How Do You Choose the Right Laser For Laser Lipolysis?

Laser lipolysis is using a laser to assist in liposuction or using the laser without suction to destroy fat layer for body contouring. Despite marketing claims to the contrary, all laser lipo works in the same way, that is, to heat the fat tissue and disrupt the fat cells. It is so common to see marketing materials claiming some unique and marvelous attribute to their wavelength. The truth is that the absorption curves of laser are well defined and the scatter curves are also known. The issue with laser lipo is "how do you heat the largest volume of fat to the right temperature in the safest way."

There are now many lasers being used for laser lipo. How should one choose? Most any laser will heat the tissue. The question is which will do it fast, safely and with minimal risks. Current wavelengths include 924 nm 980 nm, 975 nm, 132 nm, and 1444 nm. The pioneer wavelength is 1064 nm. Each claims to be the superior wavelength. Let's see what the physics of the issue has to say.

The goal of laser lipolysis is to heat the fat to between 50 and 65 degrees C. Lower temps do not cause cell death and higher temps are associated with necrosis and side effects. Temperature is a function of absorption and scatter. If the wavelength has too high an absorption co-efficient it will result in a very hot core temp. The idea is to have a balance of absorption and scatter to get a large heat volume without an overly hot core temp. It turns out that the 1064 nm laser is at the midpoint of absorption in fat and has a mid range of scatter in fat. This results in the largest thermal volume of all of the lasers.

Volumes for four Laser Lipolysis wavelengths gives:

1064 nm (the largest volume),

980 nm and 920 nm (close followers)

1320 nm (still close but smaller)

1440 nm (the smallest volume)

There is another safety concern. That is the interaction at the fat skin interface. Several lasers have a spike of heat generated at this interface creating the concern for side effects such as burn or other skin injury. Graphs showing 1064, 1320 and 1444 nm show almost no spike at 1064 and progressively larger spike at the fat skin interface from 1320 to 1444 nm. The spikes seen on 1320 and 1444 but not on 1064 represent temp spikes that may be associated with skin injury.

It seems clear that the safest choice is also the most efficient choice. The Nd:YAG has the best safety by limiting heat at the skin and achieving the largest thermal volume at the appropriate temperature. But not all Nd:YAG are built alike. You will want one that has energy feed back control, QCW, self-calibration and the power to give you the speed you need. Nd:YAG has been studied on over 15,000 patients with no reported deaths, PE, viscous perforations, phlebitis, hypovolemic shock, seizure or toxic reactions.

Thomas A. Sult, MD is Board Certified in Family Medicine. and is Fotona's US Medical Director, involved in clinical and applications research and development for Fotona worldwide.

Fotona lasers purvey quality, reliability and durability for excellent medicine and the full spectrum of aesthetic procedures. The mission: provide a model for success with advanced aesthetic systems, clinical training & ongoing support.

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