title: Prospective Internally Controlled Blind Reviewed Clinical Evaluation of Cryolipolysis Combined With Multipolar Radiofrequency andVaripulseTechnology for Enhanced Subject Results in Circumferential Fat Reduction and Skin Laxity of the Flanks.
abstract: BACKGROUND
  Increasing demand for non-invasive skin tightening and body contouring procedures has led to several technological in- novations in energy-based devices such as ultrasound, radiofrequency and cryolipolysis. An emerging trend in the eld is to evaluate whether combination therapies for skin laxity/body contouring using energy-based devices can deliver superior clinical results and patient satisfaction. As such, the objective of this prospective, internal-controlled, blind clinical study was to assess the safety and efficacy of cryolipolysis followed by multipolar radiofrequency with pulsed electromagnetic elds (PEMF) and adjustable pulsed suction for the treatment of skin laxity in the flanks.
  
  
  METHODS
  Ten subjects with focal adiposities in the anks were enrolled in the study. All subjects received one session of cryolipolysis treatment and after randomization received two sessions of radiofrequency with PEMF (spaced two weeks apart), followed by another two sessions of radiofrequency with PEMF and adjustable pulsed suction (spaced two weeks apart). Clinical photography was used to monitor the subject's results at baseline, one week, three, and six months post treatment. Blinded reviewers and the treating inves- tigator assessed the clinical outcomes using the Global Aesthetic Improvement (GAI) scale. Side effects were recorded at every visit and patient satisfaction was noted at the one week, three and six-month follow-up using a 5-scale subject satisfaction assessment questionnaire.
  
  
  RESULTS
  Analysis of the blinded investigator ratings demonstrated statistical significant enhanced skin laxity mean improvement of 1 grade on the GAI scale in subject treated with the combination treatment (cryolipolysis+RF/PEMF/suction) compared with the cryolipolysis treatment alone. The unblinded investigator GAI ratings also showed enhanced (20%) mean improvement of laxity in the combination treated subjects versus those receiving cryolipolysis alone. Over half of the participants reported satisfaction with both treatment results, but there was a 10% statistically significant higher satisfaction rating of the outcomes in the flank treated with the combination treatment. Procedures were well tolerated, side effects were transient and self-resolving and no unexpected adverse effects were reported for the duration of the study.
  
  
  CONCLUSIONS
  The results of this study show that the combination of multipolar RF with PEMF/suction following cryolipolysis is a safe, effective, and painless approach to enhance skin tightening following fat reduction procedures in the flanks. <em>J Drugs Dermatol. 2016;15(11):1354-1358.</em>.
authors.forename: Julius
authors.initials: J
authors.lastname: Few
authors.forename: Michael
authors.initials: M
authors.lastname: Gold
authors.forename: Neil
authors.initials: N
authors.lastname: Sadick
mesh_terms: D003131:Combined Modality Therapy / Q000379:methods; D003357:Cosmetic Techniques; D017679:Cryotherapy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008066:Lipolysis / Q000502:physiology; D011446:Prospective Studies; D000078702:Radiofrequency Therapy; D016037:Single-Blind Method; D012867:Skin / Q000473:pathology / Q000528:radiation effects*; D050151:Subcutaneous Fat / Q000378:metabolism / Q000473:pathology / Q000528:radiation effects*; D013848:Thigh / Q000473:pathology / Q000502:physiology / Q000528:radiation effects; D016896:Treatment Outcome