Body Contouring: The Major PlayersSponsored By:
Fat-dissolving and skin-tightening procedures are less invasive than ever and can be more efficient than traditional liposuction. The newest body-contouring devices promise reduced patient downtime and less pain and scarring. Some of the innovations include injections that dissolve fat, the use of radio frequencies to create a "nonsurgical" facelift, and ultrasound-based devices that target and destroy fat cells. Profiles written by Shannon Triplett Leade and Dennis Rogers
1) CoolTouch Inc CoolTouch Inc
9085 Foothills Blvd CoolTouch is best known for its signature 1320-nm CT3PLUS laser, which was introduced in 1994. The CoolTouch laser is used for nonablative skin rejuvenation, wrinkle reduction, active acne treatment, and acne-scar removal. The 1320-nm wavelength penetrates upper to deep dermal tissue to stimulate the generation of collagen without surface damage or pigmentary changes. The CT3PLUS also features a CoolBreeze treatment mode, which offers painless skin tightening. The firm claims that its laser technology virtually created the nonablative skin resurfacing market. In 2004, the company released the CoolTouch CTEV system for the treatment of varicose veins. The system is used in a relatively new procedure called endovenous laser ablation, which offers an alternative to vein stripping. CoolTouch CTEV is cited as having a greater than 95% closure of varicose veins after just one treatment. In 2007, the CoolTouch CoolLipo system was rolled out. The product was touted as having the ability to sculpt areas of the body that are not easily treated by conventional liposuction, such as the small areas of the neck, jowls, and chin. CoolLipo is a body-shaping and skin-tightening aesthetic procedure that uses a laser-tipped tube that works under the skin to break up fat cells. The CoolLipo cannula is just 1 mm in diameter, compared with the 4-mm tube used for traditional liposuction. A red light glows through the skin so the physician can see the tip of the cannula at all times.
According to the company, CoolLipo treatments are in-office procedures that can be performed under local anesthesia and take around 1 hour to perform; recovery is usually a few days. CoolLipo's 1320-nm wavelength provides a skin-tightening effect through collagen stimulation, and studies indicate that the method in which CoolLipo's energy is delivered provides a more effective ablation of fat with less collateral damage than other lasers, according to the company. "The new minimally invasive body-contouring techniques like the CoolLipo have the potential to revolutionize the way doctors treat fat, cellulite, and loose skin because they are so much more effective than the noninvasive technologies that promise much but deliver minimal results," explains Elwood Phillips, CoolTouch vice president of sales. "Patients have learned that it is better to spend more money on a single treatment that delivers great results than to spend the same amount of money for multiple treatments that produce marginal outcomes." Recently, CoolTouch introduced the CoolBlue Duet, which the company says is the first handpiece on the market that lases and aspirates simultaneously, saving physicians and patients time and providing tighter skin more efficiently. "Minimally invasive body contouring is at its very early stages of technical development," Phillips says. "New handpieces, accessories, and protocols will make it easy for any surgeon to get the same great results that the experts are seeing. "We see tremendous growth in this aesthetic marketplace," Phillips adds. CoolTouch has been listed as one of the 100 Fastest-Growing Companies in Sacramento (1997, 1998, 2000, 2001, 2005, and 2006). In addition, the firm has received several other awards, including the Vanguard Award in 1998 for excellence in manufacturing— and again in 2001 for achievement in worldwide export—as well as Startup of the Year Award in 1996 and Aesthetic Magazine's Best Wrinkle Laser in both 2005 and 2006. Cynosure Inc
5 Carlisle Rd Since 1991, Cynosure has developed and marketed aesthetic laser and light-based solutions, including the Smartlipo system, which is well-known among practitioners and patients for fat reduction and overall body-toning procedures. Cynosure currently holds 37 US patents and sells more than 14 different light-based systems in more than 60 countries. Its products represent a range of solid-state, liquid, and semiconductor laser technologies, according to the company. Cynosure's Smartlipo LaserBodySculpting Workstation provides aesthetic surgeons with a less invasive technique than conventional liposuction methods for treating localized fat deposits on the face and body. The product is, according to the firm, "the industry's only laser lipolysis system designed to destroy fat cells and coagulate tissue for tighter skin." In addition, Smartlipo can treat challenging areas, such as regions of high vascularity and flaccidity. Cynosure offers three Smartlipo systems: the 6W, 12W, and 18W. The higher-wattage machines allow for faster treatment, and either of the smaller-wattage systems can be upgraded.
How does Smartlipo work? A 1064-nm Nd:YAG laser fiber is introduced through a small cannula, delivering energy directly to subcutaneous fat cells, which causes the cells to rupture. The patient's fat "melts"—the device's emitted energy also coagulates tissue, thus inducing collagen retraction and tissue tightening. The laser causes small blood vessels to coagulate immediately, resulting in less bleeding, swelling, and bruising than conventional liposuction. Due to the small size of the cannula, Smartlipo also can supplement or augment traditional methods of cellulite treatment. The company claims that most patients will need only a single session for a full Smartlipo treatment. The recently released Smartlipo MPX platform combines 1064-nm and 1320-nm wavelengths with Cynosure's MultiPlex technology—a patented process that enables the rapid, sequential emission of the two wavelengths from the same optical fiber, with a short delay between fixed pulses. According to the company, the Smartlipo MPX reduces treatment time by blending the clinical benefits of the two wavelengths; combines the properties of two wavelengths for effective lipolysis and tissue coagulation, resulting in tissue tightening; enhances hemostatic effect to reduce surgical trauma and to promote faster recovery; and provides skin tightening by heating collagen bundles in dermis. Smartlipo MPX also is outfitted with the firm's SmartSense "intelligent" delivery system. This proprietary, FDA-approved handpiece delivery system ensures a precise level of energy based on the area of treatment and settings in conjunction with the motion of the handpiece. "SmartSense provides . . . an unparalleled degree of safety, precision, and control that is not available with any other laser lipolysis technology," says Michael Darvin, Cynosure's CEO. "Based on the setting you choose and the motion of the handpiece, SmartSense provides aesthetic surgeons with the precise laser power to perform laser lipolysis. To provide the maximum level of patient safety, if handpiece motion ceases SmartSense will stop the laser from firing, but remains ready and resumes firing once the handpiece is set in motion again." Other Cynosure laser-based products include the Accolade, a Q-switched Alexandrite laser that can be used to remove benign epidermal and dermal-pigmented lesions, such as freckles, Acquired Dermal Melanocytosis, Nevus of Ota, and multicolored tattoos. The company's Affirm Anti-Aging Workstation offers wrinkle reduction, scar treatment, pigmentation and redness reduction, age spot treatment, facial rejuvenation, and coagulation of tissue. The Cynergy Vascular Workstation treats various vascular and pigmented lesions, including spider veins and rosacea. This system is touted as an alternative to conventional, single-wavelength technology. The Cynosure PL is a compact, portable, pulsed-light module that operates independently from the Cynergy system. It can be used to treat sun-damaged skin, dyschromia, pigmented lesions, and rosacea. The Elite Aesthetic Workstation laser hair removal system is designed to work with "all skin types," according to the firm. In addition, it is optimized for effective treatment of facial and leg veins, as well as benign epidermal pigmented lesions. The Elite combines two optimal wavelengths in one system: the 755-nm Alexandrite laser and the 1064-nm Nd:YAG laser. Finally, the TriActive Cellulite Workstation is the only laser cleared for laser cellulite treatment and temporary cellulite reduction. Mentor Corp
201 Mentor Dr
Founded in 1969, Mentor Corp develops, manufactures, and markets innovative, science-based products for aesthetics markets around the world. Byron Medical was started in 1985 and continues to be a leader in body contouring. Since that time, Byron has partnered with Misonix to manufacture an ultrasonic-based liposuction technology called UltraSculpt. Mentor acquired an interest in the privately held company in 1998, and in 2002 exercised an option to acquire the remainder. The resulting combined firm subsequently launched Byron Body Aesthetics by Mentor, which claims to offer "the industry's broadest and most innovative liposuction products and accessories," according to a Byron Medical spokesperson. Key products include UltraSculpt with the LySonix 3000; the PSI-TEC III liposuction platform; and EZ-Pump, the only peristaltic pump that allows programmable flow rates and measures the amount of infused fluid. "Mentor continues to introduce technologies to the market that offer benefits for the patient, surgeon, and operating room staff," a company spokesperson says. "They are committed to education through physician symposiums and surgical training programs. As liposuction procedures continue to be one of the most popular cosmetic procedures performed, Mentor will continue their commitment to the growth and development of this marketplace."
The UltraSculpt body-contouring technique liquifies fat and removes it from surrounding tissue. It offers the ability to refine body areas with increased delicacy and fewer traumas than conventional liposuction procedures. This technology allows the ultrasonic waves to selectively target only fat cells and leave all other tissue virtually untouched. Some plastic surgeons have referred to this procedure as "liposuction without the suction" or the "Botox of body contouring." "Focused ultrasound may become the hot new noninvasive procedure for body sculpting," says Sam Speron, MD, of Park Ridge, Ill. "Clinical studies found the procedure significantly reduces the circumference of the leg and abdominal regions. Using ultrasound, plastic surgeons disrupt, destroy, and disperse targeted fat cells, which may be able to give patients the benefits of liposuction without the incisions and recovery time." The UltraSculpt process is implemented in two stages. The first stage works by directly targeting the compacted layers of cells. The second stage involves the dispersion of fat deposits using special vibratory and suction techniques. The UltraSculpt device lifts, folds, presses, and stretches the skin according to a site-specific computerized sequence. Low-wave ultrasound administered through the UltraSculpt device increases the depth of penetration into the treated tissue. Ultrasound enhances the destruction of unwanted fibers and improves the metabolism of tissue.
UltraSculpt can be used for treating the chin, abdomen, upper/lower back, upper arms, hips, thighs, knees, buttocks, and "love handles." It also can be used for treating gynecomastia, lipomas, surgical deformities, and uneven contour from liposuction. The frequency of treatments depends on the body area and how much fat needs to be dissolved. Typically, patients will return every week for 12 weeks. An adjunct to the UltraSculpt system, the PSI-TEC III integrated cart delivers vacuum-on-demand and a compressed air supply for infiltration and power-assisted liposuction modules. A simplified control panel makes operation easy and straightforward. The foot switch is pneumatically operated for instantaneous, current-free activation of the PSI-TEC III pump. The overall design is configured for the placement of new or existing components. "State-of-the-art ultrasound technology greatly improves the surgeon's ability to accurately extract unwanted fat. Whether the amount is very discreet or a larger surface area, UltraSculpt improves outcome by enhancing precision," according to a Mentor press release. Sound Surgical Technologies LLC
357 S McCaslin Blvd, Suite 100
Sound Surgical Technologies, founded in 1998, has pioneered ultrasound-based lipolysis treatments via its VASER technology. The term VASER stands for "vibration amplification of sound energy at resonance"; the VASER product is also known as "third-generation ultrasound." No matter how you sound it out, the VASER system enables the use of ultrasound to break up superficial fat, providing a range of treatment possibilities. As a platform for infusion, emulsification, and aspiration, the VASER Lipo System is contained in a single, easy-to-maneuver unit that requires only a minimal amount of space. VASER LipoSelection is a minimally invasive procedure that uses ultrasonic technology to gently reshape the body. What distinguishes the VASER Lipo-Selection procedure is its ability to differentiate targeted fat from other important tissues, such as nerves, blood vessels, and connective tissue. VASER-Assisted High Definition Lipo-Sculpture, or VASER Hi Def, is the latest body-sculpting technique to come from this company. The procedure creates a sculpted, athletic appearance in males and females by precisely removing both superficial and deep fat around muscle groups in order to enhance the visibility of the underlying musculature. The energy is transmitted through small probes, between 2.9 and 3.7 mm wide, with special grooves that diffuse the ultrasound waves and liquefy the fat for easy removal. The ultrasound energy is gentle enough that it can emulsify only the fat, preserving important tissues. This results in lessened or minimal bruising and pain, as well as smooth skin retraction. Traditional tumescent liposuction techniques remove unwanted fat via avulsion (forceful tearing), causing trauma to the patient and fatigue to the physician. The tools used in tumescent liposuction cannot differentiate between fat, nerves, and blood vessels, thus removing other important tissues along with the fat, which can lead to a long and painful recovery.
"VASER Hi Def. . . requires an in-depth knowledge of the superficial anatomy and the treatment of different fat layers," says Alfredo Hoyos, MD, the inventor of the product. "The procedure enhances the body contour, similar to 3-dimensional sculpting, by taking into account the shape and form of structures underneath the skin that create an athletic contour." VASER Hi Def can be performed on multiple body areas, including the abdomen, female breast, male chest, back, arms, thighs, buttocks, hips, and waist. VASER Hi Def is a refined version of traditional lipoplasty, in which the superficial muscular anatomy is molded in order to leave a highly athletic figure. Less fat is extracted, allowing for a potentially safer procedure that, the firm claims, achieves results that do not compare to standard liposuction. In addition, the procedure allows the surgeon to mold and enhance other structures, such as the gluteal area in females or the pectorals in males. The primary advantages of VASER Hi Def include the enhancement of anatomical structures, such as the abdominal and torso muscles; the enhancement of special structures that need more volume; and less extraction of fat. After the procedure, patients typically wait about 1 month before returning to their exercise routines. Physicians report the first evidence of improved muscle definition can be seen at about 2 weeks, with final results at 3 to 4 months. Advanced components for sculpting include the VASER Amplifier, which uses precise amplitude control in pulsed or continuous modes, with a time recorder to track activation; grooved probes and handpieces, vented cannulae, and VentX Aspiration for removal of fatty tissue. The firm's other products include the Precision Fluid Management System, which simplifies fluid tracking by precisely measuring to +/- 1 cc at any volume; the Precision Canister System with backsplash protection and an easily visible pressure gauge; and a reversible peristaltic pump for smooth, adjustable infusion. The company claims that more than 50,000 procedures have been performed worldwide using the VASER System. Thermage Inc
25881 Industrial Blvd
Since its inception in 1995, Thermage has become synonymous with noninvasive aesthetic procedures. The ThermaCool system helps tighten body skin by using RF technology to heat the skin's outer layer, thus stimulating collagen beneath the surface. Patients do not require general anesthesia, according to the company. During the process, the patient's collagen is renewed and tightened, improving the skin's texture and tone. New collagen continues to grow during the 6 months following the procedure, and patients will see more dramatic results as their collagen is restored during this period. "Other technologies require that a patient seek multiple treatments to get the results Thermage can produce in one treatment," says Stephen J Fanning, Thermage CEO. "This is a huge advantage for the patient and the practitioner. Thermage is a well-established and recognizable brand in the market and the widely renowned gold standard in radio frequency." The ThermaCoolNXT system is a monopolar capacitive RF device that deploys deep, uniform, volumetric heating to tighten both skin and underlying tissue. More than 2,000 physicians use the system—and its ThermaTip delivery device—worldwide. According to the company, the Thermage procedure has gained professional and consumer acceptance as an established standard of treatment. Body by Thermage encompasses a series of FDA-approved procedures that includes Face by Thermage, which was the first procedure launched by Thermage and remains its most popular, according to Fanning. The Body by Thermage procedures were upgraded mid-2007 with the launch of the ThermaTip STC, which the company claims has improved efficacy and predictability, as well as shortened treatment times. Eyes by Thermage is a noninvasive procedure that helps smooth, tighten, and contour skin around the eyes and eyelids, decreasing wrinkles, lines, and hooding for a naturally younger-looking appearance. Lips by Thermage helps create more defined-looking lips and decreased fine lines; Hands by Thermage is a procedure that can improve the appearance of aging hands; and the Body Shape procedure is designed to tighten, firm, and deep-contour patient abdomens, arms, thighs, and buttocks in a single treatment, without surgery and little to no downtime. The firm's Cellulite procedure can reduce the appearance of cellulite, and uses the new ThermaTip CL treatment tip to deeply heat the problem area, rebuild collagen connective tissues, and improve blood flow to the tissues, helping to smooth the surface of the skin and reduce the appearance of cellulite.
The system consists of a 400-watt, 6.78-MHz high-frequency generator that employs capacitive coupling technology to deliver RF energy deep into dermal tissues. The device is "the only radiofrequency-based system that can deploy deep, uniform, volumetric heating to tighten skin and renew facial contours," according to the company. Recently, Thermage introduced its ThermaTip DC and Body Shape procedure to help tighten, firm, and shape the body in a single treatment without surgery or injections, and with little to no downtime. The Body Shape procedure is the latest in a suite of procedures being sold under the Body by Thermage umbrella. The Body Shape procedure uses the new 3.0 cm2 ThermaTip DC treatment tip specifically designed for deep contouring of the skin. "We have two ThermaTip products that address body procedures," Fanning says. "Our deep contouring tip was the first deep-heating body tip, released late last year. Doctors have reportedly seen dramatic results with these deep contouring tips, sometimes resulting in a loss of several centimeters in diameter on a body part. Our newest product, the Cellulite tip, improves the appearance of dimples and smoothes skin texture on the body." The ThermaTip device's capacitive coupling electrode can disperse RF energy and create a uniform electric field across the surface of the tip and into the tissue. In conjunction with heating, the ThermaTip device also uses a method of contact cooling. By continuously applying a controlled cryogen cooling spray to the back surface of the ThermaTip electrode membrane, the tip continuously cools the epidermis and upper dermal layers through contact cooling. This combination of heating and contact cooling creates a reverse thermal gradient—the greatest heating is deep in the skin while the outer layer of the skin is cooled. The depth and degree of heating and thermal injury depends on the size and geometry of the ThermaTip, the treatment level setting, and the conductive properties of tissue being treated.
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