title: Review of the Mechanisms and Effects of Noninvasive Body Contouring Devices on Cellulite and Subcutaneous Fat.
abstract: BACKGROUND
  Today, different kinds of non-invasive body contouring modalities, including cryolipolysis, radiofrequency (RF), low-level laser therapy (LLLT), and high-intensity focused ultrasound (HIFU) are available for reducing the volume of subcutaneous adipose tissue or cellulite. Each procedure has distinct mechanisms for stimulating apoptosis or necrosis adipose tissue. In addition to the mentioned techniques, some investigations are underway for analyzing the efficacy of other techniques such as whole body vibration (WBV) and extracorporeal shockwave therapy (ESWT). In the present review the mechanisms, effects and side effects of the mentioned methods have been discussed. The effect of these devices on cellulite or subcutaneous fat reduction has been assessed.
  
  
  METHODS
  We searched pubmed, google scholar and the cochrane databases for systemic reviews, review articles, meta-analysis and randomized clinical trials up to February 2015. The keywords were subcutaneous fat, cellulite, obesity, noninvasive body contouring, cryolipolysis, RF, LLLT, HIFU, ESWT and WBV with full names and abbreviations.
  
  
  RESULTS
  We included seven reviews and 66 original articles in the present narrative review. Most of them were applied on normal weight or overweight participants (body mass index < 30 kg/m2) in both genders with broad range of ages (18 to 50 years on average). In the original articles, the numbers of included methods were: 10 HIFU, 13 RF, 22 cryolipolysis, 11 LLLT, 5 ESWT and 4 WBV therapies. Six of the articles evaluated combination therapies and seven compared the effects of different devices.
  
  
  CONCLUSIONS
  Some of the noninvasive body contouring devices in animal and human studies such as cryolipolysis, RF, LLLT and HIFU showed statistical significant effects on body contouring, removing unwanted fat and cellulite in some body areas. However, the clinical effects are mild to moderate, for example 2 - 4 cm circumference reduction as a sign of subcutaneous fat reduction during total treatment sessions. Overall, there is no definitive noninvasive treatment method for cellulite. Additionally, due to the methodological differences in the existing evidence, comparing the techniques is difficult.
authors.affiliation: Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Alizadeh
authors.affiliation: Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Farzin
authors.initials: F
authors.lastname: Halabchi
authors.affiliation: Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Mazaheri
authors.affiliation: Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Abolhasani
authors.affiliation: Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mastaneh
authors.initials: M
authors.lastname: Tabesh
keywords: Body Contouring; Cellulite; Subcutaneous Fat