Quantification of human abdominal tissue tightening and contraction after component treatments with 1064-nm/1320-nm laser-assisted lipolysis: clinical implications.

Internal lipoplasty (iLAL) represents an evolving procedure that depends on delivery of sufficient and controlled thermal energy for lipolysis and collagen denaturation. Of the two outcomes, the particular advantage of iLAL may exist in its capability to selectively denature, remodel, and contract collagen and elastin fibers for eventual skin contraction. Despite the practice of sound laser principles and clinical outcomes, laser lipolysis has not been readily accepted because of its yet unproven advantages over other liposuction devices. This limited clinical research study on the lower abdomen of three female subjects provides objective data by Vectra 3D analysis (Canfield Scientific, Fairfield, New Jersey) of significant skin contraction (average, 9.1% at three months; average, 7.6% at six months) as a consequence of the application of sequential wavelengths of 8 W 1064 nm/8 W 1320 nm within the shallow but not the deep subdermal layers. The application of sustained and confluent thermal injury within the targeted 4 x 10-cm rectangular panel (zone 5) was continually monitored by an internal temperature-sensing cannula (45-47 degrees C) and by an external surface temperature-sensing infrared camera, recording surface skin temperatures to 40-42 degrees C threshold levels. Minimal skin contraction was measured at three months in panels that were treated by tumescence (1.1%, zone 1) and cannulation (1.5%, zone 2). Of interest, the slight increase in skin contraction in zones treated by volume reduction after liposuction (3.6%, zone 3) or deep lasing plus liposuction (3.6%, zone 4) may be due more to skin accommodation than active skin contraction. The second highest amount of skin contraction was observed in zone 6 (4.2%), which was treated by shallow lasing, liposuction, and deep lasing. Further quantitative clinical studies will be needed to validate these findings.