Aesthetic Dermatology

Check clinical evidence behind body contouring devices


 

EXPERT ANALYSIS FROM CONTROVERSIES AND CONVERSATIONS IN LASER AND COSMETIC SURGERY

DANA POINT, CALIF. – If you’re in the market for a body contouring device, Dr. Robert Weiss advises factoring in "solid clinical evidence" before you buy.

"You want to see histologic evidence – apoptosis of fat cells, or at least diminution of fat cells," he said at a meeting sponsored by SkinCare Physicians and Northwestern University. "You want to see ultrasound confirmation of fat reduction, something that’s reproducible and objective. It [the device] also has to have ease of use," he said.

Courtesy Dr. Robert Weiss

This patient was treated with the Vanquish device.

"Most importantly, you want to know if patients themselves see a clinically meaningful response, a significant improvement. If they don’t see improvement, it [the objective value] doesn’t matter," he added.

Other important factors to consider before buying a body contouring device include making sure it has undergone animal studies of internal thermocoupling, and that it has an external temperature monitor for skin. "Infrared camera technology will also help to show how uniform the heating is, and how the skin relates to fat," said Dr. Weiss of the Maryland Laser Skin and Vein Institute, Hunt Valley.

Courtesy Dr. Robert Weiss

After 4 treatments, this patient’s waist circumference was reduced by 7 cm.

In his practice, Dr. Weiss uses four devices for body contouring: two cryolipolysis devices, one monopolar radiofrequency (RF) device, and one focused-field RF device. The last device, known as the Vanquish, was introduced at the 2013 American Academy of Dermatology meeting. Manufactured by Prague-based BTL Industries, Vanquish is a noncontact device that delivers focused-field RF through panels that are placed over the desired treatment area while the patient is lying horizontally. "The focal point is 10 mm below the skin surface, and it heats to 43-45° C," said Dr. Weiss, who was part of a team of researchers that demonstrated the efficacy of Vanquish in a porcine model (Lasers Surg. Med. 2013;45:235-39). "There are positive and negative fields created within the applicator," Dr. Weiss said. "What happens is that the fat creates more resistance, so the fat heats up but skin and muscle do not. We feel that this [device is] going to be a real game-changer."

Dr. Robert Weiss

In the study, a 70% reduction in abdominal fat was observed in pigs that were treated four times with the Vanquish for 30 minutes each. "Histologic evaluation revealed that epidermis, dermis, and adnexal structures such as hair follicles were unaffected by the treatment, while adipocytes were significantly affected," Dr. Weiss and his colleagues wrote.

Patients who have undergone treatment of excessive abdominal fat with the Vanquish describe a warm sensation during the procedure, with minimal side effects, Dr. Weiss said. "The more hydrated you are, the more selectivity there’s going to be, so we encourage people to drink water before the procedure," he said.

Dr. Weiss disclosed that he is a speaker and investigator for BTL Industries. He also has received honoraria and equipment from the company.

dbrunk@frontlinemedcom.com

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