How Many Passes of Liposonix and at What Frequency Gives Best Results?

Liposonix is a noninvasive procedure for permanent reduction of localized fat. It uses intense focused ultrasound (HIFU) to target fat tissue. The total amount of energy is measured in Joules, and what we know is that a total of about 150-180 is needed for results. The energy settings on the treatment range from 30 to 60, so high energy setting (more uncomfortable) would be 3 passes, lower energy 4 passes. As far as we know niether version has been proven better in terms of results. The different settings allow it to be tailored to each patient's comfort level.

In my practice we treat patients with 50J stacked pulsed three rounds per square.  It seems (anecdotally) to give patients  more aggressive results.

Currently we are treating with three passes at 55-60 Joules. We try to treat with the device set at 60 if at all possible, but sometimes the setting has to be reduced on the second or third pass for patient comfort.

 

 

 

Studies have shown that one needs to achieve a total energy count of 180kJ. There are various ways to achieve that endpoint, which could be increasing the number of apsses lor increasing the energy settings per pass.

The original studies on Liposonix indicate that results are obtained when a specific amount of energy (about 150 Joules/cm2) is delivered to the fat in order to kill the cells.  We have found the best way to deliver that energy is in three passes (each area is treated 3 times) at one third of the total recommended energy. That gives a nice even result.  

I think at this point for me there is not enough data. There is certainly enough data for me to know that we will get a satisfactory result..but we want a "home run" for every patient, of course.The manufacturer provides us with some guidelines, but most of the data that is available to me was published on the first generation Liposonix machine, and they sell us the second generation machine (more sophisticated software,hardware and ergonomically better). The most helpful data for me was published by Dr. Solish in Toronto, and the data was acquired using the first generation machine. Dr. Solish was able to go up and down by one Joule, whereas with the second generation machine, we can go up or down by increments of 5 Joules. Generally, we follow the work based on what Dr. Solish opined, which was that a minimum of 140 Joules be delivered to each site. Again, this is my interpretation of the data. Our experience is that we can safely deliver, on average, at least 150 Joules of energy to each site. The patient must receive oral analgesia in order for us to deliver this amount of energy. To date, all of the patients have tolerated the procedure well, and are happy with their results.