title: New clinical outcomes utilizing a 1064-nm Nd:YAG laser for lipolysis of the torso oblique region.
abstract: OBJECTIVE
  The safety and efficacy of a 1064-nm Nd:YAG laser (Cynosure, Westford, USA) utilizing a 300-microm optical fiber and a 1-mm diameter micro-cannula were evaluated as a treatment for reduction in the appearance or elimination of unwanted fat in the lower back/flanks ('love handles'). In addition, the use of the laser for tightening the skin and collagen regeneration in the area of lipolysis was assessed through biopsies.
  
  
  METHODS
  Ten subjects with unwanted flaccidity and fat deposits in the oblique region of the torso were enrolled in the study. Subjects underwent a single laser lipolysis treatment followed by aspiration of the treatment area. The total tumescence used, laser energy delivered, and tissue removed was recorded for each subject. All subjects had baseline photographs taken and their weight recorded prior to treatment. Pregnancy tests (if applicable) were performed prior to treatment as well. Three subjects had 4-mm biopsies taken at baseline and 6 months to evaluate collagen regeneration. Collagen and elastic tissue fibers were evaluated using special routine stains and histochemical stains designed to highlight these dermal components. Follow-up visits were conducted at 1 week, 1 month, 3 months and 6 months following treatment to evaluate side effects, weight loss and laxity. Additionally, patients kept an evaluation log for each of the first 7 days following treatment. At the 6-month conclusion, patient satisfaction was recorded.
  
  
  RESULTS
  Laser lipolysis procedures with subsequent aspiration were performed bilaterally on the flanks of 10 subjects. At 1-week post-treatment, 80% of the subjects demonstrated reduction in laxity. Similarly, 100% of patients showed visible skin improvement at 1 month, with 70% recording a score of 2 (good improvement). Three-month evaluations yielded one patient (10%) with a score of 3 (excellent improvement) and seven patients (70%) with a score of 2. Histology reports confirmed the visual clinical outcomes, describing thicker collagen bundles at 6 months, as well as coagulation of blood vessels and adipocytes. Side effects were mild and transient in nature, and the majority of discomfort, redness, bruising, swelling, and tingling experienced was resolved within 1 week post-procedure. The treatment was well tolerated and efficacious, with 90% of patients rating their results as good or excellent and 100% of patients reporting that they would recommend the procedure.
  
  
  CONCLUSIONS
  The use of the 1064-nm Nd:YAG laser with a 300-microm fiber demonstrated the ability to treat adipose tissue in the highly vascular flank area with favorable efficacy and safety. Patients exhibited a quick recovery time and excellent tolerance, as well as visually improved skin.
authors.affiliation: Department of Dermatology, Weill Medical College of Cornell University, New York, NY, USA. nssderm@sadickdermatology.com
authors.forename: Neil S
authors.initials: NS
authors.lastname: Sadick
authors.forename: Theodore
authors.initials: T
authors.lastname: Diktaban
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Smoller
mesh_terms: D000328:Adult; D001706:Biopsy; D003094:Collagen / Q000502:physiology; D004547:Elastic Tissue / Q000473:pathology; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State; D015187:Lipectomy / Q000295:instrumentation* / Q000379:methods; D028022:Low-Level Light Therapy; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012038:Regeneration
chemical_list: D003094:Collagen