Journal of Clinical and Aesthetic Dermatology

APR 2017

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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26 JCAD journal of clinical and aesthetic dermatology April 2017 • Volume 10 • Number 4 o R I g I n A L R E S E A R C h and the EndyMed Pro system. The new Shaper handpiece features six concentric electrodes, each connected to an independently controlled RF generator. The surface area of the electrodes is 40.7cm 2 , allowing focused RF energy and treatments of bigger areas than the previous handpiece in which the electrodes were arranged in a linear fashion (Figures 2A and 2B). MATERIALS AND METHODS The study included 25 healthy subjects (23 women and 2 men) ages 29 to 69 years (average, 51.28±10.02) who underwent body skin tightening and circumference reduction across two international sites. All subjects were treated with the Shaper handpiece (EndyMed Pro, EndyMed Medical, Caesarea, Israel). Subjects were recruited after they fulfilled all inclusion criteria, provided informed consent and committed to attend all treatments and follow-up visits. Treatment areas included abdomen (21), thighs (7), flanks (10), and arms (4). Some subjects were treated for more than one area. Degree of clinical improvement was assessed by the Global Aesthetic Improvement Scale (GAIS) and subjects' satisfaction by post-treatment questionnaires. Each subject underwent a series of visits including a screening visit, treatment visits, and a follow-up visit. Treatment protocol included 5 to 8 sessions. All patients were photographed prior to the treatments, before every treatment session, and at the follow-up visit. The photographs were taken using standard distance and lightening. Ultrasound gel was applied to the treatment area and followed by pre- heating of two passes (1 pass=30 sec). Surface temperature was measured by infrared thermometer and when the optimal temperature of 40 to 42°C was reached, an additional 10 therapeutic passes were performed (Figure 3). Maintaining surface temperature of 40 to 42°C during all sessions was Figure 1B. In this handpiece, six concentric electrodes are controlled simultaneously by six RF sources, thus creating multiple electrical fields of energy inside the tissue. Figures 2A and 2B. Thermal images (using FLIR SC 640) on agar compound simulating skin tissue resistance. (A) Large handpiece; (b) Shaper handpiece Figur es 3A and 3B. Thermal images (us ing FL I R S C 640) o f a t re at m e nt a re a o n i n n e r thighs. (A ) bas eline, average temperature of 30° C , w i t h u l t ra s o n i c g e l ; ( b ) Afte r s i x pas s es of 30 s econds each, the average tempe rat u re i s 42° C

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