Fat removal

Basic principle : Fat layer constitution

The basic science of noninvasive body contouring is really the basic science of the adipocyte, its storage of triglyceride, and the aggregate number of adipocytes as they relate to the focal and generalized excess of adipose tissue, the convex distension that forms the focal “bulges,” and more superficially, clinical cellulite topographically. The adipocyte is a very important cell involved in energy storage, hormonal regulation, and a host of other endocrinological functions. The adipocyte has a large amount of cytoplasm that serves as a storage depot for triglycerides, which are composed of glycerol and free fatty acids. The adipose cell is our intermediate and long-term energy storage depot. When caloric intake exceeds caloric output, adipocytes then swell with triglycerides. As adipocytes continue to enlarge within their intralobular and interlobular fascial compartments, they create “bulges” or convex distensions of soft tissue that then modify our contours.
Typical convex distensions that one sees in the female topography are “out-pouching,” “bulges,” or convex distensions of the hips, lower abdomen, outer thighs, inner thighs, inner knees, arms, and bra line. For men, the typical android distribution of subcutaneous adipose-derived convex distensions commonly include the flanks (love handles), lower abdomen, “spare tire,” male fatty breast tissue, and the submentum.(Mulholland et al., 2011)

Basic principle : Fat layer constitution

How does it work

1) Cooling lipolysis

Cooling lipolysis is a treatment that selectively removes the fat cells by using a cooling energy. When this cooling energy is transferred, fat cells are crystallized and induced to natural apoptosis; it then gradually dies. Fat cells destroyed over 14 to 90 days are later removed by a macrophagocyte and the lipid components are decomposed and perished through liver metabolism.
Reference: Nelson AA, Wasserman D, Avram MM. Cryolipolysis for reduction of excess adipose tissue. Semin Cutan Med Surg. 2009 Dec;28(4):244-9.

2) Ultrasound cavitation

20 to 70kHz ultrasonic waves transferred to fat tissues create a vacuum bubble (Fat bubbling) by cavitation. Increased pressure due to this creation of bubbles eliminate the fat cells by destroying the cell membrane
Reference: Saber M, Shalaby S, Kharbotly A, Taher N, Saber LM, Medhat A. Effect of ultrasound cavitation therapy as a non-invasive approach on adipose tissue thickness in Egyptian women. Journal of Applied Sciences Research. 2013:9(11): 5964-9.

3) Low level laser

660nm low-level laser irradiated to fat cells creates micro-poles in the cell membrane of the fat cells. Fat cells contract and get destroyed by a macro phagocyte as water, glycerol, and free fatty acid that exist within the cell are released through micro-pores.


HIFU increases the temperature within fat tissues by focusing ultrasonic waves on subcutaneous adipose tissue. Fat tissues, applied with a heat of over 56℃, cause coagulative necrosis within fat cells and destroy them. Destroyed cells are removed by a macrophagocyte through immune reaction, which results into a decrease in the layer of fat.
Reference: Saedi N, Kaminer M. New waves for fat reduction: high-intensity focused ultrasound. Semin Cutan Med Surg. 2013 Mar;32(1):26-30

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