title: Non-invasive tumescent cryolipolysis using a new 4D handpiece: a comparative study with a porcine model.
abstract: OBJECTIVE
  The growing demand for a youthful appearance, including a favorable body shape, has motivated recent developments in noninvasive body contouring techniques. Our aim was to investigate the efficacy and safety of a new version of a 4D handpiece-mounted cooling device for cryolipolysis with or without tumescent injections.
  
  
  METHODS
  We conducted a side-by-side comparative study using two female porcine models. Two areas of each pig's left abdomen were treated using a conventional device and the new cooling device, and two areas of the right abdomen were also treated using the conventional and new cooling device, but both were combined with tumescent-solution injections.
  
  
  RESULTS
  The conventional method alone yielded a 75.25% reduction in skin thickness, while the new cooling device alone yielded a 81.63% reduction. When paired with tumescent injections, the conventional device yielded a 86.3% reduction in skin thickness and the cooling device yielded a 85.9% reduction. Using histological analysis with H&E, oil red O, and toluidine blue stain, we confirmed that selective cryolipolysis was able to induce selective apoptosis of fat cells.
  
  
  CONCLUSIONS
  This in vivo study presents a new 4D handpiece-assisted cooling device with tumescent anesthesia that is safe and effective for fat reduction.
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.|GoodDay Skin & Laser Clinic, Seoul, South Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Jeong
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: T R
authors.initials: TR
authors.lastname: Kwon
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: J
authors.initials: J
authors.lastname: Seok
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: K Y
authors.initials: KY
authors.lastname: Park
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: B J
authors.initials: BJ
authors.lastname: Kim
mesh_terms: D000273:Adipose Tissue / Q000473:pathology* / Q000601:surgery*; D000818:Animals; D003357:Cosmetic Techniques / Q000295:instrumentation*; D003452:Cryosurgery / Q000295:instrumentation* / Q000379:methods; D062109:Dermatologic Surgical Procedures / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D015187:Lipectomy / Q000295:instrumentation* / Q000379:methods; D008904:Miniaturization; D013552:Swine
keywords: 4D handpiece; cryolipolysis; fat; tumescent