Combined Hyperthermic 1060nm Diode Laser Lipolysis With Topical Skin Tightening Treatment: Case Series
July 2018 | Volume 17 | Issue 7 | Original Article | 780 | Copyright © 2018
Erica B. Wang MD,b,c Evan Austin BA,b,c Jared Jagdeo MD MSb,c,d
aLife Studios Medical Group, Roseville, CA bDepartment of Dermatology, University of California at Davis, Sacramento, CA cDermatology Service, Sacramento VA Medical Center, Mather, CA dDept of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY
Background: As body contouring procedures have become more popular, post-procedural skin laxity is a concern. Non-invasive body contouring technologies may effectively reduce body fat, but modestly affect skin tightening. Objective: To assess the efficacy and safety of a topical skin tightening agent in combination with hyperthermic diode laser lipolysis. Methods: Herein, we describe five patients in which a skin tightening concentrate of 5% yeast extract, 2% hydrolyzed rice protein content, and 2.5% tripeptide was used after 1500-2100 J/cm2 of hyperthermic 1060 nm diode laser. Results: Overall, all patients had a subjective positive response and high satisfaction with the combined treatment results of improvement in skin laxity and fat reduction. In all five cases, patients demonstrated visible fat reduction and skin improvement on photographs taken between weeks 6-18 compared to baseline. Blinded investigators correctly predicted the order of the photographs based on treatment results. No adverse events were reported. Conclusion: This case series demonstrated that a combined topical skin tightening concentrate with a hyperthermic laser lipolysis device may achieve improved aesthetic outcomes without adverse events. J Drugs Dermatol. 2018;17(7):780-785.
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Body contouring is the fastest growing dermatologic procedure; the number of procedures performed increased by 2.5 times in the past five years.1 The popularity of body contouring procedures may reflect patients’ concern about excess body fat.2 Non-invasive or minimally invasive fat reduction modalities are particularly appealing to patients due to the mild and transient side effects, minimal patient downtime, and accessibility as an outpatient procedure. Various non-invasive body contouring technologies include cryolipolysis, radiofrequency, ultrasound, and laser lipolysis.As body contouring procedures have become more popular, post-procedural skin laxity is a concern. Non-invasive body contouring technologies may effectively reduce body fat, but modestly affect skin tightening. In some cases, localized adipose tissue volume reduction may reveal underlying skin laxity and poor skin texture. Improvement in skin laxity, quality, and appearance may be achieved using radiofrequency, ultrasound, laser, light-based technologies, or topical tightening treatments.3 Therefore, combination therapy of a non-invasive laser body contouring procedure with a topical skin tightening treatment may be desirable for patients. An ideal combination therapy would have consistent clinical efficacy and high patient comfort. The objective of this case series is to evaluate the efficacy and safety of a topical skin tightening agent in combination with hyperthermic laser diode lipolysis. We discuss methods, mechanism of action, safety, and efficacy of concomitant use of 1060 nm diode laser lipolysis and topical skin tightening treatment.
Five subjects with adipose fullness of their abdomen or posterior flanks were included in the study. Each subject underwent a 25-minute hyperthermic 1060 nm diode laser lipolysis treatment (SculpSure, Cynosure, Westford, MA) at power densities of 1.0-1.4 W/cm2 and fluences of 1500-2100 J/cm2. Treatment was performed by placing up to four rectangular laser applicators in the treatment area. Patient demographics and treatment settings and site are included in Table 1. At the six-week follow-up, patients could electively choose to undergo a second laser lipolysis treatment at the original or a different treatment site. Beginning immediately after the initial laser lipolysis treatment, subjects were instructed to apply a topical agent of 5% yeast extract, 2% hydrolyzed rice protein content, and 2.5% tripeptide (SkinCeuticals Body Tightening Concentrate, Garland, TX) twice daily to treatment areas for 18 weeks. Patients were advised to increase their fluid intake and maintain exercise to optimize metabolic and lymphatic removal of damaged adipose cells from their body.