title: Synergistic effects of cryolipolysis and shock waves for noninvasive body contouring.
abstract: BACKGROUND
  Excess body fat, localized adiposity, and cellulite represent important social problems. To date, techniques using radiofrequencies, cavitation and noncavitation ultrasound, and carbon dioxide have been studied as treatments for noninvasive body contouring. Ice-Shock Lipolysis is a new noninvasive procedure for reducing subcutaneous fat volume and fibrous cellulite in areas that normally would be treated by liposuction. It uses a combination of acoustic waves and cryolipolysis. Shock waves, used normally in the treatment of renal calculi and musculoskeletal disorders, are focused on the collagen structure of cellulite-afflicted skin. When used on the skin and underlying fat, they cause a remodeling of the collagen fibers, improving the orange-peel appearance typical of the condition. Cryolipolysis, on the other hand, is a noninvasive method used for the localized destruction of subcutaneous adipocytes, with no effects on lipid or liver marker levels in the bloodstream. The combination of the two procedures causes the programmed death and slow resorption of destroyed adipocytes.
  
  
  METHODS
  In this study, 50 patients with localized fat and cellulite were treated with a selective protocol for the simultaneous use of two transducers: a Freezing Probe for localized fatty tissue and a Shock Probe for fibrous cellulite.
  
  
  RESULTS
  The procedure significantly reduced the circumference in the treated areas, significantly diminishing fat thickness. The mean reduction in fat thickness after treatments was 3.02 cm. Circumference was reduced by a mean of 4.45 cm. Weight was unchanged during the treatment, and no adverse effects were observed. Histologic and immunohistochemical analysis confirmed a gradual reduction of fat tissue by programmed cell death. Moreover, the reduction in fat thickness was accompanied by a significant improvement in microcirculation, and thus, the cellulite. The safety of the method also has been highlighted because it is accompanied by no significant increase in serum liver enzymes or serum lipids.
  
  
  CONCLUSIONS
  The study aimed to observe the effects of the new technique in the treatment of localized fat associated with cellulite in order to assess adipose tissue alterations, cellular apoptosis, and levels of serum lipid or liver markers. The findings show that the action of Ice-Shock Lipolysis is a safe, effective, and well-tolerated noninvasive procedure for body contouring. In particular, the authors believe that this could be an ideal alternative to liposuction for patients who require only small or moderate amounts of adipose tissue and cellulite removal or are not suitable candidates for surgical approaches to body contouring.
authors: School of Medicine and Surgery, Department of Orthopaedic, Traumatologic, Riabilitative and Plastic-Reconstructive Sciences, Second University of Naples, L. De Crecchio 3, 80138, Naples, Italy. gaferraro@libero.it
authors: G A
authors: GA
authors: Ferraro
authors: F
authors: F
authors: De Francesco
authors: C
authors: C
authors: Cataldo
authors: F
authors: F
authors: Rossano
authors: G
authors: G
authors: Nicoletti
authors: F
authors: F
authors: D'Andrea
mesh_terms: D000273:Adipose Tissue / Q000473:pathology; D000328:Adult; D004867:Equipment Design; D005260:Female; D005615:Freezing; D019220:High-Energy Shock Waves; D006801:Humans; D015187:Lipectomy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055815:Young Adult