INTRODUCTION
While ASAPS statistics show that liposuction continues to be the most popular aesthetic surgical procedure in the US,1 the field of nonsurgical fat reduction is rapidly expanding.2,3 However, devices that initially were designed for a single treatment are now being utilized as a multi-treatment regime in order to optimize results.4,5 Patients shopping for the best nonsurgical treatment evaluate cost, down time, clinical efficacy, and the duration and number of office visits needed to achieve their fat reduction and contour correction goals.6 In a strongly consumer driven market, it is important to consider safety and clinical efficacy as well as patient satisfaction. In order to achieve more subcutaneous fat reduction in fewer treatment sessions, taking a look at the physics and mechanism of action of radiofrequency on adipose tissue can offer a method to optimize outcome. With bipolar radiofrequency devices, the focal depth of the RF heating and high voltage pulses is determined by the distance between the bipolar RF electrodes on the treatment handpiece.7 Because of this factor, a calculated depth of penetration of energy into the adipose layer can be derived for each differently sized radiofrequency based handpiece. In contrast, many alternative noninvasive devices focus at a single depth of treatment,8,9 and repeat treatments are, in effect, retreating the same area. By changing the field of treatment to a multiple depth target, more tissue volume should be able to be effectively treated during a single session than with a single level focus. The premise of this pilot study was that a longer duration of treatment time per session combined with a targeted multilevel approach could achieve results similar to that of a standard longer treatment regime.
MATERIALS AND METHODS
For this study, the Inmode Body FX radiofrequency based device was utilized for treatment of periumbilical abdominal adiposity in eight consecutive patients. Patients were required to be nonpregnant and not breast feeding. All patients were women between the ages of 35 and 63. None had a BMI greater than 30. All patients were weighed at each timepoint; scale weight was not allowed to vary more than 5 pounds from inception in order to control that variable. 2D and 3D Vectra photographs were taken before treatment, and at one month and three months after treatment cessation. The 3D Vectra photos were posture and breathing cycle controlled. Circumference measurements were digitally calculated at point zero (level of the umbilicus), and at intervals 20 mm above and below the umbilicus. The volume of the 20 mm cylindrical segments was calculated, and the additive volume was assessed at each timepoint in order to measure interval change.
