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Table 1: Baseline data and post-treatment changes
Weight (kg) BMI (kg/cm ) Somatic fat rate (%) Circumference at the abdomen (cm)
2
Before 70.95 ± 18.42 25.82 ± 3.49 27.99 ± 4.05 88.85 ± 10.73
After 70.75 ± 18.54 25.75 ± 3.51 27.99 ± 4.09 88.12 ± 10.58
The body weight, body mass index (BMI), and somatic fat rate showed slight decreases from the baseline, but they were statistically insignificant
were significantly higher (P < 0.05) throughout the periods
of measurement for this cohort [Figure 4].

TG conversely showed significantly lower values (P < 0.02)
at 10, 20, and 30 min. A gradual decline persisted, but was
not statistically significant [Figure 5].

DISCUSSION

The biological mechanisms of liporeductive effects following
exposure to high-intensity focused ultrasound (HIFU) has
been previously reported by many authors. HIFU, when
focused within subcutaneous adipose tissue, raises the
Figure 4: Summary of blood NEFA levels. Statistically significant increases regional temperature resulting in coagulative necrosis and
from baseline NEFA were observed at any pointsduring the study period, instantaneous cell death within the targeted area without
and showed the highest values at 90 min (*P < 0.05, **P < 0.02). NEFA:
nonesterifield fatty acid damage to the surrounding tissue. Lipids are subsequently
released from disrupted adipose tissue, and then cleared by
fat metabolic pathways, and the lesion gradually heals. [7,8]
Almost all the disrupted adipocytes were resorbed within
18 weeks after treatment, resulting in an overall reduction
in local fat volume without evidence of significant increases
in plasma lipids. Jewell et al. reported that clinical
[10]
[9]
laboratory tests did not reveal any abnormalities with regard
to lipid profiles obtained before HIFU treatment, 1 h after
treatment, and at weeks 1, 4, 8, and 12.
Brown et al. exploited another novel technology platform
[11]
utilizing nonthermal focused ultrasound. The energy
from the device was delivered as cavitation followed by
mechanical destruction of cells. The term cavitation refers
Figure 5: Summary of mean blood TG levels. TG levels up to 30 min from
the beginning of the study were significantly lower, and continued to to a range of complex phenomena that involve the
decline thereafter, albeit at a statistically insignificant level (*P < 0.02). creation, oscillation, growth, and collapse of bubbles
TG: triglyceride within a medium to subsequently produce mechanical
energy. Little is known about the mechanism of action of
(range 37-68 years) and an average BMI of 25.8 (range 21.3-
29.8 kg/cm ) were treated, with all subjects completing the nonfocused external ultrasound reducing adipose tissue.
2
treatments. Serial blood samples were obtained until 90 min Garcia and Schafer treated pigs with the MCI instrument
[5]
after completion of the treatment from 6 subjects, until 75 and concluded that adipose tissue was reduced by
min from 1 subject, until 45 min from 1 subject, and until 15 ultrasound cavitation inducing focal alterations of the
min from 2 subjects. plasma membrane, and lipid leakage into interstitial space
and lymphatic vessels without cell necrosis. The blood lipid
Circumference of the abdomen was significantly reduced (P profiles obtained prior to the treatments and approximately
< 0.003) from baseline measurements following treatment 25 to 30 min post-treatment did not show statistically
[Figure 2], whereas weight and BMI showed no statistically significant changes in serum cholesterol, TG, or HDL.
significant differences before and after treatment [Table 1].
Bani et al. concluded that lipid discharge from adipocytes
[6]
While NEFA showed noticeable changes in most patients was not accompanied by morphological signs of adipocyte
[Figure 3], other parameters did not predictably change. death and disruption, or interstitial inflammation in both ex
NEFA and TG were subsequently examined in greater vivo and in vivo experiments; moreover, ultrasound-induced
detail since they appeared to have more pivotal roles in fat cavitation caused selective adipose cell reduction without
reduction for body contouring. injury to skin, vessels, nerves, or connective tissue.

Although 2 subjects exhibited transient decreases in blood Although both authors noted TG changes following
NEFA, the remaining 8 subjects demonstrated higher values ultrasonic cavitation, there was no reference to NEFA levelsin
at the 90 min drawing than at baseline, and concentrations blood samples. Plasma NEFA levels significantly increased
Plast Aesthet Res || Volume 3 || April 25, 2016 109