A Systematic Approach for 3D Abdominal Lipodefinition.

BACKGROUND: 3D abdominal lipodefinition is a tool to eliminate localized fat and to enhance muscular definition. The aim of this article is to describe the standardization of defining the abdomen through 3D abdominal lipodefinition, taking into consideration the fat percentage to make the technique happen in a way the results turn out completely natural. METHODS: A retrospective study of patients who underwent 3D abdominal lipodefinition by one of the authors (R.V). Patient selection criteria, preoperative markings and technique according to fat percentage, postoperative care, outcomes and complications are described. RESULTS: A total of 285 patients underwent 3D abdominal lipodefinition. The average age was of 33 years (18-45 years). One hundred and fifty (52.63%) of the patients had a fat percentage between 25 and 30%, 92 (32.28%) of the patients had 21-24%, and 43 (15.09%) of the patients had a fat percentage lower than 20%. The average fat volume extracted was of 1600 mL with a minimum of 800 mL and a maximum of 2000 mL. The average surgery time was of 100 min (84-118 min). Twenty-seven (9.47%) complications were observed, 15 (5.26%) had seromas and 7 (2.46%) developed hyperpigmentation on the negative areas. Asymmetries were observed in three patients (1.05%). CONCLUSIONS: The standardization of the 3D abdominal lipodefinition technique is a systematic surgical approach associated to a classification dependent on the fat percentage of the patient and their physical build, that allows for results that are natural, according to each patient, reproducible and with a low complication index. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The Safety of Large-Amount Liposuction: A Retrospective Analysis of 28 Cases.

Aim: Our study aims to assess the safety of large amounts of liposuction in a new light. Materials and Methods: This is a retrospective review of patients who underwent large-volume liposuction from August 2020 to April 2021. Patient demographics, liposuction areas, the amount of infiltrate and aspirate, the surface area of liposuction areas, anesthesia duration, pain score after surgery, preoperative and 4-h postoperative hemoglobin, and basic metabolic panel (sodium, potassium, creatinine, urea) were measured. Results: Out of the 28 patients, 26 (92.85%) were females. The mean age was 37.1 years old. The mean preoperative hemoglobin was 13.73 g/dL. The average anesthesia time was 220.39 min. The average amount of liposuction infiltrated was 7.55 L, and the average amount of liposuction aspirate was 6.83 L. The mean hemoglobin 4 h postoperatively was 13.7 g/dL. Conclusions: With proper patient selection and a comprehensive physical exam with preoperative blood workup performed in an accredited facility with a highly experienced plastic surgeon and anesthesiologist, mega liposuction can be safely performed as a day surgery procedure.

Safety and Efficacy of Third-Generation Ultrasound-Assisted Liposuction: A Series of 261 Cases.

BACKGROUND: The introduction of third-generation ultrasound-assisted liposuction (3rd UAL) allows for a less invasive modality of both deep and superficial lipectomy while offering improved skin retraction and reduced rate of complications. This study examined the efficacy and safety profile of this technology over 15 years of clinical experience. METHODS: A consecutive series of patients treated from 2005-2020 by the senior author were reviewed for demographic and anthropometric measurements, intraoperative settings, surgical outcomes, and complications via retrospective chart review. Body-Q survey was used to assess patient satisfaction. RESULTS: A total of 261 patients underwent 3rd UAL in 783 areas. There were 238 female and 23 male patients with an average age of 43.5 years and BMI of 27.4 kg/m2. The most frequently treated areas were the trunk and lower limbs. An average of 2840 mL of wetting solution was used with an average of 2284 mL of lipocrit aspirate. About 65% of the cases were done in conjunction with another procedure. Overall complication rate was 4.6%, contour irregularity (1.9%), seroma (0.8%), cellulitis (0.8%), pigmentation changes (0.4%), and electrolyte imbalance (0.4%), with a minimum follow-up of 6 months. 78% of patient would undergo the procedure again and 86% would recommend it. CONCLUSION: Third-generation ultrasound-assisted liposuction can be used effectively and safely, either alone, or in conjunction with other plastic surgery procedures. VASER liposuction allows surgeons to address superficial fat plane and enhanced skin tightening. Rate of complications are lower than that of traditional liposuction with equivalent or higher patient satisfaction. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

32 Years of Ultrasonic-Assisted Lipoplasty (U.A.L.): From Aesthetic to Obesity.

In this article, we tried to take stock of the state of the art in ultrasonic-assisted lipoplasty focusing on its most recent technologic advances and in the newest clinical applications, such as overweight, obesity, breast surgery and regenerative medicine. Great space was devoted to the analysis and clarification of the most common myths and legends related to this intriguing technique.

Noninvasive Abdominoplasty.

Noninvasive and minimally invasive treatments are increasingly supplanting, or complimenting, abdominoplasty. For optimal delivery of patient care and to maintain a dominant share of the body-contouring market, plastic surgeons need to embrace these new technologies. High capital purchases, costly disposables, maintenance fees, lack of experience, conflicting anecdotal reports, energy-related complications, marketing hyperbole, and rapid obsolescence are formidable barriers to this adoption. Receptive plastic surgeons may be best served by accepting brief short-term retrospective reports by reputable innovative body contouring surgeons who present a succinct and clinically supported message.

Abdominal Etching.

Abdominal etching techniques are used to improve the aesthetics of the abdominal region, providing patients an athletic physique, using liposuction and fat redistribution. Based on the anatomy of fat layers, lipocontouring for deep fat liposuction and superficial fat liposculpting for superficial fat liposuction are proposed. The degree of abdominal etching is controlled by the surgeon through the extent of lipocontouring and superficial fat liposculpting. Therefore, we propose the classification of low-, medium-, and high-definition abdominal etching levels. This article offers a comprehensive description of the authors' technique, including preoperative assessment, intraoperative procedure, and postoperative care for patients undergoing abdominal etching.

High-Definition Excisional Body Contouring: Mini Lipoabdominoplasty (FIT Mommy) and Enhanced Viability Abdominoplasty.

The abdominoplasty procedure poses a number of unique challenges. If the stigmata of the operation is to be avoided, careful planning and surgical execution are required. We describe our experience in full and mini abdominoplasties with a 360-degree approach, involving all muscular groups and body segments as described by high-definition liposculpture. Selective fat grafting is also safely performed in specific areas to improve projection and volume.

Clinical application of cryolipolysis in Asian patients for subcutaneous fat reduction and body contouring.

BACKGROUND: Cryolipolysis, a preferred method for minimally invasive body contouring, involves the noninvasive cooling of adipocytes to induce lipolysis without damaging other tissues. This study aimed to evaluate the safety and efficacy of cryolipolysis for the treatment of excessive fat tissue. METHODS: Between May 2014 and December 2017, 231 patients with 448 areas of interest were enrolled and their records were retrospectively reviewed. We used five different vacuum applicators, and the best-fitting applicator was used for each area. One cycle of cryolipolysis was applied at a cooling intensity factor of 41.6. The efficacy was evaluated 12 weeks after treatment via review of clinical photographs, the pinch test, and ultrasonographic measurements of fat thickness. The occurrence of any complications was also assessed. RESULTS: The volume was reduced in all of the areas to which cryolipolysis was applied. The rate of reduction of the fat layer as measured via the pinch test was 19.2%, and the rate of the decrease in fat layer thickness as measured via ultrasonography was 22.8%. Fat reduction of the upper arm differed significantly from that of the abdomen and flank, but no significant difference was found between sexes. The side effects were limited to erythema, edema, bruising, and numbness at the treatment site and resolved without treatment. CONCLUSIONS: Cryolipolysis, with new and better-fitting applicators, is safe, fast, and effective for the reduction of excessive fat tissue on the abdomen, back, flank, and extremities. It is a good option for treating excess adipose tissue in Asian patients.

Lipoplasty Combined with Percutaneous Radiofrequency Dermaplasty: A New Strategy for Body Contouring.

BACKGROUND: A new technique in plastic surgery termed percutaneous radiofrequency dermaplasty (PRD) is described. Customized radiofrequency energy is applied via the percutaneous route to produce skin tightening and fascia contraction at body temperature, avoiding thermal injury. We combine PRD with lipoplasty and call this combined procedure dermaplasty-assisted lipoplasty (DAL). The purpose of this study was to review both the safety and efficacy of DAL. METHODS: We developed the required novel device and technique to perform DAL and then performed a clinical trial including Type I and Type II lipodystrophy female patients undergoing a primary liposuction of the circumferential trunk. The trial comprised two phases. In Phase I, 51 patients were included in a prospective, comparative, controlled trial and divided into two groups. In Group 1, 29 patients underwent DAL, and in Group 2, 22 patients underwent a standard suction-assisted lipectomy (SAL) alone. In Phase II, 84 patients underwent DAL, including 9 cases initially scheduled for a mini-abdominoplasty. RESULTS: Phase I: We found better aesthetic results with DAL (93.1%) than with SAL alone (72.7%) [p < .05]. Postoperative correction of flaccid skin was superior with DAL (93.1%) than with SAL alone (36.4%) [p < .01]. Phase II: DAL achieved good-to-excellent aesthetic results in 94% of the cases. CONCLUSIONS: DAL was found to be a reliable and safe treatment for fat removal with concomitant skin and fascia tightening but without compromising the viability of the overlying skin. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Interstitial Matrix Prevents Therapeutic Ultrasound From Causing Inertial Cavitation in Tumescent Subcutaneous Tissue.

We search for cavitation in tumescent subcutaneous tissue of a live pig under application of pulsed, 1-MHz ultrasound at 8 W cm-2 spatial peak and pulse-averaged intensity. We find no evidence of broadband acoustic emission indicative of inertial cavitation. These acoustic parameters are representative of those used in external-ultrasound-assisted lipoplasty and in physical therapy and our null result brings into question the role of cavitation in those applications. A comparison of broadband acoustic emission from a suspension of ultrasound contrast agent in bulk water with a suspension injected subcutaneously indicates that the interstitial matrix suppresses cavitation and provides an additional mechanism behind the apparent lack of in-vivo cavitation to supplement the absence of nuclei explanation offered in the literature. We also find a short-lived cavitation signal in normal, non-tumesced tissue that disappears after the first pulse, consistent with cavitation nuclei depletion in vivo.

The Collection of Adipose Derived Stem Cells using Water-Jet Assisted Lipoplasty for their Use in Plastic and Reconstructive Surgery: A Preliminary Study.

The graft of autologous fat for the augmentation of soft tissue is a common practice frequently used in the field of plastic and reconstructive surgery. In addition, the presence of adipose derived stem cells (ASCs) in adipose tissue stimulates the regeneration of tissue in which it is applied after the autologous fat grafting improving the final clinical results. Due to these characteristics, there is an increasing interest in the use of ASCs for the treatment of several clinical conditions. As a consequence, the use of clean room environment is required for the production of cell-based therapies. The present study is aimed to describe the biological properties of adipose tissue and cells derived from it cultured in vitro in clean room environment according to current regulation. The collection of adipose tissue was performed using the water-jet assisted liposuction in order to preserve an high cell viability increasing their chances of future use for different clinical application in the field of plastic and reconstructive surgery.

Tissue Liquefaction Liposuction for Body Contouring and Autologous Fat Transfer: A Retrospective Review Over 3 Years.

Objective: Tissue liquefaction lipoplasty is a novel, low-energy method cleared for use in aesthetic body contouring and autologous fat transfer. This is a retrospective review of the clinical effectiveness and safety of a liquefaction lipoplasty system for liposuction and autologous fat transfer. Methods: A retrospective review was done evaluating all liquefaction lipoplasty procedures with or without autologous fat transfer performed by a single surgeon (March 2013 to June 2016). Patient demographics, operative details, and any complications were tabulated from patient charts. A typical case reported is presented with pre-/postoperative photographs. Results: Two hundred fifty-five consecutive liquefaction lipoplasty procedures were performed over 39 months. The average lipoaspirate volume was 1208 ± 991 mL and the average fat graft volume was 322 ± 277 mL. The overall complication rate was 9 of 255 (3.52%). There were 2 episodes of seroma (0.78%) that were aspirated and 2 episodes of cellulitis (0.78%) that responded to oral antibiotics. In the autologous fat transfer cohort, there were 5 of 103 (4.85%) cases of mild to moderate fat necrosis, with 1 patient requiring return to the operating room for removal of an oil cyst. No revisions of donor sites were required. Conclusions: Liquefaction lipoplasty appears safe for liposuction and autologous fat transfer, with a complication profile that is comparable with other widely used forms of suction-assisted liposuction. The liquefaction lipoplasty technology also provides potential time savings in the operating room that can minimize surgeon fatigue when harvesting large volumes of high-quality fat. Liquefaction lipoplasty appears to have advantages for both the patient and the surgeon, and further studies are underway.

Imaging Findings of Liposuction with an Emphasis on Postsurgical Complications.

Liposuction is one of the most frequently performed cosmetic surgeries worldwide for reshaping the body contour. Although liposuction is minimally invasive and relatively safe, it is a surgical procedure, and it carries the risk of major and minor complications. These complications vary from postoperative nausea to life-threatening events. Common complications include infection, abdominal wall injury, bowel herniation, bleeding, haematoma, seroma, and lymphoedema. Life-threatening complications such as necrotizing fasciitis, deep vein thrombosis, and pulmonary embolism have also been reported. In this paper, we provide a brief introduction to liposuction with the related anatomy and present computed tomography and ultrasonography findings of a wide spectrum of postoperative complications associated with liposuction.

Imaging Findings of Liposuction with an Emphasis on Postsurgical Complications

Liposuction is one of the most frequently performed cosmetic surgeries worldwide for reshaping the body contour. Although liposuction is minimally invasive and relatively safe, it is a surgical procedure, and it carries the risk of major and minor complications. These complications vary from postoperative nausea to life-threatening events. Common complications include infection, abdominal wall injury, bowel herniation, bleeding, haematoma, seroma, and lymphoedema. Life-threatening complications such as necrotizing fasciitis, deep vein thrombosis, and pulmonary embolism have also been reported. In this paper, we provide a brief introduction to liposuction with the related anatomy and present computed tomography and ultrasonography findings of a wide spectrum of postoperative complications associated with liposuction.

Intercorrências e óbitos em lipoaspiração: pesquisa realizada pela comissão de lipoaspiração da SBCP / Liposuction-related complications and death: survey conducted by the BSPS commission on liposuction

Introdução: A lipoaspiração, procedimento cirúrgico com cerca de 30 anos desde sua sistematização por Fournier, Illouz e outros, atingiu, em 2011, o total de 211.108 cirurgias realizadas no Brasil e 325.332, nos Estados Unidos. Ao longo dos anos, foi reputado como procedimento seguro, baseado em conceitos da técnica tumescente. Realizado também por outras especialidades, já foi descrito como método ambulatorial, inclusive em instituições públicas no Brasil, por dermatologistas. Motivada por essa lacuna de dados, a Sociedade Brasileira de Cirurgia Plástica criou uma comissão composta por dez membros titulares, com o objetivo de realizar uma pesquisa para reconhecer a presença de possíveis fatores envolvidos nas intercorrências graves e nos óbitos, após uma cirurgia de lipoaspiração no Brasil. Métodos: Foi elaborado um questionário on-line através de um link anônimo e disponível para consulta, no site da SBCP. O questionário foi enviado, através dos e-mails de cadastro, para 4.441 membros associados e titulares da SBCP. A primeira questão indagava sobre a ocorrência de intercorrências em lipoaspiração. Somente a resposta positiva era então direcionada ao restante do questionário. Além do questionário, foram enviadas cartas pela SBCP às instituições oficiais estaduais e federais, nas quais prováveis registros de processos ou cadastro de fatos relacionados a intercorrências e/ou óbitos após lipoaspiração poderiam existir. A significância da associação entre óbito e os diversos fatores foi medida com aplicação do teste qui-quadrado. As variáveis significantes foram incluídas em Modelos de Regressão de Poisson. Foi considerado o nível de significância de 5%. Os dados foram analisados com auxílio do programa STATA versão 10.0. Resultados: Fenômenos tromboembólicos, associação de cirurgias e o local de realização da cirurgia demostraram ser fatores de risco envolvidos na mortalidade de lipoaspiração. Conclusão: Programas visando à normatização na realização das lipoaspirações podem ser eficazes na diminuição da mortalidade em lipoaspiração. Acreditamos que este artigo pode promover um impacto positivo educacional e, futuramente, gerar protocolos de segurança em lipoaspiração.

Introduction: Liposuction is a surgical procedure that was developed approximately 30 years ago by Fournier, Illouz, and others. In 2011, a total of 211,108 liposuction procedures were performed in Brazil versus 325,332 in the United States. Over the years, liposuction performed with the tumescent technique has had a good safety profile. It is also performed by other specialists, including dermatologists, and has been described as an outpatient procedure in public institutions in Brazil. The scarcity of data on the subject has led the Brazilian Society of Plastic Surgery (BSPS) to create a commission composed of 10 full members with the aim of investigating the factors involved in severe liposuction-related complications and death in Brazil. Methods: An online questionnaire was created using an anonymous link on the BSPS website. The questionnaire was sent to the registered email addresses of 4,441 associate and full members of the BSPS. The first question was about the occurrence of liposuction-related complications. The respondents could only continue to answer the questionnaire if the answer to this question was "yes." In addition to the questionnaire, the BSPS sent letters to the official state and federal institutions in which the case or complication/death-related records and/or deaths as a consequence of liposuction were expected to exist. The significance of the association between death and the various factors was determined using the chi-square test. The significant variables were included in Poisson regression models. The significance level was set at 5%. The data were analyzed using STATA software version 10.0. Results: Thromboembolic events, combined surgical procedures, and the facilities where the procedure was performed were risk factors involved in liposuction-related mortality. Conclusion: The implementation of programs that aim to standardize liposuction procedures may effectively reduce liposuction-related mortality rates. This study aimed to make a positive educational impact on the development of future safe liposuction protocols.

Liposuction devices: technology update.

Since its introduction by Illouz and others over 30 years ago, suction-assisted lipectomy/liposuction/lipoplasty has evolved tremendously and has developed into one of the most popular procedures in aesthetic plastic surgery. Liposuction is an effective procedure employed to treat localized adipose deposits in patients not suffering from generalized obesity. These accumulations of subcutaneous fat often occur in predictable distributions in both men and women. A cannula connected to a suction-generating source allows for small incisions to be strategically placed and large volumes of fat to be removed. This fat removal leads to improved harmonious balance of a patient's physique and improved body contour. Various surgical techniques are available and have evolved as technology has improved. Current technology for liposuction includes suction-assisted lipectomy, ultrasound-assisted, power-assisted, laser-assisted, and radiofrequency-assisted. The choice of technology and technique often depends on patient characteristics and surgeon preference. The objective of this review is to provide a thorough assessment of current technologies available to plastic surgeons performing liposuction.

Isolation of human adipose-derived stromal cells using laser-assisted liposuction and their therapeutic potential in regenerative medicine.

Harvesting adipose-derived stromal cells (ASCs) for tissue engineering is frequently done through liposuction. However, several different techniques exist. Although third-generation ultrasound-assisted liposuction has been shown to not have a negative effect on ASCs, the impact of laser-assisted liposuction on the quality and differentiation potential of ASCs has not been studied. Therefore, ASCs were harvested from laser-assisted lipoaspirate and suction-assisted lipoaspirate. Next, in vitro parameters of cell yield, cell viability and proliferation, surface marker phenotype, osteogenic differentiation, and adipogenic differentiation were performed. Finally, in vivo bone formation was assessed using a critical-sized cranial defect in athymic nude mice. Although ASCs isolated from suction-assisted lipoaspirate and laser-assisted lipoaspirate both successfully underwent osteogenic and adipogenic differentiation, the cell yield, viability, proliferation, and frequency of ASCs (CD34(+)CD31(-)CD45(-)) in the stromal vascular fraction were all significantly less with laser-assisted liposuction in vitro (p < .05). In vivo, quantification of osseous healing by micro-computed tomography revealed significantly more healing with ASCs isolated from suction-assisted lipoaspirate relative to laser-assisted lipoaspirate at the 4-, 6-, and 8-week time points (p < .05). Therefore, as laser-assisted liposuction appears to negatively impact the biology of ASCs, cell harvest using suction-assisted liposuction is preferable for tissue-engineering purposes.

Suction-assisted lipectomy fails to improve cardiovascular metabolic markers of disease: a meta-analysis.

BACKGROUND: The purpose of this study was to determine whether suction-assisted lipectomy (SAL) decreases the incidence of early cardiovascular disease risk factors or its biochemical and clinical risk indicators. METHODS: A systematic review of the literature was performed by conducting a predefined, sensitive search in MEDLINE without limiting the year of publication or language. The extracted data included the basal characteristics of the patients, the surgical technique, the amount of fat extracted, the cardiovascular risk factors and the biochemical and clinical markers monitored over time. The data were analysed using pooled curves, risk ratios and standardised means with meta-analytical techniques. RESULTS: Fifteen studies were identified involving 357 patients. In all of the studies, measurements of predefined variables were recorded before and after the SAL procedure. The median follow-up was 3 months (interquartile range (IQR) 1-6, range 0.5-10.5). The mean amount of extracted fat ranged from 2063 to 16,300 ml, with a mean ± standard deviation (SD) of 6138 ± 4735 ml. After adjusting for time and body mass index (BMI), leptin and fasting insulin were the only markers that were significantly associated with the amount of aspirated fat. No associations were observed for high sensitive C-reactive protein (hCRP), interleukin-6 (IL-6), adiponectin, resistin, tumour necrosis factor-α (TNF-α), Homeostasis Model of Assessment (HOMA), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, free fatty acids or systolic blood pressure. CONCLUSIONS: Based on the results of our analysis, we conclude that there is no evidence to support the hypothesis that subcutaneous fat removal reduces early cardiovascular or metabolic disease, its markers or its risk factors.

Comparison of laser-induced damage with forward-firing and diffusing optical fiber during laser-assisted lipoplasty.

BACKGROUND AND OBJECTIVES: Laser-assisted lipoplasty is made possible by using an optical fiber that delivers light endoscopically to subcutaneous fat tissue. Most optical fibers for laser-assisted lipoplasty are designed to be irradiated in a forward direction. In this study, we compared forward-firing fiber and diffusing fiber for use in laser-assisted lipoplasty. The effective parameters of the ablation pattern which resulted from the laser-induced damage are discussed for both systems. In particular, we note the effect resulting from the different beam emission patterns and the contours of laser fluence. METHODS: We used two different laser delivery systems (a forward-firing fiber and a diffusing fiber) to examine how the beam emission pattern affects the laser-assisted coagulation and damage pattern of in vitro fat tissues. A porcine liver tissue (water-rich tissue) was used as a secondary laser target to investigate how the laser-assisted coagulation pattern depends on both the type of tissue (water-rich and lipid-rich tissue) as well as the delivery system. An evaluation using a digital camera and a thermal camera was conducted for the tissue ablation processes in order to observe the generated heat transfer in fat and liver. RESULTS: The overall shape of the laser-assisted coagulation zone was different from the beam emission pattern in the case where a forward-firing fiber was used within fat tissue. The center of the laser-affected zone is characterized by the formation of a reservoir of melted fat. In the thermal image analysis, there existed a discrepancy between the temperature distribution of the fat tissue and the liver tissue during the forward-firing fiber irradiation. In the liver tissue ablation process, the temperature distribution during the laser ablation also demonstrated an elongated ellipse that matches well with the laser-induced damage zone. The temperature distribution in fat tissue adhered to a more discoid pattern that corresponded to the laser-induced damage zone. CONCLUSIONS: Based on our findings, we have proposed mechanisms that can explain the laser-induced damage in both tissues when a forward firing fiber is employed as the delivery system. In the case of fat tissue, the ablation mechanism can be characterized by the reservoir formation of melted lipids while the ablation is characterized as the well-known drilling effect for liver tissue.

Low-level laser therapy for fat layer reduction: a comprehensive review.

BACKGROUND AND OBJECTIVE: Low-level laser (light) therapy (LLLT) is a noninvasive, nonthermal approach to disorders requiring reduction of pain and inflammation and stimulation of healing and tissue regeneration. Within the last decade, LLLT started being investigated as an adjuvant to liposuction, for noninvasive body contouring, reduction of cellulite, and improvement of blood lipid profile. LLLT may also aid autologous fat transfer procedures by enhancing the viability of adipocytes. However the underlying mechanism of actions for such effects still seems to be unclear. It is important, therefore, to understand the potential efficacy and proposed mechanism of actions of this new procedure for fat reduction. MATERIALS AND METHODS: A review of the literature associated with applications of LLLT related to fat layer reduction was performed to evaluate the findings from pre-clinical and clinical studies with respect to the mechanism of action, efficacy, and safety. RESULTS: The studies as of today suggest that LLLT has a potential to be used in fat and cellulite reduction as well as in improvement of blood lipid profile without any significant side effects. One of the main proposed mechanism of actions is based upon production of transient pores in adipocytes, allowing lipids to leak out. Another is through activation of the complement cascade which could cause induction of adipocyte apoptosis and subsequent release of lipids. CONCLUSION: Although the present studies have demonstrated safety and efficacy of LLLT in fat layer reduction, studies demonstrating the efficacy of LLLT as a stand-alone procedure are still inadequate. Moreover, further studies are necessary to identify the mechanism of action.