• Jörg Faulhaber, Matthias Sandhofer, Christel Weiss, Gerhard Sattler, and Neil S Sadick.
• Department of Dermatology, Venerology and Allergology, Universitätsmedizin Mannheim, Ruprecht-Karls-Universits Heidelberg, Mannheim, Germany.
• J Cosmet Dermatol. 2019 Aug 1; 18 (4): 1014-1019.

BackgroundCryolipolysis combined with shockwave therapy has been previously shown to have synergistic effects in body contouring results.ObjectiveThis open-label, prospective, multicenter, comparative study investigated the safety and efficacy of combined cryolipolysis, shockwave therapy with cryolipolysis, shockwave therapy, and injection polyenylphosphatidylcholine-based lipolysis.MethodsEnrolled patients were treated in the abdominal or flank area with cryolipolysis, shockwave therapy and injection lipolysis (n = 10) or cryolipolysis and shockwave therapy (n = 4). All treatments were conducted the same day. Evaluations were conducted 3 months after treatment and included histological analysis, standardized photography, blinded-investigator efficacy, and safety ratings, as well as patient ratings of satisfaction and tolerance.ResultsCompared to baseline, the 3-month follow-up histological analysis revealed a more profound subcutaneous adipose tissue reaction with the triple combination therapy (cryolipolysis, injection lipolysis, radial shock wave) than with the double combination with regard to adipocyte damage and grade of inflammation. Waist circumference was significantly reduced in patients of both groups, but patients in the triple combination group were shown to have a significantly more pronounced reduction in subcutaneous fat. Factors that were shown to influence treatment outcome included baseline BMI and waist circumference. Age and gender had no effect. The abdominal area reacted better to the treatment compared to flanks. No significant side effects or adverse events were reported. The procedure was well-tolerated, and the majority of patients were satisfied with the treatment results.ConclusionsCombination of cryolipolysis, radial shockwave, and injection lipolysis is a safe, well-tolerated treatment for reduction in subcutaneous fat.© 2019 Wiley Periodicals, Inc.

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