This guide details the appropriate use of all Liposonix cartridges and the specific clinical applications for the four energy delivery modes, based on a machine capable of delivering 22 lines of High-Intensity Focused Ultrasound (HIFU) per shot.
Cartridge Selection
Cartridge selection is critical and determined by the thickness of the pinchable fat in the target area. The ideal focal depth is half the pinch thickness, ensuring the thermal lesion is centered deep within the fat layer, at least 1-1.5 cm away from the underlying muscle or organs.
Protocol Note: For best results in thicker areas (e.g., lower abdomen), consider a combination treatment: 1. First Pass with the 13 mm cartridge for deep destruction, followed by 2. Second Pass with the 8 mm or 10 mm cartridge to address the remaining mid-layer fat.
Energy Delivery Modes Explaination
The Liposonix machine’s modes dictate how the 22 lines of HIFU energy are patterned, affecting the thermal coagulation zone (TCZ) shape, treatment speed, and suitability for different contours.
Selection Rule: Use Linear (MP Mode) for large, flat areas needing speed and volume reduction. Use Dot (Normal) for maximum depth penetration in thick spots. Use Circle modes for curved areas and blending.
Step-by-Step Treatment Protocol
Phase 1: Pre-Treatment Assessment and Planning
Patient Suitability: Confirm the patient has at least 2.5 cm of pinchable fat and no contraindications.
Mapping & Measurement: Perform the pinch test across the entire area. Record the measurements to select the deepest required cartridge (e.g., 13 mm).
Treatment Area Marking:
Place the Liposonix disposable grid template on the skin.
Trace the grid with a surgical marker.
Mark exclusion zones (bones, scar tissue, hernia, near the naval) which must not be treated.
Cartridge and Mode Selection: Load the deepest required cartridge (e.g., 13 mm). Determine the primary energy mode based on the area shape (e.g., Linear MP for the abdomen, Circle Linear for the flanks).
Pain Management: Administer chosen pain relief (oral medication, nerve block, or conscious sedation) 30-60 minutes before the first shot.
Phase 2: Execution – Systematic Energy Delivery
Preparation: Clean the skin and apply a thick, continuous layer of high-viscosity ultrasound coupling gel over the marked grid.
Handpiece Contact: Place the handpiece flat and firmly on the first grid square, ensuring 100% skin contact. Poor contact leads to inconsistent heating and painful hot spots.
First Pass (Deep Layer):
Settings: Use the deepest cartridge (e.g., 13 mm) and the selected primary mode (e.g., Linear MP).
Delivery: Initiate the shot. The machine delivers 22 lines of focused energy.
Progression: Move the handpiece systematically, square by square, delivering one shot per square until the entire marked area is covered. Monitor patient comfort continuously.
Mode/Cartridge Change (If applicable): If treating a curved transition area (e.g., moving from abdomen to flank):
Switch the mode to Circle in Linear for the flank/love handle squares to ensure better blending.
Second Pass (Mid-Layer – Optional):
If significant fat remains, switch to a shallower cartridge (e.g., 8 mm) to address the residual fat layer above the first pass’s TCZ.
Settings: Use the 8 mm cartridge with a mode suitable for the area (e.g., Dot or Linear MP).
Phase 3: Post-Treatment Care
Cleaning and Assessment: Clean the skin thoroughly, remove the grid marks, and inspect the skin for expected erythema and mild edema.
Patient Instructions:
Inform the patient about expected side effects (bruising, swelling, tenderness) which may last for several weeks.
Emphasize the importance of hydration and light activity (walking) to assist lymphatic drainage.
Documentation: Take standardized post-treatment photos immediately.
Follow-up: Schedule the final assessment and photography at 12 weeks, when the maximal fat reduction results are typically visible.
How many sessions does liposonix need?
Liposonix is designed to be a single-session treatment for most patients. However, if a second treatment is deemed necessary for further reduction, there is a specific waiting period.
Number of Sessions: One session is typically all that is required. Liposonix is designed to achieve the maximum possible fat reduction (often about 1 inch/2.5 cm reduction in waist circumference) in a single treatment.
If a Second Session is Needed: If the patient wishes for more reduction after the initial treatment, the recommended waiting period is 8 to 12 weeks (approximately 2 to 3 months).
This interval is necessary because the body requires that much time to naturally process and eliminate the fat cells destroyed by the initial HIFU / Liposonix treatment, allowing for a proper assessment of the final results before deciding if a booster treatment is warranted.
When Can I See the Effect and Why?
You can see immediately effect after the Liposonix treatment, but the best effect appears around 3 months. They appear gradually, driven by the body’s natural healing and waste elimination processes.
Some patients may notice very subtle changes or less tightness in clothing around 4 to 6 weeks post-treatment, especially if they are highly compliant with post-treatment care (hydration and light exercise). The most significant and noticeable results typically become apparent between 8 to 12 weeks (2 to 3 months) after the session. The full and complete result, reflecting the maximum possible reduction from that single treatment, is typically seen at 12 weeks or slightly beyond.
The delayed timeline is due to how High-Intensity Focused Ultrasound (HIFU) technology works:
- Fat Cell Destruction: The Liposonix handpiece delivers HIFU energy, instantly heating the targeted fat tissue (adipose cells) to temperatures above 56°C. This causes irreversible coagulative necrosis (destruction) of the fat cells.
- Cellular Debris: The destroyed fat cells are now cellular debris that the body must clear out.
- Natural Clearance Process: Macrophages (specialized white blood cells) are recruited to the treatment area. Their job is to engulf and eliminate the non-viable fat cell material through the body’s natural lymphatic and metabolic pathways.
- Gradual Elimination: This process of inflammation, phagocytosis (engulfing), and elimination is slow and gradual, taking several weeks to complete. The reduction in circumference only occurs as the debris is cleared and the tissue remodels, which is why the final outcome is seen at 12 weeks.
Do I Need to Repeat the Treatment Every Year to Keep the Effect?
No, the results from Liposonix are considered permanent in the treated area.
Fat Cell Removal: Liposonix works by permanently destroying the targeted fat cells. Once those cells are eliminated by the body, they do not regenerate.
Long-Term Maintenance: You do not need an annual treatment to maintain the results, provided the patient maintains a stable weight and healthy lifestyle.
Weight Gain Risk: If the patient gains a significant amount of weight after the treatment, the remaining fat cells in the treated area—and fat cells throughout the rest of the body—can still expand in size (hypertrophy). This is how patients can “regain” volume, even after a treatment that permanently removed cells.
Key Maintenance Points for Patients
The Goal: The treatment is for contouring, not weight loss.
Permanence: The treated cells are gone for good.
Future Protection: Maintaining a stable diet and exercise routine is essential to prevent the expansion of existing fat cells, thereby preserving the achieved contour.
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