Internal liposuction remains the standard and most reliable method to remove fat and contour the face and body. The recent introduction (2006 FDA clearance) of a higher and more controlled energized internal laser system is purported to increase tissue contraction and damage unwanted fat deposits through dual 1064 nm/1320-nm wavelengths that are initially used at a deep level of subcutaneous fat, and subsequently at a shallow level beneath the dermis along with liposuction. Using classical principles of selective photothermolysis, the sequential exposure of these wavelengths on target tissue chromophores results in selective thermo-lipolysis and thermo-denaturation of collagen fibers (H2O) within the septal architecture and lower reticular dermis for enhanced skin retraction (accommodation) and contraction. This article reviews this innovative laser system, discusses the latest clinical protocol changes, tabulates the measurements of time and energy during each phase of treatment and temperature endpoints, and correlates the histologic findings to energy deposition. The collected objective data are used to improve on the safety and efficacy treatment profiles at 11 sites in 75 consecutive patients. Further clinical studies and comparative trials are recommended to validate these outcomes.
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