A 12-Week, Prospective, Non-Comparative, Non-Randomized Study of Magnetic Muscle Stimulation for Improvement of Body Satisfaction With the Abdomen and Buttocks.

BACKGROUND AND OBJECTIVE: Magnetic muscle stimulation (MMS) is a relatively new energy-based technology that provides a non-invasive option for body contouring through stimulation and toning of underlying skeletal muscles. This study was conducted to examine the safety, efficacy, and body satisfaction scores of MMS using a CoolToneTM prototype for the aesthetic improvement of abdominal and buttock contour. STUDY DESIGN/MATERIALS AND METHODS: This was a prospective, non-comparative, non-randomized, 12-week, multicenter study. Male and female participants aged 22-65 years received 4 MMS treatment sessions to the abdomen and/or buttocks. Body Satisfaction Questionnaire (BSQ) scores for abdomen and/or buttocks were assessed at baseline, immediately post final treatment, at 4 weeks (primary endpoint), and 12 weeks post final treatment. Subject-rated Global Aesthetic Improvement Scale (SGAIS) was assessed at 4 weeks post final treatment (secondary endpoint), and 12 weeks post final treatment. Additional efficacy assessment included abdominal circumference obtained by 3D imaging at baseline, immediately post final treatment, and at 4 and 12 weeks post final treatment. A Subject Experience Questionnaire (SEQ) was used to assess treatment satisfaction and perspectives at 4 weeks and 12 weeks post final treatment. Adverse events (AEs) were monitored throughout the study. RESULTS: A total of 110 participants were recruited, who were 75% female, 80% Caucasian (mostly non-Hispanic), average age of 39.5 years (range 22-59) with an average body mass index (BMI) of 23.3 kg/m2 (range 18-29.9). At the 4-week post final treatment visit, the average BSQ score for participants receiving abdominal treatment (n = 93) was significantly improved with a 5.1 average increase in total score from baseline (possible score range 10-50) and by a 5.5 average increase from baseline for participants receiving buttocks treatment (n = 32) (p < 0.05). At 4 weeks post final treatment, the proportion of participants with SGAIS scores >"Improved" was 68.1% for participants receiving treatment of the abdomen (n = 94), and 81.8% for those receiving buttocks treatment (n = 33). The mean total decrease from baseline in waist circumference was significant at all time points. At the 12-week post final treatment visit, SEQ data revealed that a majority of participants were "Satisfied" or "Very Satisfied" with overall treatment results and "Agreed" or "Strongly Agreed" that they were motivated to maintain results either by working out or by additional treatment. A total of 6 AEs related to the device and/or treatment were reported, which resolved spontaneously during the study. CONCLUSION: Treatment of the abdomen and/or buttocks with MMS was well-tolerated and demonstrated significant improvement in aesthetic appearance through the 12-week post final treatment study duration. As a stand-alone treatment, MMS expands the range of options for individualized treatment planning for patients seeking abdominal and/or gluteal muscle toning. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals, Inc.

Multiple same day cryolipolysis treatments for the reduction of subcutaneous fat are safe and do not affect serum lipid levels or liver function tests.

OBJECTIVE: Cryolipolysis is a safe and effective non-surgical procedure for reducing subcutaneous fat. It spares adjacent structures, is associated with few adverse events, and is well-tolerated by patients. Previous studies involving one or two simultaneous treatment sites have shown no effect on serum lipid levels or liver tests. The purpose of this study was to determine whether multiple same day treatments (abdomen plus both flanks) result in changes in these blood tests, and is safe. STUDY DESIGN: Thirty-five adult males and females underwent same-day cryolipolysis (CoolSculpting System, ZELTIQ Aesthetics) of the lower abdomen and flanks for reduction of subcutaneous fat. Serum lipids and liver tests were measured prior to treatment and at 1, 4, and 12 weeks post-treatment. Expected treatment side-effects were assessed immediately post-treatment and at the 12-week follow-up visit. Adverse events were also monitored. METHODS: Treatment consisted of one cycle to the lower abdomen using a large vacuum applicator and simultaneous treatment of both flanks, one cycle each, with medium vacuum applicators .Time between the abdomen and flanks procedures was not to exceed 30 minutes. RESULTS: The procedures were well-tolerated by patients; expected treatment effects were in general mild or moderate, and resolved without intervention. There were no clinically meaningful changes from baseline to any subsequent time point in any serum lipid test. This was also true for all liver tests. There were no treatment-related adverse events. CONCLUSION: Multiple cycle, same day cryolipolysis treatment of the lower abdomen and both flanks is well-tolerated and safe. It does not lead to changes in serum lipids or liver tests at any of the measured time points following the procedure. Lasers Surg. Med. 49:640-644, 2017. © 2017 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals Inc.

Sclerotherapy of reticular and telangiectatic veins of the face, hands, and chest.

BACKGROUND: Prominent tortuous veins of the face and hands may result from the process of aging and constitute a source of distress for many patients. Marked telangiectases of the chest and face are similarly distressing to some patients. OBJECTIVE: To determine the safety and efficacy of sclerotherapy for telangiectatic veins of the face and chest and varicose veins of the hands. METHODS: Twenty facial telangiectases and tortuous veins in 14 patients and 20 total facial sites were treated with sclerotherapy. Patients did not suffer from collagen vascular diseases, had no chronic illnesses, and were thoroughly informed of the strictly cosmetic nature of the procedure. A hyperosmolar sclerosant was used in 16 of 20 sites and the remaining 4 sites were treated with a detergent sclerosant (polidocanol 0.5-0.75%). The follow-up period ranged from 9 months to 15 years. Similarly the varicose veins of 14 hands in seven patients were treated with sclerotherapy using a detergent sclerosant [sodium tetradecyl sulfate (STS)] at various concentrations (1-3%). The follow-up period ranged from 1 to 6.5 years. Tortuous veins and telangiectases on the chest of three patients were treated with either STS 0.25-0.50% or polidocanol 0.75% with a follow-up of 2-9 years. RESULTS: Tortuous facial veins and telangiectases had a mean improvement of 70%, with 11 of 20 sites showing a 90-100% improvement. Hand varicosities had a mean improvement of 97.8%, and all sites showed a 90-100% resolution of varicosities. Finally, the tortuous veins and telangiectases of the chest improved by 50-100% with sclerotherapy. Only minimal to moderate telangiectatic matting was observed in two patients (one in the lateral canthal area and one near the treatment site of chest reticular veins). No ulceration or hyperpigmentation occurred long term in facial or hand veins. One patient developed an arterial ulceration on the left lateral breast. CONCLUSION: Sclerotherapy of varicose and telangiectatic veins of the face, hands, and chest can be safe and effective. Care must be given to sclerotherapy in the chest area, particularly the breast.

Treatment of facial scarring and ulceration resulting from acne excoriée with 585-nm pulsed dye laser irradiation and cognitive psychotherapy.

BACKGROUND: Self-inflicted skin ulcers and scars are often observed in patients with compulsive skin picking. The term "neurotic excoriation" has been used to describe this condition and may or may not coexist with other true skin pathologies, such as acne. The condition poses a diagnostic and treatment challenge because patients often also have an undiagnosed underlying psychologic disorder. CASE REPORTS: Two patients with numerous linear and stellate facial ulcers and hypertrophic and erythematous scars were diagnosed with acne excoriée in the setting of an obsessive-compulsive disorder linked to emotional stress and anxiety. The scars were treated with a 585-nm flashlamp-pumped pulsed dye laser using a 7-mm spot size, 1.5-msec pulse duration, and fluence range of 4.5 to 6.0 J/cm(2). The patients received concomitant cognitive psychodynamic therapy to halt the cycle of impulse-driven skin picking and ulcer/scar formation. Marked clinical improvement of the scars and successful treatment of the acne excoriée were achieved with this combination approach. Relapses occurred when psychodynamic intervention was interrupted. CONCLUSION: The 585-nm flashlamp-pumped pulsed dye laser improves the appearance of hypertrophic erythematous facial scars and ulcers in patients with severe acne excoriée. Proper diagnosis of underlying impulse-control disorders and ongoing psychodynamic therapy is necessary to maintain improvement.

Full face laser resurfacing: therapy and prophylaxis for actinic keratoses and non-melanoma skin cancer.

BACKGROUND: Although there are many effective treatment modalities for individual actinic keratoses (AKs), widespread lesions on the photoaged face pose a challenge due to inefficient and ineffective therapy resulting in high rates of recurrence after local destruction. Full face laser resurfacing offers an effective and efficient treatment option that successfully reduces the number of AK's on diffusely damaged skin and may show a prophylactic benefit for preventing non-melanoma skin cancers. OBJECTIVE: To assess the efficacy of full face laser resurfacing in reducing the number of facial AK's by comparing preoperative and postoperative numbers of lesions present and to observe the incidence of non-melanoma skin cancer after full face laser resurfacing. STUDY DESIGN: A retrospective chart review of 24 patients with widespread facial AK's (greater than 30) treated with full face UPCO(2) and/or Er:Yag laser resurfacing was performed. All patients were a minimum of 1 year post-operative following facial laser resurfacing. The recurrence of AK's and the occurrence of facial non-melanoma skin cancers in these patients was assessed through chart analysis. RESULTS: Widespread AK's were effectively eliminated in all patients. Twenty-one patients (87%) remained lesion free for at least 1 year. Fourteen of the 24 patients (58.3%) showed no new lesions during a 2-year follow-up. There was an overall 94% reduction in total number of AK's. Adverse effects included transient perioral scarring in one patient, S. aureus infection in two patients, and dyschromia in two patients. CONCLUSIONS: Full face laser resurfacing provides long-term effective prophylaxis against AKs and may reduce the incidence of AK related squamous cell carcinoma.

Treatment of basal cell carcinoma with the pulsed carbon dioxide laser: a retrospective analysis.

BACKGROUND AND OBJECTIVE: Treatment options for basal cell carcinoma include surgical excision, cryotherapy, radiation, photodynamic therapy, Moh's micrographic surgery, and topical treatment with 5-fluorouracil and immunomodulators such as imiquimod. Resurfacing and ablation with a CO(2) laser (UltraPulse, Coherent Inc.) may present an attractive and effective treatment option in the management of these cutaneous cancers. We demonstrate the efficacy and safety of the UltraPulse CO(2) in the treatment of basal cell carcinomas of the skin. METHODS: We performed a retrospective chart review of 23 patients treated with the UltraPulse CO(2) laser. A total of 61 biopsy-proven superficial and nodular basal cell carcinomas without prior treatment were included in the study. The patients were followed postoperatively for a period of 15 to 85 months (mean 41.7 months) and assessed for clinical recurrence. RESULTS: Of the 61 tumors treated, clinical recurrence was observed in two cases (3.2%). Adverse effects included significant hypertrophic scarring in one patient and hypopigmentation in one patient. CONCLUSIONS: Destruction of superficial and nodular basal cell carcinomas may be accomplished successfully and safely with the UltraPulse CO(2) laser with a cure rate of 97%.

Treatment of pigmented hypertrophic scars with the 585 nm pulsed dye laser and the 532 nm frequency-doubled Nd:YAG laser in the Q-switched and variable pulse modes: a comparative study.

BACKGROUND: Pigmented hypertrophic scars are a difficult condition to treat. They may result from traumatic injuries or from surgical and cosmetic procedures. The 585 nm flashlamp-pumped pulsed dye laser (FLPDL) has been used to treat this condition, with significant improvement of varying degrees. It remains to be determined whether other laser modalities may have a similar or even greater success in the treatment of pigmented hypertrophic scars. OBJECTIVE: To determine the efficacy of the 532 nm frequency-doubled Nd:YAG laser in the treatment of pigmented hypertrophic scars as compared to the 585 nm FLPDL. METHODS: Six patients with pigmented hypertrophic scars and skin phototypes II-IV were chosen. A scar was selected for treatment in each patient and divided into four equal 2 cm segments. Three segments were each treated with a different laser modality and one was left untreated to serve as the control. A 585 nm FLPDL was used with an energy of 3.5 J, a pulse duration of 450 microsec, and a 10 mm spot size. A 532 nm Q-switched frequency-doubled Nd:YAG laser was set to an energy of 2.8 J, a 10-nsec pulse, and a 3 mm spot size. The same 532 nm laser was set to the variable pulse mode to treat a 2 cm scar segment, with an energy of 9.5 J, a 10-msec pulse, and a 4 mm spot size. An average of 3.3 treatments were performed on each scar segment, at intervals of 4-6 weeks and long-term follow-up at 22 weeks. Treatment outcome was graded by a blind observer using the Vancouver General Hospital (VGH) Burn Scar Assessment Scale. A SigmaStat t-test was used to determine the statistical significance of the values obtained. RESULTS: Treatment of pigmented hypertrophic scars with the 532 nm Q-switched Nd:YAG laser led to a significant improvement of 38% in the VGH scores when compared to baseline (P =.005). The 585 nm FLPDL also had a favorable effect on the scars, with an average improvement of 36.1% in the VGH scores. There was no significant difference noted between the outcome of treatment with either of these two lasers. Treatment with the 532 nm variable pulse Nd:YAG laser led to a 19% improvement in the VGH scores of scars, which did not differ significantly from the 16.1% improvement observed in control scars on the last follow-up visit. No side effects or complications from treatment were noted or reported during the course of the study. At the conclusion of the study, five of six patients chose the segment treated with the 532 nm Q-switched Nd:YAG laser as the best segment overall. CONCLUSION: The 532 nm Q-switched Nd:YAG laser and the 585 nm FLPDL offer comparable favorable results in the treatment of pigmented hypertrophic scars. The 532 nm Q-switched Nd:YAG laser may be preferred by patients particularly distressed by the dark color of their scars.