There is an increasing number of transcutaneous energy delivery devices currently available. They are classified according to the type of energy they deliver to their target—mechanical (e.g., suction, massage), radiofrequency, ultrasound, cryolipolysis, and laser. Of these, radiofrequency devices are the most popular. Adverse outcomes following noninvasive treatments are uncommon but may include thermal injuries and temporary dysesthesia.

Unwanted local fat deposits negatively affect body shape and image. Diets, exercise, medications and/, liposuction, or gastric surgeries may effectively control obesity. Surgical or minimally invasive body shaping can dramatically improve the shape and proportion of your body, enhancing your appearance and boosting your self-confidence. For patients who require minor improvement or are unwilling or unable to undergo a surgical procedure, nonsurgical fat reduction is an alternative for surgical procedures. Nonsurgical and minimally invasive options for fat reduction use various modalities, including freezing, ultrasound, radiofrequency, infrared light, vacuum massage, and injectable medication. Realistic expectations on the part of patients and the appropriate application of technologies by surgeons are the key to achieving patients’ aesthetic goals.

Minimally invasive procedures to tighten and lift skin give natural results with minimal risk and recovery time. Monopolar radiofrequency deliver a high-frequency electric current—tissue resistance to electrical current, resulting in volumetric heating to the deep dermis and underlying tissue. The resulting heat leads to immediate collagen contraction and a delayed wound healing response, with new collagen formation up to 4 to 6-month post-treatment.  The FDA initially approved monopolar radiofrequency (RF) devices to treat periorbital wrinkles. Since then, they have been used to treat laxity of the forehead, cheeks, nasolabial folds, marionette, lines, jawline, and neck. Although the results of RF are not as dramatic as a facelift, over 90% of patients obtain noticeable tightening of the treated areas, and it never looks “pulled.” Another benefit of radiofrequency is reducing fat and tightening the skin by directing energy to target collagen. For example, a patient with flabby upper arms may have more loose skin than fat in this area. In this instance, Prof Moawad might use radiofrequency to tighten the skin first and then remove excess fat. However, if he determines that there is fat primarily in an area, he will remove the fat first and then tighten the skin afterward. “Radiofrequency is a very versatile procedure that can be used on any area of the body – from large areas like the abdomen to minimal areas such as the chin – with the same degree of success.

Many things change after you have a baby: schedules, sleep time, and a sense of freedom, to name a few. Along with, there are many physical changes you’ll see. Chief among them is stretch marks. Stretch marks or striae are a form of scarring on the skin with an off-color hue. Stretch Marks are the result of the dermal tear, which over time may diminish, but will not disappear completely. Stretch marks are often the result of the rapid stretching of the skin associated with rapid growth or rapid weight changes. Stretch marks may also be influenced by hormonal changes associated with puberty, pregnancy, bodybuilding, hormonal replacement therapy, etc. Stretch marks formed during pregnancy, usually during the last trimester. It generally appears on the belly and commonly on the breasts, thighs, hips, lower back, and buttocks. For the treatment of red stretch marks, clinicians may consider the PDL, 1,064-nm Nd: YAG laser, and 532-nm KTP laser, which would likely improve the redness (vascular component) of red stretch marks. Recently, several emerging treatment modalities, including fractionated micro-needling RF, ultrasound, and PRP and micro-needling, have reported good clinical improvement of stretch marks.  Stretch marks prevention and treatment stay a clinical challenge. Physicians should set realistic expectations with patients seeking stretch marks treatment and inform patients that the appearance and texture of stretch marks may improve but will not completely resolve to be an integral part of setting these expectations.

The term cellulite refers to the ‘orange peel,’ ‘mattress,’ or ‘dimpling’ appearance on the thighs, buttocks, and sometimes lower abdomen and upper parts of the arms of otherwise healthy women. Approximately 85% of post-pubertal woman has a form of cellulite. This appearance is much more common in women than in men because of differences in how fat, muscle, and connective tissue are distributed in men’s and women’s skin. Although rarely observed in men, those men presenting with cellulite are commonly deficient in male hormones. The lumpiness of cellulite is caused by fat deposits that push and distort the connective tissues beneath the skin, leading to characteristic changes in the appearance of the skin. The causes of cellulite are not well understood. Theories include genetics, circulatory problems, inflammation, hormonal disturbances, tight clothing, and lifestyle factors. Although being overweight is not a prerequisite for cellulite, excess body fat makes cellulite more visible. The aging process can worsen the appearance of cellulite, as skin loses elasticity and is less able to resist irregular tension created by the fibrous bands. Despite many treatments available—all of which claim to work somehow—few do work, and many works with unpredictable results.  The new minimally invasive techniques of power liposuction (without suction) and fat transfer are rewarding to achieve acceptable results.