Hot Topics in Cosmetic Enhancement

The world of cosmetic medicine is continually evolving and advancing. Here’s the skinny on some of the latest technology science has brought to the table.

Chewing the fat

It’s inevitable that certain areas of the body harbour stubborn fat deposits that just won’t shift despite a sensible diet and exercise, so body contouring is one of the hottest spots for new technology at present. Both surgical and non-surgical solutions can lend a helping hand.

Advancements in the field of body contouring offer non-surgical procedures that can achieve noticeable results with a significantly shorter recovery period than traditional liposuction. The best candidates are usually those with small to medium localised fat deposits that are resistant to diet and exercise, rather than those seeking large-volume fat removal.

While non-surgical body contouring can deliver significant results, you should have realistic expectations of what it can achieve for you. It should also be noted that, like liposuction, it is not a solution for weight loss or a treatment for obesity.

This type of procedure typically does not require any anaesthesia or sedation and is usually performed in an in-office setting. There is normally no downtime, minimal patient discomfort and complications are rare. In conjunction with a healthy diet and exercise regime, results should be long lasting.

Radiofrequency body contouring

This non-surgical treatment uses radiofrequency (RF) energy to penetrate the skin – without damaging the outer layers – to contour the body and reduce the appearance of cellulite and fat. It breaks down fatty cells and stimulates collagen production, which improves skin tone and elasticity.

The RF energy provides deep, controlled heating of the targeted fat, tightening tissue and increasing blood circulation at the same time as it targets fatty deposits. The broken down fat cells are drained via the lymphatic system and then excreted as urine.

The heat generated from the RF energy causes microscopic changes to tissues and collagen fibres, with further collagen remodelling over the subsequent months following the procedure.

Localised fatty deposits such as on the abdomen, hips and thighs can be effectively treated with RF body contouring treatments. This technology can also reduce the appearance of cellulite and tighten sagging skin.

Depending on the device being used, results can be observed after a single treatment, although a series of treatments is usually recommended for significant results. Each treatment lasts for around one hour and is virtually painless (you may feel a warm or sometimes hot sensation on the area being treated) and you can usually return to normal activities immediately after the treatment.

Ultrasonic body contouring

Ultrasonic body contouring treatments use targeted ultrasound frequencies to break down fat, particularly on the abdomen, hips, thighs and ‘love handles’. The best candidates are close to their ideal weight but have stubborn areas of localised fatty deposits that do not respond to changes in diet and exercise.

The focused ultrasound waves are delivered in short bursts of energy, or pulses, to destroy fat cells while leaving surrounding tissue, nerves and blood vessels unaffected, as well as protecting the outside layers of the skin.

Each pulse breaks down the membranes of the targeted fat cells so that a layer of fatty tissue beneath the skin is eventually disrupted. The contents of the fat cells, called triglycerides, are then dispersed and processed through the body’s vascular and lymphatic systems and eliminated naturally.

Generally one treatment per area is sufficient to achieve noticeable, measurable results, although results may vary. It can take around four weeks for the final result to be visible as your body gradually eliminates the fatty debris.

The treatment is generally considered to be discomfort-free, and side effects are uncommon.

Hot or not?

New treatments in non-surgical body contouring employ the power of hot and cold, and light, to shed fat cells in the areas where fatty deposits bother us most.

Freezing the fat cells until they die with a procedure known as Cryolipolysis, which involves freezing the fat cells to trigger the process of lipolysis. The treatment area is cooled to near-freezing temperatures, resulting in the breakdown of body fat. The cells can then be flushed out of the body naturally.

Researchers report that this procedure does not cause damage to the surrounding tissues and blood vessels, and will not traumatise the nerves and bones around the area.

The ‘hot’ system works by using low frequency ultrasound waves to create a cavitational effect in the target fat cells, causing them to be destroyed. The term ‘cavitation‘ refers to the formation of micro steam bubbles that burst inside the cell, the energy of which causes the cell to implode and be destroyed. As a result, lipids and triglycerides are released from the cell and are passed through the lymphatic system to the liver where it is naturally processed by the body.

Infrared light energy has also been touted for its skin tightening results. This occurs when the light initiates collagen growth, strengthening and tightening the skin. It is commonly incorporated with non-surgical body shaping technologies to treat the skin in conjunction with the fat.

Liposuction

There are numerous liposuction techniques available today, however each doctor has their preferred method, all of which offer effective, predictable results. No single technique, piece of equipment or instrument necessarily offers better results so most doctors will adapt techniques and tools to each individual patient to achieve optimal results. However, one of the latest introductions in liposuction is energy-assisted liposuction.

Recent advancements have seen the advent of different energy sources being used on the tip of the cannula to assist in dissolving and removing fat. These techniques include ultrasound-assisted liposuction, power-assisted liposuction, laser-assisted liposuction and water-assisted liposuction.

Generally, energy-assisted liposuction is less aggressive than traditional techniques and can be particularly beneficial for large-volume liposuction surgeries as the length of the procedure is usually reduced and the patient spends less time under anaesthetic. However, energy-assisted liposuction requires more technical skill as there is a greater risk of removing too much fat, resulting in unevenness. The heat generated during ultrasound- or laser-assisted liposuction can also burn the skin or damage the tissue under the skin.

Ultrasound-assisted liposuction (UAL) involves a cannula that produces ultrasonic (high-frequency sound) energy. The ultrasonic vibrations disrupt the fat cell membranes and liquefy the fat tissue, making its subsequent removal easier and quicker. The tissue-selective ultrasound energy means only unwanted fat is targeted, preserving surrounding blood vessels, nerves and connecting tissue and promoting smoother contours with faster healing time. Ultrasonic liposuction can have the added advantage of tightening the skin during the process.

Laser-assisted liposuction uses laser energy to melt fat, coagulate blood vessels (to reduce bleeding and bruising) and simultaneously tighten overlying skin. The cannula used is usually only 1 to 2mm in diameter, which further reduces bruising and healing time. Sometimes the energy is limited, so the procedure can take longer to perform. For this reason, some doctors believe it is better suited to smaller areas of the body, such as the neck, inside thighs and for ‰Û÷touch up’ body contouring.

Skin tightening and cellulite treatments

Radiofrequency, ultrasound and infrared energy technologies are also popular in addressing skin laxity all over the face and body and even to improve cellulite. They target deeper levels of the dermis to induce new collagen formation and remodelling, improving skin texture and reducing sagging skin, as well as subtle contouring of the jaw line and softening wrinkles around the mouth, eyes and forehead.

For suitable candidates presenting with a moderate degree of skin laxity, non-surgical skin tightening modalities can offer an effective, natural-looking improvement and postpone the need for surgical procedures.

Non-surgical skin tightening typically involves minimal discomfort and downtime so patients can continue their daily routine as quickly as possible.

Non-surgical skin tightening modalities are also commonly combined with other treatments, such as skin resurfacing and laser, for a more holistic approach to rejuvenating an ageing face.

Thread lifting

While not strictly a non-surgical procedure, thread lifting offers a less invasive way to lift and support sagging skin than a traditional facelift. The thread lift is a technique to rejuvenate and lift sagging facial tissues using small ‘threads’, which are placed under the skin via a tiny incision. Acting as a kind of scaffolding, the soft barbs on the threads gently adhere to the tissue as they lift and contour the skin in a more youthful position.

The latest thread lifting technology is Promoitalia absorbable threads. They effectively grip to the soft tissue, creating fibrous collagen-forming supportive scaffolding to the soft tissue but have the added advantage of dissolving within around nine to 12 months yet still maintaining the revitalising effect for several years to come.

While not a substitute for a traditional facelift, for the suitable candidate a thread lift can emphasise the natural contours of the face and neck by gently lifting the skin to reveal its natural bone structure, creating a natural-looking, rejuvenated effect.

Platelet Rich Plasma

A reasonably new technique used to treat overall loss of volume in the face is Platelet Rich Plasma (PRP) therapy – a treatment that uses the patient’s own blood plasma to rejuvenate a tired complexion. Platelet Rich Plasma contains certain growth factors that are central to tissue regeneration and repair, and also take part in stimulating new blood vessel formation and connective tissue (collagen and elastin) repair.

The treatment involves several injections of 10 to 20ml of the patient’s own plasma, which is taken via a blood sample and centrifuged to separate and concentrate the platelets from the blood. The whole treatment takes approximately one hour, with results taking about three months to appear.

Polyurethane breast implants

Polyurethane covered implants reduce the risk of two of the most common concerns involving breast augmentation procedures, which surgeons and manufacturers alike have sought to reduce for years. While they have been used internationally, they have only recently gained approval in Australia.

Research has shown that the Brazilian implant offers key benefits of minimising the risk of capsular contracture, rotation and displacement. The advantage comes from the modification in the body’s response to the implant. The tissue interface created over the implant by the body naturally stabilises the implant with scaffolding that the collagen fibres wrap themselves around. Because the fibres are disjointed and not lined up, they are less likely to slide over each other leads to a softer and, what many doctors who use the implant say, a more natural-feeling result.

The lack of movement and rotation has also allowed doctors more confidence in placing anatomic (teardrop) implants.

Increasing variations of Silimed implants are being introduced, meaning the different shapes, dimensions and projections can meet the needs of a broader range of patients. These variations also mean individual implants can be selected to correct asymmetry, ptosis and other irregularities.