Abstract
Several ultrasonic devices have recently been investigated for their ability to decrease areas of focal adiposity and tighten small areas of the skin. Studies show that ultrasound technology offers a safe, reliable, and predictable means to sculpt the body of nonobese patients, but its efficacy remains uncertain. Although most studies claim statistically significant results, the clinical significance of ultrasound technology has yet to be determined. Most studies use waist circumference measurements to determine statistical significance and efficacy. The majority of the current studies also have a relatively a short follow-up period of 3 months. More studies are needed to assess the true efficacy of ultrasound technology using more reliable measurements such as diagnostic ultrasound and computed tomography (CT) imaging and to include a follow-up period longer than 6 months to obtain more valid results.
Level of Evidence III
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Similar content being viewed by others
References
Hwang JH, Crum LA (2009) Current status of clinical high-intensity focused ultrasound. Conf Proc IEEE Eng Med Biol Soc 2009:130–133
Kennedy JE, Ter Haar GR, Cranston D (2003) High-intensity focused ultrasound: surgery of the future? Br J Radiol 76:590–599
Capla JM, Rubin JP (2011) Discussion: randomized sham-controlled trial to evaluate the safety and effectiveness of a high-intensity focused ultrasound device for noninvasive body sculpting. Plast Reconstr Surg 128:263–264
Jewell ML, Solish NJ, Desilets CS (2011) Noninvasive body sculpting technologies with an emphasis on high-intensity focused ultrasound. Aesthetic Plast Surg 35:901–912
LipoSonix. Retrieved at http://liposonix.com/. Accessed 18 Dec 2013
Hughes CE III (2001) Reduction of lipoplasty risks and mortality: an ASAPS survey. Aesthet Surg J 21:120–127
Lehnhardt M, Homann HH, Daigeler A, Hauser J, Palka P, Steinau HU (2008) Major and lethal complications of liposuction: a review of 72 cases in Germany between 1998 and 2002. Plast Reconstr Surg 121:396e–403e
Grazer FM, Grazer FM, de Jong RH (2000) Fatal outcomes from liposuction: census survey of cosmetic surgeons. Plast Reconstr Surg 105:436–446 discussion 47–48
Commons GW, Halperin B, Chang CC (2001) Large-volume liposuction: a review of 631 consecutive cases over 12 years. Plast Reconstr Surg 108:1753–1763 discussion 64–67
Jewell ML (2001) Prevention of deep vein thrombosis in aesthetic surgery patients. Aesthet Surg J 21:161–163
Triana L, Triana C, Barbato C, Zambrano M (2009) Liposuction: 25 years of experience in 26,259 patients using different devices. Aesthet Surg J 29:509–512
Chan NP, Shek SY, Yu CS, Ho SG, Yeung CK, Chan HH (2011) Safety study of transcutaneous focused ultrasound for noninvasive skin tightening in Asians. Lasers Surg Med 43:366–375
Avram MM (2004) Cellulite: a review of its physiology and treatment. J Cosmet Laser Ther 6:181–185
Sadick NS, Mulholland RS (2004) A prospective clinical study to evaluate the efficacy and safety of cellulite treatment using the combination of optical and RF energies for subcutaneous tissue heating. J Cosmet Laser Ther 6:187–190
van Vliet M, Ortiz A, Avram MM, Yamauchi PS (2005) An assessment of traditional and novel therapies for cellulite. J Cosmet Laser Ther 7:7–10
Coleman KM, Coleman WP III, Benchetrit A (2009) Noninvasive, external ultrasonic lipolysis. Semin Cutan Med Surg 28:263–267
Atiyeh BS, Dibo SA (2009) Nonsurgical nonablative treatment of aging skin: radiofrequency technologies between aggressive marketing and evidence-based efficacy. Aesthetic Plast Surg 33:283–294
Manuskiatti W, Wachirakaphan C, Lektrakul N, Varothai S (2009) Circumference reduction and cellulite treatment with a TriPollar radiofrequency device: a pilot study. J Eur Acad Dermatol Venereol 23:820–827
Caruso-Davis MK, Guillot TS, Podichetty VK, Mashtalir N, Dhurandhar NV, Dubuisson O et al (2011) Efficacy of low-level laser therapy for body contouring and spot fat reduction. Obes Surg 21:722–729
Jackson RF, Dedo DD, Roche GC, Turok DI, Maloney RJ (2009) Low-level laser therapy as a noninvasive approach for body contouring: a randomized, controlled study. Lasers Surg Med 41:799–809
Fodor PB SB, Stecco KA, Desilets CS (2006): Biochemical Changes in Adipocytes and Lipid Metabolism Secondary to the Use of High-Intensity Focused Ultrasound for Noninvasive Body Sculpting. Presented at the annual meeting of the American Society of Aesthetic Plastic Surgery, Orlando, FL
Weiss M (2012) Commentary: noninvasive skin tightening: ultrasound and other technologies: where are we in 2011? Dermatol Surg 38:28–30
Teitelbaum SA, BurTeitelbaum SA, Burns JL, Kubota J, Matsuda H, Otto MJ, Shirakabe Y et al (2007) Noninvasive body contouring by focused ultrasound: safety and efficacy of the Contour I device in a multicenter, controlled, clinical study. Plast Reconstr Surg 120:779–789 discussion 90
O’Brien WD Jr (2007) Ultrasound-biophysics mechanisms. Prog Biophys Mol Biol 93:212–255
Quistgaard JU, Desilets C, Martin P (2010) High-Intensity Focused Ultrasound. Retrieved xxxx at http://digital.miinews.com/publication/?i=34631&page=1: Medicis Technologies Corporation, Bothell, WA. Accessed 18 Dec 2013
Haar GT, Coussios C (2007) High-intensity focused ultrasound: physical principles and devices. Int J Hyperthermia 23:89–104
Suh DH, Shin MK, Lee SJ, Rho JH, Lee MH, Kim NI et al (2011) Intense focused ultrasound tightening in Asian skin: clinical and pathologic results. Dermatol Surg 37:1595–1602
UltraShape® V3 Body Shaping via Fat Cell Destruction. Retrieved xxxxx at http://syneron-candela.com/int/product/ultrashape: Syneron® Medical Ltd., 2012. Accessed 18 Dec 2013
Ascher B (2010) Safety and efficacy of UltraShape Contour I treatments to improve the appearance of body contours: multiple treatments in shorter intervals. Aesthet Surg J 30:217–224
Moreno-Moraga J, Valero-Altes T, Riquelme AM, Isarria-Marcosy MI, de la Torre JR (2007) Body contouring by noninvasive transdermal focused ultrasound. Lasers Surg Med 39:315–323
Brown SA, Greenbaum L, Shtukmaster S, Zadok Y, Ben-Ezra S, Kushkuley L (2009) Characterization of nonthermal focused ultrasound for noninvasive selective fat cell disruption (lysis): technical and preclinical assessment. Plast Reconstr Surg 124:92–101
Alam M, White LE, Martin N, Witherspoon J, Yoo S, West DP (2010) Ultrasound tightening of facial and neck skin: a rater-blinded prospective cohort study. J Am Acad Dermatol 62:262–269
Shek S, Yu C, Yeung CK, Kono T, Chan H (2009) The use of focused ultrasound for noninvasive body contouring in Asians. Laser Surg Med 41:751–759
Medicis Announces FDA Clearance of LIPOSONIX(R) System. Investor Relations Press Releases. Retrieved xxxx at http://www.globenewswire.com/newsarchive/mrx/pages/news_releases.html?d=231745. Accessed 18 Dec 2013
Fatemi A (2009) High-intensity focused ultrasound effectively reduces adipose tissue. Semin Cutan Med Surg 28:257–262
Avelar J (1989) Regional distribution and behavior of the subcutaneous tissue concerning selection and indication for liposuction. Aesthetic Plast Surg 13:155–165
Ferraro GA, De Francesco F, Nicoletti G, Rossano F, D’Andrea F (2008) Histologic effects of external ultrasound-assisted lipectomy on adipose tissue. Aesthetic Plast Surg 32:111–115
Gadsden E, Aguilar MT, Smoller BR, Jewell ML (2011) Evaluation of a novel high-intensity focused ultrasound device for ablating subcutaneous adipose tissue for noninvasive body contouring: safety studies in human volunteers. Aesthet Surg J 31:401–410
Garcia-Murray E, Rivas O, Stecco K, Desilets C, Kunz L: The Use and Mechanism of Action of High-Intensity Focused Ultrasound for Adipose Tissue Removal and Noninvasive Body Sculpting. Presented at the annual meeting of the American Society of Plastic Surgeons, Chicago, IL, 2005
Fatemi A, Kane MA (2010) High-intensity focused ultrasound effectively reduces waist circumference by ablating adipose tissue from the abdomen and flanks: a retrospective case series. Aesthetic Plast Surg 34:577–582
Jewell ML, Baxter RA, Cox SE, Donofrio LM, Dover JS, Glogau RG et al (2011) Randomized sham-controlled trial to evaluate the safety and effectiveness of a high-intensity focused ultrasound device for noninvasive body sculpting. Plast Reconstr Surg 128:253–262
Solish N, Lin X, Axford-Gatley RA, Strangman NM, Kane M (2012) A randomized, single-blind, postmarketing study of multiple energy levels of high-intensity focused ultrasound for noninvasive body sculpting. Dermatol Surg 38:58–67
White WM, Makin IR, Barthe PG, Slayton MH, Gliklich RE (2007) Selective creation of thermal injury zones in the superficial musculoaponeurotic system using intense ultrasound therapy: a new target for noninvasive facial rejuvenation. Arch Facial Plast Surg 9:22–29
Larrabee WFJ MK, Henderson JL: Surgical Anatomy of the Face: Superficial Musculoaponeurotic System. In: Merritt J (ed) Lippincott, Williams, and Wilkins, Philadelphia, PA, 2004
Mendelson BC (2001) Surgery of the superficial musculoaponeurotic system: Principles of release, vectors, and fixation. Plast Reconstr Surg 107:1545–1552 discussion 53–55, 56–57, 58–61
Har-Shai Y, Bodner SR, Egozy-Golan D, Lindenbaum ES, Ben-Izhak O, Mitz V et al (1996) Mechanical properties and microstructure of the superficial musculoaponeurotic system. Plast Reconstr Surg 98:59–70 discussion 1–3
Gliklich RE, White WM, Slayton MH, Barthe PG, Makin IR (2007) Clinical pilot study of intense ultrasound therapy to deep dermal facial skin and subcutaneous tissues. Arch Facial Plast Surg 9:88–95
Laubach HJ, Makin IR, Barthe PG, Slayton MH, Manstein D (2008) Intense focused ultrasound: evaluation of a new treatment modality for precise microcoagulation within the skin. Dermatol Surg 34:727–734
White WM, Makin IR, Slayton MH, Barthe PG, Gliklich R (2008) Selective transcutaneous delivery of energy to porcine soft tissues using intense ultrasound (IUS). Lasers Surg Med 40:67–75
McKinney P, Mossie RD, Zukowski ML (1991) Criteria for the forehead lift. Aesthetic Plast Surg 15:141–147
Alster TS, Tanzi EL (2012) Noninvasive lifting of arm, thigh, and knee skin with transcutaneous intense focused ultrasound. Dermatol Surg 38:754–759
Conflict of interest
The authors declare that they have no conflicts of interest to disclose.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sklar, L.R., El Tal, A.K. & Kerwin, L.Y. Use of Transcutaneous Ultrasound for Lipolysis and Skin Tightening: A Review. Aesth Plast Surg 38, 429–441 (2014). https://doi.org/10.1007/s00266-014-0286-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00266-014-0286-6