SKIN TIGHTENING AND BODY CONTOURING

Body contouring is the removal of excess fat from the body and/or tightening of loose skin in order to achieve a more natural or cosmetically-desirable shape. Non-invasive body contouring is used as a broad term to describe non-surgical fat reduction, skin tightening, and cellulite therapy.

Patient Selection

An ideal candidate for skin tightening is the one:

1. With mild-to-moderate skin laxity
2. From 20 to 65 years of age
3. Not in favour of invasive procedures
4. Wants procedures with minimal downtime

An ideal candidate for body contouring is the one:

1. With BMI less than 30kg/m2
2. With localized fat pockets
3. Willing to exercise and control his/her diet

Indications:

1. Skin Tightening: Tightens the skin around the neck, jowls, and décolleté.

2. Wrinkle Reduction: Diminishes fine lines, deep folds, and wrinkles.

3. Non-surgical Body Contouring: Enhances the shape of your body by contouring the buttocks and thighs.

4. Cellulite Reduction: Reduces the appearance of stretch marks and cellulite.

5. Circumferential Reduction: Tightens the abdomen for achieving a flattened, more defined waistline.

Contraindications:

1. Candidates having unrealistic expectations
2. Candidates having no control on diet and exercise
3. Candidates having active infection
4. For RF-patients having metal implants or cardiac pacemakers
5. Candidates having psychological disorders such as dysmorphophobic personalities
6. Candidates experiencing severe skin laxity
7. Patients above 65 years of age
8. Candidates who are pregnant and lactating

Pre-procedure Work:

1. Patient’s detailed health history is taken into consideration. It is important to know if he/she is prone to any infection, cold aggravated conditions, or any other hormonal imbalances.

2. Informed consent is signed.

3. Proper physical examination of the patient is essential along with the measurement of the treatment area.

4. Counselling of the patient is conducted informing him/her about the procedure, the downtime involved, number of sessions needed, and expected outcome. It is always explained & emphasized upon that the treatment works in synergy with the patient’s diet and exercise regime. Thus, counselling helps patients to set real expectations from the treatment and come out happy after the treatment.

5. Drinking 2 to 3 glasses of warm water before and after the treatment helps a lot in lipolysis.

6. Pre-procedure photographs are taken after exposing the treatment area properly.

7. Cleansing of the area to-be treated is done. Marking of the area with excessive fat is done with one colour and the area that needs skin tightening with another colour.

Mechanism of Action:

Body contouring is a combination of collagen remodelling and fat reduction.

1. Collagen Remodelling

When the dermis is heated to a critical threshold temperature, which varies between 40° C and 65° C, collagen remodelling occurs due to the disruption of the hydrogen bonds and the unfolding of the collagen triple helix structure. This can be seen with RF or focused ultrasound technology.

The thermal wound healing takes place in 3 stages:

a. Inflammatory

b. Proliferative

c. Remodelling

It is a slow process that continues even after the heating stimulus is long gone; resulting in a remodelled compact dermis achieved over 2-6 months.

2. Fat Reduction

Heating the fat layer stimulates the fat cell metabolism, breaks down the adipose tissue, and results in shrinkage of adipocytes. Further, allowing shrinkage of collagen fat chambers.

NON-INVASIVE CONTOURING DEVICE

I. Radiofrequency

It is a type of electromagnetic radiation that is bipolar. In this device two electrodes are placed close to each other. The depth of the penetration is approximately half the distance between the two electrodes.

II. Cavitation:

Through low frequency vibration of ion, cavitation reaches the ideal effect for cellulite reduction. The vibration of ion wave would produce a strong power through positive and negative alternation, which brings different pressures to the cell membranes internally and externally. When the cell membrane fails to endure the pressure, it explodes breaking into liquid, which then gets out the human body through metabolism. Hence, the quantity of fat is reduced. The ideal effects for cellulite reduction are achieved and the fat metabolism is improved.

PROCEDURE:

Gel is applied over the treatment area after cleansing is done. Firm pressure is applied perpendicularly to the skin surface making sure that the entire surface of the probe is in contact with the skin.

POST PROCEDURE:

1. There may be slight post-procedure erythema and minimal swelling, which is settled in a day or two.
2. Patient is advised to take 3-4 litres of warm water per day to facilitate lipolysis.
3. Patient must exercise and go for regular walk

SCHEDULE: This should be performed once in 2 weeks, taking up to 6 to10 sessions in case of body contouring and up to 4 to 8 sessions in case of face, neck and, décolletage area to achieve optimum results.

SIDE EFFECTS: Since both RF and ultrasound are colour blind technologies, there are very few chances of side effects apart from little redness, which can settle in few hours or in a day or so.