INTRODUCTION
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.
METHODS
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.