Wuhan Dimed Laser Technology Co., Ltd
Dimedlaser - Proffessional Manufacture Of Medical Lasers
|Place of Origin:||China,Wuhan|
|Brand Name:||Dimed laser|
|Model Number:||peralas 1064nm cherylas 1210nm berylas 980nm|
|Minimum Order Quantity:||1 set|
|Packaging Details:||Pelican case|
|Payment Terms:||T/T, Western Union|
|Supply Ability:||20units per month|
|Application:||Laser Lipolysis And Sking Tightening||Model:||Peralas 1064nm Cherylas 1210nm Berylas 980nm|
|Operation Mode:||CW, Single Or Repeat Pulse||Warranty:||Two Years|
Despite these findings, some clinicians have been reluctant to accept laser lipolysis citing longer procedural times, increased risk of adverse reactions, and lack of evidence supporting superiority over traditional liposuction. On the other hand, surgeons already familiar with laser technology may more enthusiastically embrace laser lipolysis as an adjunctive tool to satisfy the growing demand for minimally invasive technologies that enhance body sculpting and skin tightening without disfiguring scars.
many experimental and histological publications have reported that external application of laser energies, including 1064nm and 1320nm wavelengths, and radiofrequency devices increase fibroblast numbers, stimulate new collagen, and augment tissue tightening and elasticity. Low level laser therapy and cryolipolysis are additional newer modalities purporting lipolysis and collagenesis externally. Until further optimization of these devices occurs, and penetration and absorption through the skin is efficiently achieved, internal application of laser energy may be the most effective method of reducing fatty tissue and enhancing skin tightening.
In 1992, Apfelberg was the first to describe the direct action of laser in the adipose tissue—laser lipolysis. In 1994, Apfelberg et al conducted the first multicenter trial studying laser-assisted liposuction. A neodymium-doped yttrium aluminium garnet (Nd:YAG) laser with 40W, 0.2-second pulse duration, 600μm fiber inserted in a 4 or 6mm cannula was used. This fiber was encased within a cannula and was not in direct contact with the fatty tissue. The study implied decreased ecchymoses, pain, and edema and less effort for the surgeon. However, the benefit of laser lipolysis was not significantly demonstrated, it was not FDA approved, and the sponsoring company (Heraeus Lasersonics) abandoned the technology.
Between 2000 and 2003 Blugerman, Schavelzon, and Goldman introduced the concept of the pulsed 1064nm Nd:YAG system for laser lipolysis. Their work founded the current principles and techniques behind laser lipolysis. This group was the first to demonstrate the effect of the laser energy on fat as well as the surrounding dermis, vasculature, apocrine, and eccrine glands.
In 2003, Badin supported these findings in a study titled, “Laser Lipolysis: Flaccidity Under Control.” The author demonstrated the histological changes after thermal damage by the laser. The adipocyte membranes were disrupted, blood vessels were coagulated, and new collagen was reorganized. These histological changes were felt to correlate with the clinically observed decrease in local adiposity, ecchymoses, and blood loss as well as improved skin tightening. Badin concluded that laser-assisted lipolysis was less traumatic due to smaller cannula size as well as the unique tissue reaction of the Nd:YAG system, which improved skin retraction.
A subsequent study by Goldman treated 1,734 patients, including 313 men and 1,421 women between the ages of 15 and 78. This group also documented less blood loss and ecchymoses, improved patient comfort postoperatively, and better efficacy for reducing fat in more dense areas such as in the case of gynecomastia.
A 2006 study by Kim and Geronemus used magnetic resonance imaging (MRI) to evaluate the volume of fat reduction after laser lipolysis. In addition to the 17-percent fat volume reduction documented by MRI, patients noted a 37-percent improvement in only three months, quick recovery times, and good skin retraction.
After the FDA approved the first laser lipolysis device, a 6W Nd:YAG laser (manufactured by Deka and distributed by Cynosure, Westford, Massachusetts), a rapid influx of additional devices and wavelengths entered the market. Aggressive marketing by these companies and word-of-mouth publicity from satisfied patients have peaked interest in laser lipolysis procedures. These systems employed a variety of wavelengths in an effort to pinpoint the most effective for lipolysis and skin tightening. In 2007, Mordon et al detailed a mathematical model of laser lipolysis that evaluated a 980nm diode device with a 1064nm Nd:YAG device. This study suggested that heat, rather than a particular wavelength, led to lipolysis and skin tightening. They cite an internal temperature range of 48 to 50°C as sufficient to induce skin tightening.
Goldman proposed that two properties must be considered in determining the efficacy of laser lipolysis given a particular device— wavelength and energy delivered. Different wavelengths have been selected for laser lipolysis in an attempt to specifically target fat, collagen (water), and blood vessels. According to the theory of selective photothermolysis, these chromophores will preferentially absorb laser energy on the basis of their absorption coefficients at specific wavelengths. Various wavelengths, including 924, 968, 980, 1064, 1319, 1320, 1344, and 1440nm, have been evaluated for interactions within the subcutaneous compartment.
Some authors have suggested that certain wavelengths lead to superior lipolysis. Parlette and Kaminer documented that the 924nm wavelength has the highest selectivity for fat melting, but may not be as effective for skin tightening as other modalities unless combined with another wavelength. They continue by stating that the 1064nm wavelength has good tissue penetration, but relatively low fat absorption. The lower fat absorption of the 1064nm wavelength may be tempered by its superior heat distribution and therefore skin-tightening effect. Finally, the 1320nm wavelength demonstrates greater fat absorption with less tissue penetration and scatter and, therefore, may be safer for treatment around more fragile areas, such as the neck, inner thighs, and arms. These claims are not well supported in the literature; however, they have been identified as a few of the current theories.
Photoacoustic, photomechanical, and photothermal effects are additional theorized mechanisms of action in laser lipolysis. However, in this author's experience with several clinical trials and histological examinations, heat is the primary stimulant for lipolytic and skin-tightening effects. During a 2008 pilot study regarding safety and efficacy of a combined 1064nm/1320nm device, McBean and Katz assessed temperature changes within a defined treatment area. Internal temperatures varied by several degrees Celsius when compared to external temperature as measured by infrared thermometer. According to Mordon's mathematical analysis and additional thermoregulatory studies, an internal temperature between 48 and 50°C must be reached for collagen denaturation and subsequent skin tightening. External temperatures between 38 and 41°C were identified as safe and efficacious. Histological slides from skin biopsies demonstrated new collagen fibrils, myofibroblasts, and lipolyzed fat cells.
This author agrees with Goldman when he reports that most of the hypothesized actions (photoacoustic, photomechanical, or photothermal effects) are either secondary to, or have been replaced by, the idea that heat generated on tissue is the primary mode of action in laser lipolysis. Khoury et al proposed that photoacoustic ablation lends to thermal damage, although photoacoustic damage is difficult to evaluate histologically. Thus, the favored mechanism of action for laser lipolysis is a purely thermal effect.
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