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12 Immediate Effect and Safety of HIFU Single Treatment For
12 Immediate Effect and Safety of HIFU Single Treatment For
DOI: 10.1111/jocd.12466
ORIGINAL CONTRIBUTION
1
Centro de Cie^ncias Biolo
gicas e da Sa
ude,
Universidade do Vale do Taquari (Univates), Summary
Lajeado, RS, Brazil Background: The increasing search for procedures for fat reduction is related to
2
Laboratorio de Cultura de Celulas,
s-graduacß~
dissatisfaction with body shape. High-intensity focused ultrasound (HIFU) has been
Programa de Po ao em
Biotecnologia, Universidade do Vale do proven effective in body sculpting when used noninvasively to reduce subcutaneous
Taquari (Univates), Lajeado, RS, Brazil
fat and improve body contour.
3
Instituto Innovate, Caxias do Sul, RS, Brazil
Aims: This study aimed to evaluate the immediate effect and safety of HIFU single
Correspondence treatment for male localized fat and body remodeling.
Shanna Bitencourt, Programa de Po s-
graduacß~ao em Biotecnologia, Univates, Patients/Methods: Twenty-four male subjects (18 to 59 years old) with
Lajeado, RS, Brazil. BMI ≤ 30 kg/cm² and at least 2 cm of abdominal fat received a single HIFU treat-
Email: shanna.lab@gmail.com
ment session. Individuals were subjected to abdominal measurements before and
Funding information after procedure. In addition, biochemical analyses of blood samples were performed
Coordenacß~ao de Aperfeicßoamento de
Pessoal de Nıvel Superior (Capes) to assess possible inflammatory effects or oxidative stress induction by the treat-
ment.
Results: High-intensity focused ultrasound was found to be an effective treatment
in reducing localized adiposities in the abdominal region. A significant decrease
(0.6%) was observed in infraumbilical circumference of subjects submitted to HIFU
single treatment when compared with control subjects. The laboratory parameters
did not present any appreciable changes.
Conclusion: This study further strengthens the current view that HIFU is an effec-
tive and safe tool for localized fat reduction.
KEYWORDS
adipocytes, body contouring, localized fat
pulse duration are not well defined, besides mechanism of action not cholesterol, high-density lipoprotein [HDL], low-density lipoprotein
clearly understood.6,7 As the thermal effect of HIFU can result in [LDL], very low-density lipoprotein [VLDL], triglyceride); hepatic,
adipocyte necrosis in the treatment area, it is important to evaluate pancreatic and renal function (alanine transaminase [ALT], aspartate
safety of HIFU to confirm the lack of significant adverse reactions. 7
aminotransferase [AST], c-glutamyl transpeptidase [GGT], albumin,
This study was designed to evaluate the immediate effect and safety lipase, creatine phosphokinase [CK]); lactic dehydrogenase [LDH];
of HIFU clinical use for the treatment of localized fat and body C-reactive protein [CRP]; hematology and coagulation profiles.
remodeling in male subjects.
F I G U R E 1 Surface temperature changes of the porcine model during application of High-intensity focused ultrasound (HIFU). A, Cooled
ultrasound transducer. B, Initial measurement of adipose tissue during HIFU application. C, Measurement immediately after HIFU application.
HIFU delivered heat intensively only to the subcutaneous fat layer of the focal area and did not affect surrounding skin tissue
F I G U R E 2 Percentage difference of abdominal measurements 30 minutes after High-intensity focused ultrasound (HIFU) treatment.
A, Abdominal circumference of supraumbilical, umbilical and infraumbilical areas. B, Thickness of subcutaneous fat on the right and left
abdomen. Data are expressed as mean SEM (n = 12). *P < .05
consequent increase of granulocytes (6.2%) in the group of indivi- temperature raise of 27°C of porcine adipose tissue without causing
duals who received HIFU treatment when compared with the group damage to adjacent tissues. These data are in keeping with those of
that did not receive treatment (data not shown). previous in vivo porcine studies, in which HIFU was shown to cause
selective adipose cell reduction without injury to skin.10,11 Based on
these data, we decided to use the same HIFU parameters for appli-
4 | DISCUSSION cation on male subjects.
To verify possible immediate effects of HIFU treatment with
Porcine skin and subcutaneous tissue closely resemble human tissue regard to the anthropometric measurements of the treated area,
with respect to morphological and physiological properties making it abdominal circumference and skinfold were performed. Although
a reliable model.10 In this sense, we initially evaluated ex vivo the there was no significant difference in skinfold and abdominal circum-
temperature at the local area of application of HIFU in swine tissue. ference of supraumbilical and umbilical areas, there was a 0.6%
Our findings showed that Dual SOONTM HIFU device reached a decrease in infraumbilical circumference. It is noteworthy that this
4 | GUTH ET AL.
HDL, High-density lipoprotein; LDL, low-density lipoprotein; VLDL, very low-density lipoprotein; CRP,
C-reactive protein; CK, creatine phosphokinase; AST, aspartate aminotransferase; ALT, alanine transami-
nase; GGT, c-glutamyl transpeptidase; LDH, lactic dehydrogenase.
Data are expressed as mean SEM.
*P < .05.
region is the area of greater fat deposit and the one that received subjects. Although the limitation of the present study includes the
most of HIFU application compared with other abdomen regions. lack of histological assessment and a longer follow up period, it fur-
Previous studies using other methodological parameters demon- ther strengthens the current view that HIFU is an effective and safe
strated that the reduction in circumference happens even 3 months tool for liporeductive purposes in the abdominal region.
after HIFU application. Fatemi5 reported that 282 patients who
underwent a single HIFU treatment on the abdomen and flanks
ACKNOWLEDGMENT
showed an average reduction of 4.7 cm in waist circumference after
3 months. In addition, Teitelbaum, Burns12 reported a mean reduc- This work was supported by a Postdoc Grant from Coordenacß~ao de
tion of approximately 2 cm in abdomen, thighs or flanks circumfer- Aperfeicßoamento de Pessoal de Nıvel Superior (Capes) awarded to
ence and approximately 2.9 mm in skin fat thickness in 137 healthy Shanna Bitencourt.
subjects within 2 weeks and sustained at 12 weeks after a single
HIFU treatment.
ORCID
According to previous studies, when raising the temperature of
adipose tissue above 58°C, HIFU can promote the death of adipo- Shanna Bitencourt http://orcid.org/0000-0002-5854-1550
cytes by heating without affecting adjacent tissue.13 In the search Giovana Sinigaglia http://orcid.org/0000-0002-4614-3272
for the physiological responses that can lead to improvement of the
body contour without harming, we assessed biochemical markers.
Our results demonstrated that under the experimental conditions, REFERENCES
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