Ultrasound in Body Sculpting -Lipolysis, But Also AngiogenesisIntroductionThe health benefits of removing fat are widely known.Ultrasound as a modality to provide shockwave therapy using acoustics to eliminate tough to get at fat in the overweight and not particularly overweight is reviewed here.DisclosuresDon’t conduct any of these therapies on your own for yourself or your loved ones. Consult with a physician. A team approach with a physician who believes in a team approach, you and her, is the best approach.DiscussionNonsurgical body sculpting is here to stay.Results are exciting. But a 600% increase in body sculpting modalities in general in the past 20 years is only half the story. The really exciting thing is that slimmer and slimmer patients with excess fat finding it difficult to mobilize fat in certain body areas are joining in, and are super happy about the results they have seen from having entered into this care...Body contouring. By now, it is becoming more widely known that there are multiple nonsurgical, so non-invasive, energy transferring modalities that are being used to burn fat (lipolysis) in medical therapy generally known as body sculpting. Cryo-therapy is really gaining popularity. And laser therapy and heat therapy are also widely used. Electromagnetic therapy is also being used to impart an energy form into fat containing tissue to burn fat. It’s the newest kid on the block, and everybody’s waiting to see the pros and cons as it makes its debut this year.Slightly more invasive, needle therapy is also somewhat popular because it allows the physician to inject fat burning chemicals into very specific areas where lipolysis is desired. This therapy of course thus provides chemical burning. Obviously, there are a few downsides with needle therapy - pain, needles, chemical burning. In contrast, we can provide all of the other energy imparting body sculpting modalities noninvasively.Body sculpting is the term loosely used to describe destroying fat in areas where it has always been tough to destroy fat. These areas usually overlie muscle, so what is left is well-defined muscle, and the patients really dig it.In addition to cold, heat, and laser energy, there is yet another energy modality that can be transferred noninvasively to burn fat. And that’s acoustic energy; and it’s generated with ultrasound. Ultrasound at one range of settings is widely known for imaging techniques. Well, at other settings, it destroys fat. It also has been discovered to increase the vascularity in the tissues where it is applied, if the correct settings are used — but I’m getting ahead of myself. Fat burning properties of ultrasound or shock wave therapy first. In ultrasound therapy, acoustic waves are generated which are sent directly into the skin. Depending on the settings, scatter can be minimized or maximized, but depending on the effect you want to achieve, it is most safely exploited.If those waves produce bubbles of a certain size that cause a certain type of impact, blood vessel growth is stimulated and produced. At different settings, ultrasound acoustic, shockwave therapy actually destroy fat. So it brings both of those things to the table.And there’s another advantage to ultrasound. Unlike other modalities being used for non-surgical body sculpting, ultrasound produced fat destruction does not produce inflammation. With non-heat generating ultrasound techniques, there is no heat generated (clever name, right?). If there’s no heat generated, there’s no inflammation. If there’s no inflammation, there is less induration. If there is less induration, there is less downtime. If there is less downtime, the patient can continue to work out, critical for weight loss and staying in shape and toned, as everyone obviously knows. So the fat exodus is not only faster because of the increased vascularity allowing the body to rid itself of the dead fat quicker . There is less pain. And there is less downtime for the patient.So for two separate reasons, increased vascularity and decreased inflammation, ultrasound shockwave therapy produces faster body sculpting results that are nicely effective. Every patient can be excited about this.ConclusionMany nonsurgical modalities now exist to burn difficult to get at fat. Alternatively, ultrasound is yet another nonsurgical, thus noninvasive modality used for body sculpting to burn fat. But in addition to burning fat, it also increases the vascularity of that tissue, albeit at different settings. And it does all this non-thermally, without generating heat, so as to improve tolerance, increasing speed of response and recovery even more. This increased vascularity increases the speed of fat elimination after lipolysis. So, instead of leaving the fat in place for the body to deal with more slowly on its own with its limited vascularity, ultrasound’s increased vascularity eliminates the traffic jam.And the other big distinction of ultrasound acoustic shockwave therapy in comparison to other non-surgical body sculpting modalities, it is nonthermal so you don’t get the inflammation. So you don’t get the induration, you don’t get the swelling, you don’t get the pain. So the patient appreciates that! Plus sees results faster. (Note: this type of ultrasound, nonthermal, US care must be clearly distinguished from heat generating ultrasound which is also available today for lipolysis.)Most body sculpting conducted by physicians is being done in dual modality modes. To choose ultrasound as one of those paired modalities would seem wise.Stay well,David Allingham, MD