitted the fat content to go from inside to outside the cell. The cells in the interstitial space and the capillaries remained intact. Low-level laser-assisted lipoplasty has a significant impact on the procedural implementation of lipoplasty techniques.