Laser Lipolysis - Efficacy, Safety and Speed Are Key

Lots of lasers are marketed for lipolysis. How should you choose the right laser? Here is a novel thought...let's use science. All of the lipo lasers on the market will work, but the issue is not just efficacy - it is also safety and speed.

There are only so many things a laser can do to inside the tissue. It can be absorbed, reflected, diffused and refracted... that is about it. What you are looking for is a balance. So often companies will show how their laser is the highest absorption or has the largest Fluence and so on. While that is sometimes helpful, what we are really after is clinical utility, safety and efficacy. A laser with too great absorption in fat will result in an extremely hot laser tip and no real volume of heat. We are not looking to ablate the fat, we are looking to melt the fat. So a laser with a mid-range of fat absorption and a mid- range of fat diffusion will give the largest volume of heat. If the laser has enough power we can then control the heat within that volume and get the largest volume at the right heat to do the best job. Of the several wavelengths on the market, the largest volume is with 1064 followed by 980 and 920. The 1320 and 1440 are smaller yet. The small volume of the 1440 nm results in intense heat in that region. Some have suggested this is an advantage. This is clearly not the case. What this means is that with each pass of the laser cannula you will heat a larger volume of fat to the clinically correct temperature (about 65O C). Because of this, fewer passes and faster procedures result with Nd:YAG at 1064 nm.

Different lasers have different absorption in different tissues. You do not want a laser that has high absorption in the skin because if you are working near the under surface of the skin, you may see problems of over-heating the skin that can result in burns. In the complete article with graphs, you will see two illustrations that represent the effect of laser energy when pointed in the direction of the skin. The left side of the graph is the skin surface. The 1 to 1.5 mark is the under side of the skin. What you will see is that the 1440 laser shows significant spikes at the depth. This is a temperature spike. You will see that the temperature is a function of the angle of the laser energy to the skins under surface. When working close to the undersurface of the skin, it is fairly easy to push the cannula up against the underside of the skin and fire the laser at "point blank" and 0 degrees resulting in a lot of heat into the skin. This can result in side effects. With Nd:YAG or 1064 we do not see these spikes. This results in fewer side effects and a better safety profile.

In addition, you will want to choose a laser with variable square pulsing (VSP). There are several reason for this. The first is as I always say... you don't want a one trick pony. With VSP your lipolysis laser can have QCW - that is Quazi Continuous Wave. This has been show to coagulate blood better that Continuous Wave, resulting in fewer bruises and faster recovery. In addition, because V means Variable you can select longer pulse widths. That allows for other treatments such a transcutaneous skin tightening (as in FRAC3), vascular work (such as spider veins) and hair removal. In addition, this same wavelength, for the same reasons, is excellent at endovascular veinous therapies.

CONCLUSION

The 1064 nm Nd:YAG lasers are the most widely used lasers for lipolysis, with the longest clinical record of safety and efficacy. The clinical observations of minimal discomfort, exceptional long-term success and short recovery are attributed to the 1064nm Nd:YAG's ability to optimally target laser energy into fatty tissue, thereby limiting undesirable mechanical and thermal effects in the surrounding tissues.

In addition, the Nd:YAG 1064 nm laser systems have developed significantly since their introduction for laser lipolysis. For example, the latest XP-2 Focus laser has a 30W QCW mode power-generating capacity, reaching higher procedure speeds and efficiency while operating at a fraction of its maximum capacity. This ensures system durability, essentially lowering running costs. In conjunction with the VSP (Variable Square Pulse) technology, a wide range of selectable pulse durations are now available in Nd:YAG lasers. This provides better procedure control and extreme versatility. The latest Nd:YAG laser devices can be used not only for laser lipolysis but also for endo and exo-vascular procedures, FRAC3 skin rejuvenation, acne treatments, hair removal, and other procedures. The high performance and versatility of the latest technology solid crystal Nd:YAG 1064 nm laser systems, combined with their optimal efficacy and safety, make these lasers the medical devices of choice when compared with other wavelength devices for laser lipolysis.

Click fotonamedicallasers.com/aesthetic-laser-system-for-laser-lipolysis/ Here to view this article complete with illustrative diagrams.

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

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

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