Decorato John W, Chen Bo, Sierra Rafael
Private Practice in Plastic Surgery, Staten Island, New York.
Cynosure, Inc., Westford, Massachusetts.
Lasers Surg Med. 2017 Jul;49(5):480-489. doi: 10.1002/lsm.22625. Epub 2017 Jan 19.
We postulated that a hyperthermic treatment using a 1,060 nm laser can cause a controlled adipocyte injury resulting in non-invasive fat reduction. This three-part study identified treatment parameters for a safe and tolerable treatment, demonstrated short- and long-term tissue response, and assessed the potential of this treatment for non-invasive fat reduction.
In vivo temperature measurements were conducted prior to abdominoplasty via a thermal camera (for surface readings) and thermocouple needle (for subcutaneous readings). Short- and long-term tissue response was evaluated on the abdomen immediately post to 6 months post a 1,060 nm laser treatment. Laser dosage was varied to identify safe and effective parameters for fat reduction. Tissue biopsies for hematoxylin/eosin (H&E) staining were taken at weeks 1 and 2, as well as at 1, 2, 3, and 6 months (if applicable). Additionally, six subjects received a hyperthermic laser treatment to the flanks; four patients receiving laser treatment to one flank and cryolipolysis on the other, and two patients receiving laser treatment on one side with the other side as an untreated control. Efficacy measurements included ultrasound measurement of fat thickness at baseline, 2, 3, and 6 months; Magnetic Resonance Imaging (MRI) to calculate fat volume at baseline, 3 and 6 months; and blinded photograph evaluation at baseline, 1, 2, 3, and 6 months.
In vivo temperature measurements demonstrated that the hyperthermic temperature target (42-47°C) can be achieved and maintained in subcutaneous adipose tissue via a 1,060 nm laser in conjunction with surface cooling. Short- and long-term tissue responses were evaluated by tissue histology up to 6 months following treatment. Histological changes included inflammation, followed by macrophage infiltration starting at approximately 2 weeks, with evacuation of cellular debris completed by approximately 6 months. Clinical results demonstrated average fat thickness reduction at 14%, 18%, and 18% at 2, 3, and 6 months, respectively. Average fat volume reduction measured by MRI at 3 and 6 months was 24% and 21%, respectively. Blinded photo evaluation showed improvement starting at 1-month post-treatment and was maintained at 6 months. Adverse events were rare and included mild tenderness that resolved by 1-week post-treatment.
Parameters were identified that selectively injure and reduce adipocytes in subcutaneous tissue using a 1,060 nm externally applied laser. The treatment had an excellent safety profile and was well tolerated. The clinical study demonstrated that a 1,060 nm hyperthermic laser treatment for non-invasive fat reduction can be safe and effective. Lasers Surg. Med. 49:480-489, 2017. © 2016 Wiley Periodicals, Inc.
我们推测，使用1060纳米激光进行的高温治疗可导致可控的脂肪细胞损伤，从而实现非侵入性减脂。这项分为三个部分的研究确定了安全且可耐受的治疗参数，展示了短期和长期的组织反应，并评估了这种治疗用于非侵入性减脂的潜力。
在腹部整形手术前，通过热成像仪（用于表面读数）和热电偶针（用于皮下读数）进行体内温度测量。在1060纳米激光治疗后立即至6个月内，对腹部的短期和长期组织反应进行评估。改变激光剂量以确定安全有效的减脂参数。在第1周和第2周以及1、2、3和6个月（如适用）采集组织活检样本进行苏木精/伊红（H&E）染色。此外，六名受试者接受了双侧腰部的高温激光治疗；四名患者一侧接受激光治疗，另一侧接受冷冻溶脂，两名患者一侧接受激光治疗，另一侧作为未治疗对照。疗效测量包括在基线、2、3和6个月时通过超声测量脂肪厚度；在基线、3和6个月时通过磁共振成像（MRI）计算脂肪体积；以及在基线、1、2、3和6个月时进行盲法照片评估。
体内温度测量表明，通过1060纳米激光结合表面冷却，可在皮下脂肪组织中实现并维持高温目标（42 - 47°C）。治疗后长达6个月通过组织组织学评估短期和长期组织反应。组织学变化包括炎症，随后大约在2周开始出现巨噬细胞浸润，细胞碎片清除在大约6个月时完成。临床结果显示，在2、3和6个月时平均脂肪厚度分别减少了14%、18%和18%。通过MRI测量，在3个月和6个月时平均脂肪体积减少分别为24%和21%。盲法照片评估显示，治疗后1个月开始改善，并在6个月时保持。不良事件罕见，包括轻度压痛，在治疗后1周内消退。
确定了使用外部施加的1060纳米激光选择性损伤并减少皮下组织中脂肪细胞的参数。该治疗具有良好的安全性，耐受性良好。临床研究表明，1060纳米高温激光治疗非侵入性减脂可以是安全有效的。《激光外科与医学》49:480 - 489，2017。©2016威利期刊公司
