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In the name of God. Laser Lipolysis Laser Body Contouring Laser Liposuction Laser-Assisted Lipolysis Laser Lipo Suction Laser-Assisted Body Contouring.

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Presentation on theme: "In the name of God. Laser Lipolysis Laser Body Contouring Laser Liposuction Laser-Assisted Lipolysis Laser Lipo Suction Laser-Assisted Body Contouring."— Presentation transcript:

1 In the name of God

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3 Laser Lipolysis Laser Body Contouring Laser Liposuction Laser-Assisted Lipolysis Laser Lipo Suction Laser-Assisted Body Contouring

4 Careful discussions regarding your reasons for wanting treatment are very important before you undertake any procedure.

5 1-Diet 2-Exercise 3-???? 4-Laser Lipolysis

6 The average human body has up to 40 billion fat cells. The rounded fat cells (pink) are called adipocytes. Connective tissue fibres (yellow) have a supporting function for the fat cells. Almost the entire volume of each adipocyte is occupied by a single lipid droplet formed from triglycerides. Fat not used up in metabolic processes is housed in these cells. Adipose connective tissue forms a thick layer under the skin, around the buttocks, thighs and kidneys. It functions as an insulating layer and energy store. Magnification: x115 at 6x7cm size.

7 The rounded fat cells (pink) are called adipocytes. Connective tissue fibres (yellow) have a supporting function for the fat cells. Almost the entire volume of each adipocyte is occupied by a single lipid droplet formed from triglycerides. Fat not used up in metabolic processes is housed in these cells. Adipose connective tissue forms a thick layer under the skin, around the buttocks, thighs and kidneys. It functions as an insulating layer and energy store.

8  In biology, adipose tissue is loose connective tissue connective tissue  composed of adipocytes.adipocytes  It is technically composed of roughly only 80% fat; fat in its solitary state exists in the liver and muscles.  Adipose tissue is derived from lipoblasts.lipoblasts  Its main role is to store energy in the form of lipids,energylipids  cushions and insulates the body.insulates  adipose tissue as a major endocrine organ, hormones such as leptin, estrogen, resistin, and the cytokine TNFα.endocrine hormonesleptinestrogen resistincytokineTNFα

9 Adipose tissue is the greatest peripheral source of aromatase in both males and females, contributing to the productionperipheralaromatase of estradiol.estradiol Adipose derived hormonesAdipose derived hormones include: Adiponectin Resistin Plasminogen activator inhibitor-1Plasminogen activator inhibitor-1 (PAI-1) TNFα IL-6 Leptin EstradiolEstradiol (E2) Adipose tissues also secrete a type of cytokines (cell-to-cell signalling proteins) called adipokines (adipocytokines), which play a role in obesity-associated complications. cytokinesadipokines

10 only when insulin is low can FFA leave adipose tissue.

11 Leptin is produced in the white adipose tissue and signals to the hypothalamus.hypothalamus  When leptin levels drop, the body interprets this as loss of energy, and hunger increases. Mice lacking this protein eat until they are four times their normal size.  Leptin, plays a different role in diet-induced obesity in rodents and humans. Because adipocytes produce leptin, leptin levels are elevated in the obese. However, hunger remains, and, when leptin levels drop due to weight loss, hunger increases. The drop of leptin is better viewed as a starvation signal than the rise of leptin as a satiety signal.[However, elevated leptin in obesity is known as leptin resistance. The changes that occur in the hypothalamus to result in leptin resistance in obesity are currently the focus of obesity research.[satietyleptin resistancehypothalamus

12 "Dying to be thin: A dinitrophenol related fatality".  McFee, RB; Caraccio, TR; McGuigan, MA; Reynolds, SA; Bellanger, P (2004). "Dying to be thin: A dinitrophenol related fatality". Veterinary and human toxicology 46 (5): 251–4. PMID PMID  ^ Miranda, EJ; McIntyre, IM; Parker, DR; Gary, RD; Logan, BK (2006). "Two deaths attributed to the use of 2,4-dinitrophenol". Journal of analytical toxicology 30 (3): 219–22. PMID ^ PMID

13 The best and healthiest way to lose weight is with a combination of diet and exercise.

14 Adipose tissue as an endocrine organ regulating growth, puberty, and other physiological functions.

15 Being overweight is a contributing cause of many preventable illnesses. Perhaps more important than weight is the percentage of fat in the body. For healthy women, fat can account for as much as 25 % of body weight, 17 % is a healthy percentage for men. Most of the extra calories we eat that we do not need for immediate energy is stored as fat. Obesity – even moderate overweight – puts undue stress on the back, legs and internal organs an this can eventually exacerbate many physical problems and compromise health.

16 Obesity increases the body’s resistance to insulin  susceptibility to infection  higher risk for developing coronary artery disease  diabetes, stroke, and other serious health problems  premature death.  Complications of pregnancy  liver damage  suffer psychologically as well as physically. , providing insulation from heat and cold.  Around organs, it provides protective padding.  its main function is to be a reserve of lipids, which can be burned to meet the energy needs of the body and to protect us from excess glucose by storing triglycerides produced by the liver from sugars.  Adipose depots in different parts of the body have different biochemical profiles. Under normal conditions, it provides feedback for hunger and diet to the brain.  Biotechnology  human embryonic stem cells. induced pluripotent stem cells without the need for feeder cells.embryonic stem cells induced pluripotent stem cells

17 Excess fat Without fat  you would freeze to death in weather that was anything less than warm, have no energy stores, and have to eat constantly. If you did anything at all that expended energy, your body would have to start burning muscle tissue to create that energy. Without body fat, you would be uncomfortable sitting or laying down because your bones would have no padding.  susceptibility to infection  higher risk for developing coronary artery disease  diabetes, stroke, and other serious health problems  premature death.  Complications of pregnancy  liver damage  suffer psychologically as well as physically.

18 International research has shown that the common causes of obesity are:  • Poor diet/eating habits  • Hormonal Imbalances  • Lack of exercise  • Glandular Malfunctions  • Diabetes  • Hypoglycaemia  • Hyperinsulinemia  • Emotional Tension  • Boredom  • And many, many others.

19 Science Behind the Treatment  Fat tissue (anatomy,physiology,histology)  Adipocytes(Cellular characteristics,subcellular organells,metabolism)  Nutrition & Diet  Exercise programms  Tumescent aesthesia  Laser –fat interaction &Technical information

20 نردبام اين جهان مال و مني است عاقبت اين نردبان بشكستني است لاجرم هركس كه بالا تر نشست استخوانش سخت تر خواهد شكست

21 BODY SLIMMING Decrease in Adipocytes size Lypomed &LLLT Decrease in number of adipocytes Laser lipolysis &liposuction  No invasion  Less expensive  More sessions  If weight gain occurs no risk  More invasive  Risk of abnormal fat deposition if weight gain  More expensive  Limited session

22 Fat Location and Distribution: Subcutaneous and Visceral Fat The superficial and deep subcutaneous layers are separated by a membrane called fascia. subcutaneous fat (the superficial layer)  is less commonly removed, suctioned out in liposuction. (Hyper hidrosis)  is denser than the deep layer and is tightly packed with nerves and blood vessels. This fat layer is the location of the dreaded cellulite, which is caused by tight bands of connective tissue that squeeze portions of the fat cells and cause the bumpy irregularities on the skin.  Liposuction in the superficial layer must be done carefully so as not to damage the functional components of the skin.  This damage can result in visible permanent irregularities, discolorations, and possible death to that section of skin (skin necrosis).  The deep subcutaneous fat layer is the one that is commonly removed in liposuction. subcutaneous fat (the deep layer

23 Definition  Laser Lipolysis is a minimally invasive way of removing small localised fat deposits. It is a newer laser assisted liposculpture procedure first used around 2004 for the removal of 'saddlebags', 'love handles', and 'double chins' etc. It can effectively reduce areas of fat resistant to diet or exercise whilst reducing the risks associated with traditional procedures such as liposuction.

24 Indications  Body sclpturing & Beauty  Metabolic correction e.g.DM  Axillary hyperhidrosis & Bromhydrosis  Hydradenitis suppurative (apocrine hydradenitis )  Gynecomastia

25 Devices  It is currently available in the UK using mainly the Smartlipo® laser, although more and more clinics are now offering a variety of other devices including the OSYRIS Pharaon Laser Lipolysis System and the CoolTouch  CoolLipo™. Private costs for Laser Lipolysis treatment depends on the size and number of area(s) being treated and can range from £1,500 – £4,500.  1064nm/1320/1444/Diode

26 Smartlipo MPX system. Smartlipo MPX affects adipocytes through  photo-mechanical  Thermal interactions.  The energy was delivered until the tissue was pliable.

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28 The procedure  is performed by introducing a fine fibre- optic probe under the skin which delivers low-level laser energy - this selectively breaks up fat cells transforming them into an oily substance that is absorbed and eliminated by the body over the following weeks, or sucked out at the time of the procedure.

29 The Smartlipo MPX, offering two distinct wavelengths, is a safe and effective procedure for laser lipolysis and skin tightening. The combination of wavelengths appears to increase the speed and efficiency of disrupting the adipocytes. The laser tissue interaction supporting the addition of the 1320 nm wavelength to the current 1064 nm Nd:YAG system is based on the strong absorption and minimal scattering characteristics of the 1320 nm wavelength in fat tissue allowing the majority of the energy to be deposited in a localized region near the laser fiber tip in the subcutaneous layer. This results in efficient heating of the subcutaneous layer and effective lipolysis.

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31 The 1064 nm laser has less absorption and larger scattering than the 1320 nm counterpart allowing for disruption of a broader region of fat tissue. The 1064 nm wavelength heats tissue more evenly while generating broader heating zones than the 1320 nm wavelength. Sequential lasering with both wavelengths in the MultiPlex mode, not only generates higher temperature rise at the front of the laser tip but also heats peripheral tissue. It allows for more efficient lipolysis, and safer and more efficient heating of collagen bundles in the dermis resulting in tissue tightening.

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33 Two different types of adipose tissue Brown adipose tissueWhite adipose tissue

34 Difference between Liposuction & Laser Lipolysis LiposuctionLaser Lipolysis  uses an invasive mechanical technique to tear the fat cells and suck them out of the body.  usaes a thermal process to gently heat up and destroy the fat cells, leaving it in a liquefied state which makes it easier for the Specialist to remove, or for the body to naturally metabolize the fat.  The heat stimulates the fibroblast resulting in a skin- tightening effect. This also happens to be an extremely beneficial post-pregnancy treatment.

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36 Tumescent anesthesia

37 Marking in different positions

38 Marking &positioning both before and during surgery

39 Today’s tumescent anesthesia Tumescent Liposuction Body sculpture by liposuction is literally a dream come true.  you can improve upon your appearance without incurring the cost and risk associated with “going to sleep” under general anesthesia. Skilled cosmetic surgeon gives women the option of in-office cosmetic surgery with tumescent anesthesia.  advantages of tumescent anesthesia with breast augmentation, liposuction, lipoabdominoplasty and other cosmetic procedures.  1975/Georgia &Arpad fischer/Rome  1987/Klein/california/Derm atologist &pharmacologist  Max dose 35mg/kg lidocaine or 50mg/kg for prilocaine up to 6 liters

40 Tumescent anesthesia (lidocaine has antibacterial properties)

41 Anytime you can avoid general anesthesia, you should.  The anesthetic solution containing approximately either 0.05% or 0.1% with epinephrine 1:1,000,000 is prepared by adding either 500 mg or 1000 mg lidocaine ( 50 or 100 ml of 1% lidocaine ), 1 mg epinephrine (1 ml of 1:1000), and 12.5 meq of sodium bicarbonate (1 meq/ml) to 1000 ml of normal saline (0.9% NaC1).  Recipe for Tumescent Technique Anesthetic Solutions for Liposuction  (Lidocaine 0.05%, Epinephrine 1:1,000,000)  Lidocaine 500 mg (50 ml of 1% lidocaine solution)  Epinephrine 1 mg (1 mg of 1:1,000,000 solution of epinephrine  Sodium bicarbonate 12.5 meq (12.5 ml of an 8.4% NaH 2 CO 3 solution)  Normal saline 1000 ml of 0.9% NaC1 solution  The resultant solution is lidocaine (0.047%), epinephrine (1:1063,500), and sodium bicarbonate 11.8 meq/L in ml of saline 0.84%

42 The addition of sodium bicarbonate to the anesthetic solution minimizes the pain of infiltration. Using a local anesthetic solution without sodium bicarbonate often necessitates the use of IV sedation and narcotic anesthesia. With the tumescent technique, IV sedation and narcotic analgesia are virtually unnecessary.

43 Tumescent Technique for Regional Anesthesia Permits Lidocaine Doses of 35 mg/kg for Liposuction Jeffrey A. Klein, M.D.  Abstract. The tumescent technique for local anesthesia permits regional local anesthesia of the skin and subcutaneous tissues by direct infiltration. The tumescent technique uses large columns of a dilute anesthetic solution to produce swelling and firmness of targeted areas. This investigation examines the absorption pharmacokinetics of dilute solutions of lidocaine (0.1% or 0.05%) and epinephrine (1:1,000,000) in physiologic saline following infiltration into subcutaneous fat of liposuction surgery patients. Plasma lidocaine concentrations were measured repeatedly over more than 24 hours following the infiltration. Peak plasma lidocaine levels occurred hours after beginning the infiltration. Clinical local anesthesia is apparent for up to 18 hours, obviating the need for postoperative analgesia. Dilution of lidocaine diminishes and delays the peak plasma lidocaine concentrations, thereby reducing potential toxicity. Liposuction reduces the total amount of lidocaine absorbed systemically, but does not dramatically reduce peak plasma lidocaine levels. A safe upper limit for lidocaine dosage using the tumescent technique is estimated to be 35 mg/kg. Infiltrating a large volume of dilute epinephrine assures diffusion throughout the entire targeted area while avoiding tachycardia and hypertension. The associated vasoconstriction is so complete that there is virtually no blood loss with liposuction. The tumescent technique can be used with general anesthesia or IV sedation. However, with appropriate instrumentation and surgical method, the tumescent technique permits liposuction of large volumes of fat totally by local anesthesia, without IV sedation or narcotic analgesia. J Dermatol Surg Oncol 1990; 16:

44 How much is sufficient ? The word tumescent means swollen &firm Watermelon  Distension  Sound  40-50ml/palm area

45 Peauds orange apearance Means  The volume of tumescense is sufficient in the upper part of SQ tissue and dermis

46 Why is tumescent anesthesia a safer option?  Anytime you can avoid general anesthesia, you should. Well-publicized risks include respiratory problems, stroke, heart attack and even death.  The vasoconstrictor element (adrenaline) of tumescent anesthesia helps prevent blood loss during surgery because it constricts the blood vessels. Lidocaine acts both as a pain reliever and a bacteriostatin so you’re better protected from infection. Tumescent anesthesia also offers the advantages of diminished bruising, faster recovery and less pain after surgery.

47 Lidocaine Toxicity with Tumescent Liposuction A Case Report of Probable Drug Interactions by Jeffrey A. Klein MD and Norma Kassarjdian, MD  We report a case of mild lidocaine toxicity. A reduced rate of lidocaine metabolism following tumescent liposuction may result from an inhibition of cytochrome P450 3A4 (CYP3A4) by sertraline (Zoloft) and flurazepam (Dalmane).

48 Awake but pain-free, patients can comfortably interact with Dr. during cosmetic surgery to provide input on size and body contouring General local anesthesiaTumescent local anesthesia  FDA based its official 7mg/kg maximum recommended dosage for lidocaine with epinephrine for infiltration  35mg/kg

49 High-intensity exercise is one way to effectively reduce total abdominal fatat least 10 MET-hours per week of aerobic exercise is required for visceral fatMETaerobic exercise visceral fat Abdominal obesity Abdominal obesity  An excess of visceral fat is known as central obesity, or "belly fat", in which the abdomen protrudes excessively.central obesity  The correlation between central obesity and cardiovascular disease is strong. Excess visceral fat is also linked to type 2 diabetes, insulin resistance, inflammatory diseases,and other obesity-related diseases.obesity cardiovascular diseasetype 2 diabetesinsulin resistance inflammatory diseases

50 Subcutaneous fat is not related to many of the classic obesity-related pathologies, such as heart disease, cancer, and stroke, and some evidence even suggests it might be protective. The typically female (or gynecoid) pattern of body fat distribution around the hips, thighs, and buttocks, is subcutaneous fat, and therefore poses less of a health risk compared to visceral fat.[ Like all other fat organs, subcutaneous fat is an active part of the endocrine system, secreting the hormones leptin and resistin.leptinresistin

51 Advantages of tumescent liposuction  Absence of the need for a general anesthesia  Significantly reduce blood loss  Immediate patient mobilization  Convalescence  Long lasting post operative analgesia(8-16h)  Positioning during surgery  Compensating intraoperative fluid losses  Stabilizing SQ tissue so less trauma

52 Patience results  The procedure would be  Less painful for the patient  Less strenuous physically for the surgeon  Q Why should I choose "True" Tumescent Liposuction over other techniques? A 1. Better and smoother results–using micro- cannulas. 2. Safer–all local anesthesia, no IV sedation, virtually no blood loss. 3. Decreased post- operative discomfort. 4. Resume normal activities within only 2 days.

53 Patience (30-60minutes) Patience Patience Patience Patience Patience

54 Laser Lipolysis with Sequential Emission of 1064 nm and 1320 nm Wavelengths The 1320 nm wavelength heats the blood converting hemoglobin to methemoglobin. The 1064 nm wavelength has a 3-5 time greater affinity for methemoglobin than for hemoglobin thereby increasing absorption resulting in more efficient coagulation leading to skin tightening.

55 Repeat Treatments  More often than not, one treatment session per area is considered to be enough, however it all depends on the amount of fat to be removed, and if it is felt that the final result (after 4 – 6 months) needs improving on or not

56 Skin tightening abdominal as well as the submental area. Thermal denaturation of structural proteins in fresh tissue has been reported at 40 – 45 degrees Celsius. Due to lasing in the dermal plane, temperature may rise delivering additional heat to the dermis. Thus, our lasing was stopped when the skin temperature reached degrees Celsius.

57 the SmartSense delivery system an intelligent chip – the “ Accelerometer ” - which attaches to the laser handpiece providing feedback to the laser. Through the use of SmartSense, the laser is deployed only when the handpiece is in motion and adjusts the amount of energy delivered with the motion of the handpiece. The laser energy distribution is proportional to the rate of movement of the handpiece. As the surgeon slows the movement of the handpiece, the laser energy drops accordingly. If the laser handpiece comes to a complete stop, the laser will stop within 0.2 second. This method ensures optimal patient safety by preventing excessive thermal damage.

58 Unrealistic expectations  Sensible diet  Exercise  Lipolaser

59 The last 10 or 15 pounds of fat seems resistant to further weight loss efforts The last 5-6 KG

60  After puberty, fat cells (adipocytes) remain constant in number and change their size and volume according to the lipid (fat) content the body decides to store. Sometimes this fat assumes abnormal proportions in well- defined areas, such as under the chin, upper arms, thighs, hips and waist - even when your body weight is normal for your height. Attempts to reduce these localised fat deposits by diet or exercise alone are often unsuccessful.

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62 Digital Surface Imaging Clinics 360° 3D Image Capture: Complexion Analysis & Consultation

63 پيكر تراش پيرم و با تيشه خيال يك شب ترا ز مرمر شعر آفريده ام  Digital Surface Imaging Clinics 360° 3D Image Capture: Complexion Analysis & Consultation

64  Over the years, a variety of surgical interventions have been used to remove localised fat deposits including  suction-assisted lipoplasty, ultrasound-assisted liposuction, and power-assisted liposuction. Although these procedures can be effective in reducing relatively large fat deposits, they do result in a lot of bruising and swelling in the treated area, requiring several days to recover; and they can cause some permanent numbness of the skin due to nerve damage. In addition, very small localised areas of fat deposits can be more difficult to treat with conventional liposuction techniques.lipoplasty

65 Laser Lipolysis is a liposculpture procedure that  is generally more suitable for the removal of cmaller stubborn pockets of fat such as 'saddlebags', 'love handles', and 'double chin' etc. It can effectively reduce areas of fat resistant to diet or exercise whilst reducing the risks associated with traditional procedures such as liposuction. liposuction

66 The goal of liposuction is removing inches not pounds.

67 What is Laser Lipolysis and how does it work?  The procedure is performed by introducing a fine fibre-optic probe under the skin which delivers low-level laser energy - this selectively breaks up fat cells (a process known as lipolysis) transforming them into an oily substance that is absorbed and eliminated by the body in a natural manner over the following weeks. In general, no fat is aspirated or “sucked out” of the body, (which helps to avoid the damage to blood vessels and nerve endings often associated with liposuction), however it has been noted that in some cases it can be more beneficial to the speed and results of the treatment for suction to be used. In addition, the low level laser energy helps to stimulate collagen production in the skin resulting in skin tightening.

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69  Anaesthesia  A local anaesthesia will be used in the area to be treated before commencing; therefore you will remain comfortable and awake throughout the procedure.

70 How long will it take to recover from Laser Assisted Lipolysis? You may be required to rest in a room afterwards for an hour or so following treatment, but normal activities can usually be resumed a day or so following the procedure. It is best to avoid vigorous physical activity or sports for one to two weeks after this procedure.

71 What are the risks and potential complications ?  The actual procedure is generally well tolerated, due to the local anaesthesia. You may feel a tugging sensation during treatment but should not feel pain.  People may experience minor swelling, bruising or tenderness for a few days or weeks following treatment - this tends to be worse if suction is used during the procedure.

72 Are there any risks of office liposuction?  bruising,  swelling,  and temporary numbness.  Although irregularities of the skin are possible following liposuction, the use of the tumescent technique and smaller cannulas minimize this risk, compared to traditional liposuction using larger cannulas. Smaller cannulas allow for a more gradual, targeted, and measured or controlled removal of fat. Rare problems that can occur with any surgery include  bleeding,  infection,  or nerve injury.  The tumescent technique minimizes these risks.  skin irregularity, lumpiness, dimpling, loose skin

73 Post-treatment recommendations  :  avoid vigorous physical activity or sports for one to two weeks afterwards,   keep the compression bandage/clothing supplied on for the advised period - usually 24 – 48 hours for treatments on the face and under the chin, and days in other areas.  take the short course of antibiotics that has been prescribed for 5 days,  keep the area clean and dry for 2 – 3 days following treatment,  avoid alcohol consumption for 12 hours following the procedure,

74 Post-treatment recommendations  gentle massage or treatment is allowable af  ter days,  avoid vigorous massage in the treated area for months,  contact your practitioner immediately if you notice any signs of infection or if you experience heavy bleeding or a sudden increase in pain.

75 ‍‍ Contraindications ?  Women who are pregnant or breastfeeding are not suitable candidates.  Laser Lipolysis is not a cure for obesity. If you are generally healthy and not obese, Laser Lipolysis could help you to re- contour your body with minimal risk. The procedure works best on small areas such as the chin, “love handles”, “saddle bags”, knees, inner thighs, calves etc.  As Laser Lipolysis is generally used for removal of smaller pockets of fat, it is important that you are realistic as to what can be achieved using this procedure.  In general, if you have a Body Mass Index (BMI) over 30, you will not be a suitable candidate for Laser Lipolysis (unless you are a body builder). To calculate your Body Mass Index – weight/ (height) 2

76 (BMI) below 30 unless you are a (body builder)

77 Most patients are surprised at how quickly they return to normal activity. There is no limitation of physical activity other than what common sense would dictate. Some patients are able to return to normal work and light aerobic exercise within a day or two after surgery.

78 Repeat Treatments  More often than not, one treatment session per area is considered to be enough, however it all depends on the amount of fat to be removed, and if it is felt that the final result (after 4 – 6 months) needs improving on or not.  On average a total of 500mls (about the size of a can of coke) can be realistically removed in one treatment session.

79 Permanence of Results Fat that is removed by liposuction NEVER comes back.  Fat that is removed by liposuction NEVER comes back. As long as the individual does not gain excessive amounts of weight, the new silhouette is permanent. When a patient who has undergone liposuction gains weight, the areas originally treated by liposuction maintain their new desirable silhouette, whereas areas not treated by liposuction show new deposits of fat

80 Science Behind the Treatment  Laser lipolysis is a revolutionary new method for the removal of excess fatty tissue in areas that are normally resistant to dieting and physical exercise.

81  Standard lipolysis involves the injection of fat-dissolving phosphatidyl choline into localized regions of the body to target fat layers beneath the skin. Laser  Laser lipolysis uses laser technology to remove these stubborn fatty deposits.  Different system ® for this body sculpting procedure.  The Osyris Pharaon Lipo System ® employs a 980nm diode laser to heat the fat cells in the targeted area causing them to break down. Over a short period of time the fat deposits are simply absorbed and expelled through our body's natural metabolic process. During the procedure the laser seals off minor blood vessels, significantly reducing bruising and downtime.  In addition to the removal of fat, the introduction of heat from the laser to the treated area stimulates collagen production to give a smooth, tightened and sculpted appearance to the treated skin and underlying tissue.

82 Difference between Liposuction & Laser Lipolysis  Liposuction uses an invasive mechanical technique to tear the fat cells and suck them out of the body.  Laser Lipolysis uses a thermal process to gently heat up and destroy the fat cells, leaving it in a liquefied state which makes it easier for the Specialist to remove, or for the body to naturally metabolize the fat.  The heat stimulates the fibroblast (a cell that contributes to the formation of connective tissue fibres) which allows you to produce new collagen fibres, resulting in a skin-tightening effect. This also happens to be an extremely beneficial post- pregnancy treatment.

83 Effectiveness of treatment  In effect, the treatment is the first laser that literally vaporizes subcutaneous fat. It not only takes away the fat, it also tightens the skin overlying it. and the procedure leaves no scars, and there is no downtime associated with it. Improvements are usually seen within approximately 6 weeks of treatment and continue to gradually improve up to 4 months post treatment.  Laser Lipolysis is perfect for eliminating common and stubborn problem areas such as inner and outer thigh, tummy, jaw line jowls and similar areas.  The overall results depends on the amount of fat in the area to be treated.

84 The procedure is performed under sterile conditions in a treatment room.  The area to be treated is marked by the Aesthetic Specialist, and the area of fat to be removed is locally aneasthetized so that no discomfort is experienced during the procedure. A very fine ( 1.5mm diameter) cannula which contains the laser fibre is inserted under the skin through a tiny incision and directly into the fat. The laser beam is then slowly and methodically guided through the area and directed onto the fat cells. The energy and heat from the laser destroys the fat cells with no damaging effect on the surrounding tissues. In addition to destroying fat cells the heat from the laser tightens the skin through collagen stimulation and new collagen production. Your body will absorb this liquefied fat and eventually quite naturally excrete it through the body's natural metabolic process. Depending on the area treated, the procedure generally takes about an hour. Usually there is very little bleeding bruising or swelling and return to normal activity is possible shortly after the procedure.

85 What happens afterwards? You will be given verbal and written post procedure instructions, and be provided with your medical requirements before leaving. Depending up on the area treated, you are usually required to wear a compression garment for weeks. There is almost no bruising, swelling or pain and very few people require more than an occasional mild painkiller. Most people can return to work and most normal activities the next day. فلينظرالانسان الي طعامه

86 Is treatment permanent? Laser lipolysis is not a solution to obesity. Ideal candidates are those that are in relatively good health mentally and physically. Laser Lipolysis is not a replacement for liposuction but can be complementary to it, and is often used post-liposuction for enhanced body sculpting and skin tightening. There is a limit as to how much fat can be removed at any one time and if you need to remove larger amounts of fat in one session then liposuction may be the preferred option. Laser Lipolysis is a very effective treatment, however, like any body sculpting programme a sensible dieat and lifestyle is necessary to maintain the condition and its effectiveness.

87 The use of low-level laser therapy for Non-invasive body contouring  LLLT yields a valuable response without generating a photothermal or photoacoustic means.  LLLT operates within the parameters of photochemistry,changes on cell performance via modulation of intracellular biochemical reactions.  Non –invasive body slimming; histologically & clinically validated

88 LLLT  An identified targe t is the terminal enzyme in the inner mitochondrial membrane cytochrome c oxidase regulating cell bioenergetics  Modulatory capacity of light on non-photocynthetic cells

89 The purpose of low level laser technology You will not get any greater benefit by having a treatment five times per week compared to twice per week. However once per week is not enough to maintain the effect.  pain relief  cell re-generation for healing.  A clinical trial demonstrated that modifying the frequencies and output was effective for fat reduction. Adipose tissue is one of the main types of connective tissue. connective tissue

90 "cold" laser therapy  because it doesn't heat your body. The effects on your fat cells are not due to the heat as in laser surgery. High power lasers - which are used in surgery - work because they produce heat which cuts the tissue. The Low power laser, used in the Lumislim machine, is only able to operate at a constant light wavelength of 650nm which won't cut your tissue; it just stimulates your cells. Laser lipolysis is safe because your cells have a natural ability to resist over-stimulation. It is not possible to harm your body's tissues by over- dosing on the laser lipolysis treatments

91 AbdominalAbdominal fat has a different metabolic profile— being more prone to induce insulin resistance.metabolic

92 LLLT causes upregulation in cellular and metabolism respiration  At first as an adjuant to liposucton  Later as a stand-alone for non-invasive body countouring  Histologically validated and placebo-controlled,randomized, double-blind multi-center studies.  is only able to operate at a constant light wavelength of 650nm which won't cut your tissue; it just stimulates your cells.

93 how does LLLT work?  The light from the low power laser penetrates your skin up to a depth of 9mm. That's just deep enough to reach the sub-cutaneous fat layer.  The walls of your fat cells are disrupted by the laser and develop tiny pores; the fat then flows out into the space between your fat cells.  This is when your lymphatic system gets to work. Your lumph vessels transport excess fluids away from the spaces in your body tissue and take them back into your bloodstream. When you start to exercise after a treatment, your body will search for an energy source (your fat).  Normally it would take fat from around your vital organs (liver, lungs, kidney etc). But because you have had a laser lipolysis treatment, your body will take the fat from the treated areas (which is the path of least resistance ). And so you will lose inches from these areas.  If you do not undertake cardio-vascular exercise following a treatment the fat will just get deposited somewhere else on your body, for example on your tummy or bottom. This is why we encourage you to use my Vibration Plate immediately afterwards.

94 آگاهي دقت حوصله تعادل تجسم سه بعدي  Liposuction is not effective for people who are unable to maintain a reasonable weight by dieting. However, an overweight person whose weight has remained stable for many years and has specific problem areas may be an excellent candidate.

95 Thank you for your attention


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