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treatment, hair regrowth occurred at a faster rate when compared to the sham treatment group. Additionally, LLLT did not hinder the efficacy of the chemotherapeutic procedures [44]. 3. LLLT for Fat Reduction 3.1 Lipoplasty and Liposuction: Charles Dujarrier, a French surgeon, first introduced the concept of lipoplasty (also known as liposuction) in the 1920s. Dujarrier attempted to perform body sculpting on the knees of one of his patients, a ballerina, but ultimately the patient ended up developing gangrene, leading to amputation of her affected limb and thus the notion of lipoplasty faced a major setback [45]. In 1974, Dr. Giorgio Fischer and his son reintroduced liposuction, and they innovatively utilized oscillating blades within a cannula to chisel away subcutaneous fat [46]. In 1983, YG Illouz reported his 5-year experience with a new liposuction technique that could utilize relatively large cannulas along with suction tubing to securely remove fat from several regions of the body [47]. This ushered in the era of modern lipoplasty. Over the following decades, the concept of tumescent liposuction allowed for better results and decreased morbidity associated with liposuction. 3.2 LLLT for Fat Reduction: In 2000 Niera et al. demonstrated the use of low level laser as new means for liposuction, and successfully utilized it with doses that did not produce any detectable increases in tissue temperature or cause any noticeable macroscopic alterations in the tissue structure [48, 49]. Prior investigations concerned with the effects of LLLT on wound healing, pain relief and edema prevention paved the way for this therapeutic application [50, 51]. The development of LLLT as a therapeutic modality to augment liposuction while avoiding macroscopic tissue alterations were based on determination of optimal parameters such as wavelength and power output for use [52]. Evidence suggests that wavelengths suitable for biomodulation range between 630 and 640 nm [53-58]. Niera et al. made several intriguing observations regarding the effects of LLLT on adipocytes. They utilized low level diode laser (635 nm) and a maximal power of 10mW with energy values ranging from 1.2 to 3.6 J/cm2 [48]. Using scanning electron microscopy (SEM) and transmission electron microscopy (TEM) it was demonstrated that adipocyte plasma membranes exhibited transitory pore formation as result of irradiation. It was formulated that this enabled the release of intracellular lipids from the adipocytes and thus supplemented the liposuction as it was expected to reduce the time taken for the procedure, allowed for extraction of greater volumes of fat and overall, reduced the energy expenditure of the surgeon. Although the findings associated with LLLT enjoyed much praise and enthusiasm, an extensively study conducted put these findings surrounding LLLT into question [59]. In their study, cultured human preadipocytes did not show any differences when compared to non-irradiated cells after 60 minutes of irradiation using an LLLT source (635 nm and fluence 1 J/cm2) [59]. Furthermore, histological examination of lipoaspirates, in a porcine model exposed to LLLT for 30 minutes and human lipoaspirates, failed to demonstrate transitory pores when analyzed using SEM [59]. Additional data, raised questions regarding the ability of red light (635 nm) to effectively penetrate below the skin, into the sub-dermal tissues [60]. Peter Foddor supportively stated: “One could postulate that the presence of the black dots on scanning electron microscopy images on the surface of fat cells reported by Neira et al. could represent an artifact.” [59] . Since the data reported by Brown et al. from 2004, there have been several publications reporting the efficacy of LLLT. Proc. of SPIE Vol. 8932 89320X-7PDF Image | Low-level light therapy (LLLT) for cosmetics and dermatology
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