Rodrigo Neira

Low-level laser-assisted liposculpture: Clinical report of 700 cases

BACKGROUND Suction-assisted lipoplasty has limitations, particularly in dealing with fibrous areas such as the back, sides, and male chest, or when secondary lipoplasty is performed. OBJECTIVE The use of low-level laser-assisted lipoplasty was evaluated in a series of 700 cases. METHODS After adequate infiltration was obtained in all targeted body areas, a 635-nm electric diode laser was applied to the targeted areas for 6 to 12 minutes, depending on the specific area, to liquefy the fat, which was extracted immediately after laser treatment. RESULTS Excellent aesthetic results, including an improved silhouette contour, smooth abdominal surface, and good skin retraction, were obtained in 95% of cases. Postoperative recovery was rapid, and complications were minimal. CONCLUSIONS Low-level laser-assisted lipoplasty can be a valuable adjunctive tool for the performance of lipoplasty. (Aesthetic Surg J 2002;22:451-455.).

In vitro effects of 635 nm low intensity diode laser irradiation on the fat distribution of one adipose cell

In vitro effects of 635-nm diode laser irradiation on the lipidic inclusions and the cellular fat distribution were observed in situ on a selected multilocular adipose cell in culture by an effective laser power of 3.16 mW. Selected microscopic field was 12 times sequentially irradiated, using 100 seconds exposures, a free spot of 5 mm and effective energy density of 1.6 Jcm-2 per exposure. Same field was irradiated 24 times using a beam spot of 10 mm, 0.4 Jcm-2. Digital microphotograph sequences permit to observe and follow changes in fat distribution. Results show changes in fat vesicles. Microscopic follow-up shows an almost empty vacuole 15 hours after irradiation, the cell was empty after 42 hours, and dies after 52 hours.

Low-Level Laser-Assisted Lipoplasty Appearance of Fat Demonstrated by MRI on Abdominal Tissue

Introduction: In an effort to study the changes of subcutaneous fat after exposure to a low-level diode laser and tumescent infiltration, the magnetic resonance imaging (MRI) findings are presented. The subcutaneous abdominal fat is exposed for 4 and 6 minutes irradiation time. This has previously been studied using a scanning electron microscope. The anatomical characteristics of the superficial and deep fat previously described by other authors are correlated with the scanning electron microscope and MRI. The changes in the characteristics of the fat before and after tumescence and before and after application of the low-level diode laser are shown. Materials and Methods: By using MRI techniques, 3 patients were evaluated prior to infiltrating the subcutaneous tissue with tumescent fluid with T1 and T2 sequences. The same patients were evaluated again after applying or infiltrating the tumescence and again after exposure using the low-level laser beam for 4 and 6 minutes. Conclusion: The MRI showed no laser exposure in the T1 sequence; the adipose tissue, both superficially and deep, appears to have a bright signal and is homogenously distributed. After 4 minutes of laser exposure, the T1 sequence demonstrated that the adipose tissue is partially coalescent and has changed its signal. After 6 minutes of laser exposure, the MRI demonstrated that the adipose tissue is much more coalescent and is blurred. The fatty density and organization seems to have changed completely after exposure to the laser beam for this period of time. (The scanning electron microscope revealed that at this particular time 100% of the fat was in the interstitial space and the transitory pore was now open.) The MRI evaluation of the subcutaneous fat seems to correlate well with the findings of the scanning electron microscope, showing that there is a definite change in the consistency of the subcutaneous fat following exposure to the low-level electronic diode laser.

Low-Level Laser-Assisted Liposuction

It is human nature to strive for and look for the best method to obtain an ideal and a human’s well-being. In this anxious seeking to find answers to many questions for what is the best for our patients, the author, in collaboration with a multidisciplinary group, has attempted to gain knowledge and research the equipment to elucidate the interaction between low-level laser energy and adipose tissue. All the answers have not been resolved but in the near future and with the collaboration of others, liposuction techniques will be developed that have less risk to the patient.

Laser-induced lipolysis on adipose cells

Recently, a new liposuction technique, using a low-level laser (LLL) device and Ultrawet solution prior to the procedure, demonstrated the movement of fat from the inside to the outside of the adipocyte (Neira et al., 2002). To determine the mechanisms involved, we have performed Scanning and Transmission Electron Microscopy studies; Light transmittance measurements on adipocyte dilutions; and a study of laser light propagation in adipose tissue. This studies show: 1. Cellular membrane alterations. 2. LLL is capable to reach the deep adipose tissue layer, and 3. The tumescence solution enhances the light propagation by clearing the tissue. MRI studies demonstrated the appearance of fat on laser treated abdominal tissue. Besides, adipocytes were cultivated and irradiated to observe the effects on isolated cells. These last studies show: 1. 635 nm-laser alone is capable of mobilizing cholesterol from the cell membrane; this action is enhanced by the presence of adrenaline and lidocaine. 2. Intracellular fat is released from adipocytes by co joint action of adrenaline, aminophyline and 635 nm-laser. Results are consistent with a laser induced cellular process, which causes fat release from the adipocytes into the intercellular space, besides the modification of the cellular membranes.

Erratum: Re: “Application of Low‐Level Laser Therapy for Noninvasive Body Contouring” Lasers in Surgery and Medicine, 2012;44(3):211–217

In the recent Clinical Report titled, ‘‘Application of Low-Level Laser Therapy for Noninvasive Body Contouring’’ Lasers Surg Med. 2012 Feb;44(3):211–17. DOI: 10.1002/lsm.22007.), the article should have included the following author conflict of interest disclosure statement: Jillian Maloney, MD, presently provides research guidance for Erchonia, the manufacturer of the device used in this study. However, she did not treat any patients or communicate with the participating physicians.

Laser light propagation in adipose tissue and laser effects on adipose cell membranes

Recently Neira et al. have presented a new liposuction technique that demonstrated the movement of fat from inside to outside of the cell, using a low-level laser device during a liposuction procedure with Ultrawet solution. The clinical observations, allowed this new surgical development, started a set of physical, histological and pharmacological studies aimed to determine the mechanisms involved in the observed fat mobilization concomitant to external laser application in liposuction procedures. Scanning and Transmission Electron Microscopy, studies show that the cellular arrangement of normal adipose tissue changes when laser light from a diode laser: 10 mW, 635 nm is applied. Laser exposures longer than 6 minutes cause the total destruction of the adipocyte panicles. Detailed observation of the adipose cells show that by short irradiation times (less than four minutes) the cell membrane exhibits dark zones, that collapse by longer laser exposures. Optical measurements show that effective penetration length depends on the laser intensity. Moreover, the light scattering is enhanced by diffraction and subsequent interference effects, and the tumescent solution produces a clearing of the tissue optical medium. Finally, isolate adipose cell observation show that fat release from adipocytes is a concomitant effect between the tumescent solution (adrenaline) and laser light, revealing a synergism which conduces to the aperture, and maybe the disruption, of the cell membrane. All these studies were consistent with a laser induced cellular process, which causes fat release from inside the adipocytes into the intercellular space, besides a strong modification of the cellular membranes.

Effects of Low-Level Laser-Assisted Liposuction on Plasma Triglycerides in Humans

Introduction: The low-level laser-assisted liposuction technique, also known as the Neira 4L technique, has been described as an adjuvant technique of liposculpture that involves the external application of an electric diode laser (635-nm wavelength at 10 Mw) for 6 minutes per area, allowing the passing of fat from the intracellular space (adipocyte) into the extracellular space (interstitial tissue). Therefore, it is possible that these fatty acids that are free in the extracellular space could pass into the bloodstream and increase plasma triglycerides. Methods: Blood triglyceride levels were accordingly determined in 12 healthy patients before irradiation with the Neira 4L technique, 1 hour after irradiation with the Neira 4L technique, and 30 days after surgery. Results: Study results indicated no significant increases in plasma triglycerides at any time when measurements were made. Discussion: Monitoring indicated that the Neira 4L technique does not increase blood triglycerides above normal values at 1 hour after irradiation or at 30 days after surgery.