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from baseline at all posttreatment times until 90 min after tissue, further study in this field is warranted.
completion of the treatments.
Financial support and sponsorship
Elevation of blood NEFA levels suggests that nonfocused Nil.
ultrasound metabolized TG within fat cells to glycerol
and NEFA, followed by release of NEFA into the blood Conflicts of interest
stream through the lymphatic system While lymphatic There are no conflicts of interest.
drainage manipulation might shift NEFA in the lymphatic
system to adipose tissue via blood circulation, blood NEFA REFERENCES
levels increased before application of lymphatic drainage
procedures. Given the half-life of NEFA of 1.7-3.0 min, such 1. Mulholland RS, Paul MD, Chalfoun C. Noninvasive body contouring with
shifts of NEFA from lymphatics to the blood circulation is radiofrequency, ultrasound, cryolipolysis, and low-level laser therapy. Clin
Plastc Surg 2011;38:503-20.
unlikely to maintain the high levels of NEFA until 90 min 2. Honda T, Suzuki T, Tanaka I, Goto H, Kure K, Hishiyama J, Isago T. Clinical
after drainage. It might be possible for the TG in the blood analysis of noninvasive body contouring by nonfocused ultrasound device.
vessels within the adipose tissue being a source; however, J JSAPS 2014;3:10-20. (in Japanese)
blood vessels in adipose tissues are sparse. It is more likely 3. Teitelbaum SA, Burns JL, Kubota J, Matsuda H, Otto MJ, Shirakabe Y, Suzuki
Y, Brown SA. Noninvasive body contouring by focused ultrasound: safety
that the NEFA originated from the abundant TG in the and efficacy of the Contour 1 device in a multicenter, controlled, clinical
adipocytes within the adipose tissue. study. Plast Reconstr Surg 2007;120:779-89.
4. Jewell ML, Solish NJ, Desilets CS. Noninvasive body sculpting technologies
There is no definitive evidence that TG can be released with an emphasis on high-intensity focused ultrasound. Aesth Plast Surg
into inter-cellular spaces due to increased permeability of 5. 2011;35:901-12.
Garcia O, Schafer M. The effects of nonfocused external ultrasound on
adipocyte membranes, and then degraded to NEFA and tissue temperature and adipocyte morphology. Aesthetic Surg J 2013;33:117-
glycerol-3-phosphate in transit to the blood stream. An 27.
alternative involves lipolysis activation within adipocytes 6. Bani D, Quattrini A, Freschi G, Russo GL. Histological and ultrastructural
resulting in elevation of blood NEFA. TG may be metabolized effects of ultrasound-induced cavitation on human skin adipose tissue. Plast
Reconstr Surg Glob Open 2013;1:e41.
within adipocytes by ultrasonic stimulations, mimicking a 7. Haar GT, Coussios C. High intensity focused ultrasound: physical principle
photochemical mechanism. The body contouring mechanism and devices. Int J Hyperthermia 2007;23:89-104.
of low-level laser treatment may involve activation of 8. Gadsden E, Aguilar MT, Smoller BR, Jewell ML. Evaluation of a novel high-
cyclic adenosine monophosphate in mitochondria within intensity focused ultrasound device for ablating subcutaneous adipose
tissue for noninvasive body contouring: safety studies in human volunteers.
adipocytes, and subsequent activation of hormone-sensitive Aesthetic Surg J 2011;31:401-10.
lipases resulting in metabolism of TG in adipocytes. [12,13] 9. Fatemi A. High-intensity focused ultrasound effectively reduced adipose
tissue. Semin Cutan Med Surg 2009;28:257-62.
The current study suggests nonfocused ultrasound 10. Jewell ML, Baxter RA, Cox SE, Donofrio LM, Dover JS, Glogau RG, Kane
MA, Weiss RA, Martin P, Schlessinger J. Randmized sham-controlled trial to
metabolizes TGs immediately after treatment, but it evaluate the safety and effectiveness of a high-intensity focused ultrasound
is unclear whether this involves intra- or extra-cellular device for noninvasive body sculpting. Plast Reconstr Surg 2011;128:253-62.
spaces of adipocytes. Since there was no control group 11. Brown SA, Greenbaum L, Shtukmaster S, Zadok Y, Ben-Ezra S, Kushkuley
in the current study, but given the short half-life of NEFA, L. Characterization of nonthermal focused ultrasound for noninvasive
selective fat cell disruption (lysis): technical and preclinical assessment.
the significant elevation of blood NEFA must be due to Plast Reconstr Surg 2009;124:92-101.
the effects of activated lipolysis within the adipose tissue 12. Avci P, Nyame TT, Gupta GK, Sadasivam M, Hamblin MR. Low-level laser
induced by ultrasound-induced cavitation. therapy for fat layer reduction: a comprehensive review. Lasers Surg Med
2013;45:349-57.
13. McRae E, Boris J. Independent evaluation of low-level laser therapy at 635
Given the paucity of clinical or biochemical evidence for nm for non-invasive body contouring of the waist, hips, thighs. Lasers Surg
mechanisms of nonfocused ultrasound reduction of adipose Med 2013;45:1-7.
110 Plast Aesthet Res || Volume 3 || April 25, 2016