Fat loss and weight reduction are still very hot issues worldwide. According to data from the American Society for Aesthetic Plastic Surgery,1 liposuction is currently the second most frequently performed aesthetic surgical procedure in the United States, with approximately 313,000 cases performed by core specialists in 2012.
Nonsurgical fat removal devices were approved in the United States in 2009 and include cryolipolysis (Zeltiq, Pleasanton, CA), ultrasound (Liposonix; Solta Medical, Hayward, CA), and low-level light (Zerona; Erchonia, McKinney, TX). Recently, radiofrequency (RF) devices such as TruSculpt (Cutera, Brisbane, CA) and others have been marketed for fat reduction and body contouring, although direct FDA approval has not been granted for fat reduction. Radiofrequency use was based on data showing that heating adipose tissue to 45° C with radiofrequency energy causes a 60% loss of cell viability. The issues with these devices are inconsistency of tissue heating and pain/discomfort with skin heating.
Vanquish (BTL Aesthetics, Boston, MA) is a new device that offers selective RF-multipolar technology that emits an electromagnetic field over a large area to specifically target the deep tissue layer, where the energy is optimally absorbed. It uses a proprietary frequency of the ISM RF band that is delivered wirelessly and is reserved internationally for industrial, scientific, and medical purposes other than communications. This technology was designed to emit energy based on different electromagnetic impedances of body tissue. Tissue with higher impedance has higher resistance to the flow of the electromagnetic field, thus increasing the temperature in that specific tissue only. The frequencies that Vanquish uses are best matched to the impedance of adipocytes in this deep tissue layer. The device selectively heats adipose tissue; therefore the depth of penetration varies based on the thickness of adipose tissue and the distance of the applicator from the body. The closer the applicator is to the body, the more superficial the penetration. Conversely, the further the applicator is from the body, the deeper the penetration. To achieve heat efficacy in the fat layer, the applicator should be placed so that it is approximately 10 mm from the skin surface.