title: Combination laser-assisted liposuction and minimally invasive skin tightening with temperature feedback for treatment of the submentum and neck.
abstract: BACKGROUND
  There is need for better nonsurgical treatment of excessive neck fat and skin laxity.
  
  
  OBJECTIVE
  To assess combination laser-assisted liposuction (LAL) and minimally invasive skin tightening (MIST) of the submentum and neck under direct temperature control.
  
  
  METHODS
  Randomized, prospective, three-arm study of single LAL-MIST treatment comparing 1,064, 1,319 nm, and blended 1,064 and 1,319 nm.
  
  
  METHODS
  Twelve subjects were randomized to three arms. LAL was fiber administered into the adipose layer, followed by aspiration. MIST was laser fiber administered into the subdermal plane. Multiple passes were administered until uniform 45-48°C was attained in the targeted plane. Energy delivery totalled 5,000-7,000 J. Subjects were photographed at baseline and 1, 2, 3, 4, 5, and 6 months after treatment and assessed using a 4-point quantitative laxity grading scale and fat aspirate quantitation.
  
  
  RESULTS
  Mean ± standard deviation baseline, follow-up, and difference in laxity grades and percentage improvement over baseline for the three study arms and total were 3.19 ± 0.38%, 1.88 ± 0.85%, 1.31 ± 0.55%, and 43.8 ± 18.5%, respectively, for 1,064 nm; 3.75 ± 0.29%, 2.38 ± 0.25%, 1.38 ± 0.25%, and 36.6 ± 5.9%, respectively, for 1,319 nm; 3.38 ± 0.48%, 2.13 ± 0.63%, 1.25 ± 0.29%, and 39.3 ± 12.9%, respectively, for 1,064/1,319 nm; and 3.44 ± 0.43%, 2.13 ± 0.61%, 1.31 ± 0.36%, and 39.4 ± 12.1%, respectively, total. Mean fat aspirate volumes were 6.13 ± 3.28 mL for 1,064 nm, 8.25 ± 2.50 mL for 1,319 nm, and 6.50 ± 5.74 mL for 1,064/1,319 nm. Clinical improvement was consistent across all subjects; all before-and-after photographs are presented (save a recognizable subject for privacy). No blistering, scarring, or dyspigmentation was observed.
  
  
  CONCLUSIONS
  Combination temperature-controlled LAL-MIST treats excess fat and skin laxity of the submentum and neck with excellent safety and efficacy.
authors.affiliation: Department of Dermatology, School of Medicine, Yale University, New Haven, Connecticut, USA. dralexiades@nyderm.org
authors.forename: Macrene
authors.initials: M
authors.lastname: Alexiades-Armenakas
mesh_terms: D000328:Adult; D000368:Aged; D062109:Dermatologic Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D015187:Lipectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009333:Neck; D011446:Prospective Studies; D012060:Rejuvenation; D015595:Skin Aging; D013696:Temperature; D016896:Treatment Outcome