Patients who are suitable for this treatment should have at least 1 inch (2.4cm) of fat in the target area. This can be verified through a “pinch an inch test.” Nerves or blood vessels that lie close to the skin surface should be avoided. Unlike in other body sculpting procedures, I wait at least 3 months for the visible outcome to appear for Liposonix. But I set the intervals shorter for Liponix for repeated treatments in the same area. In my experience, the process that goes through panniculitis, apoptosis, subcutaneous fat reduction, collagen remodeling, and subcutaneous fat contraction seem to be maintained longer with Liposonix (Figure 3). The outcome will be drastic when the patient’s efforts at weight loss are added. I recommend continued follow~up visits to my patients and provide education and guidance. Prior to treatment, it is important to communicate to the patient the possibility of pain, bruising, redness and swelling which can continue for 7~14 days.

 

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The patient in <Figure 4> received Liposonix treatment in 7 sites around the navel, 10 sites in the right flank, and 9 sites in the left flank for abdomen and waist fat reduction. I used a total energy level of 140 J/cm² per site (Figure 4). The benefits of Liposonix are greatly enhanced if the patient adds weight loss efforts (sufficient sleep, exercise and dietary control, etc.) for 8~12 weeks after treatment. I encourage my patients to add their personal efforts as much as possible.  

 

Figure 3. Histological reaction after HIFU. 

 

To maximize the benefits of Liposonix and, sufficient energy should be used in the target area. This inevitably causes a certain level of pain. Liposonix can be carried out with grid repeat (irradiate over the entire lesion first and repeat the irradiation over the entire lesion) and site repeat (repeated irradiation over the same area). The grid repeat tends to cause less pain, whereas the site repeat can raise the total energy faster but can be painful. Despite its noninvasiveness, general anesthesia is sometimes used due to pain. However, having the patient conscious during the procedure is more helpful for accurately locating the target area and lowering the risk of nerve damage and other side effects. Pain and the required number of repeat treatments were improved through last summer’s software upgrade and the device is able to provide a more efficient noninvasive treatment. The pain, however, is a challenge for doctors as it is inevitable due to the high amount of energy that needs to be used. Liposonix’s advantage is that it can pinpoint the exact area of desired fat reduction with excellent efficacy. It brings volume reduction and simultaneous tightening effects in areas with sagging skin. Liposonix is particularly beneficial for patients who want abdomen fat reduction and tightening after childbirth.

 

Many Korean manufacturers have presented HIFU devices that can be used in the face. I hope that this technology is expanded into developing HIFU devices for body sculpting. A new device that maintains the advantages of Liposonix such as precise and consistent energy delivery, and skin protection device, while improving upon the pain, limited focusing point, and cost of expendable parts, etc., will provide a breakthrough in the field of noninvasive fat reduction treatment. 

 

Figure 4. Before and after Liposonix treatment.

 

Figure 5. Liposonix device.

 

-To be continued