Sonofocus


Sonofocus Equipamento de Lipocavitação Focalizada
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The equipment

Sonofocus is focused lipocavitation equipment, which produces high intensity focused ultrasonic energy for the treatment and is designed for esthetic treatments. Sonofocus presents frequency of 1.8 MHz modulated by PWM and concave transducer which allows the concentration of ultrasound energy on the focal point at controlled depth between 1 and 1.5 centimeters). This is the ideal depth to reach the adipose tissue without offering any risks to the patient.  Sonofocus is efficient, safe, easy to operate and accurate equipment.

The equipment must be used only under prescription and supervision of a licensed professional.

 

What is focused ultrasound?

High Intensity Focused Ultrasound (HIFU – High Intensity Focused Ultrasound) was originally developed for the treatment of tumors by ablation. In that case, the high energy concentration on the focal point must be enough to destroy the tumor cells and treat cancer.

HIFU used in aesthetic treatments, consists in the propagation of ultrasonic energy through biological tissues without causing  damage, because the beams of ultrasound carry energy that converges within the volume of the focal area, which can increase cavitation of the area and increase the temperature enough to cause lesion to the subcutaneous adipose tissue, with consequent degradation of the adipocytes in the treatment area. This process occurs without causing damage to the tissue around or adjacent to the treatment area.

When the adipose tissue in the focal area receives these massive doses of energy, a Strong cavitation allied to the acoustic shockwaves is produced.  This combination of mechanical effect, associated with the thermal effects, which produces the emulsification of the fat contained in the adipocytes without significantly affecting the adjacent structures. Such combinations of mechanical and thermal stress triggers in the cells a cascade of events which induces apoptosis, or programmed cell death. Specialized cells digest, by release of enzymes, part of the lipids released and rests of dead cells in the treated area. This process is subclinical and generally asymptomatic.

Accessories

  • 1 PP female cable I.E.C. de 3 x 0.75 x 1500mm;
  • 1 Sonofocus metallic rack;
  • 1 p polypropylene board 20×20 with 0.25mm;
  • 1 Sonofocus banner 0.70cm x 1m;
  • 1 gel kit 1kg (measuring tape, adipometer, cuvette spatula);
  • 1 footswitch;
  • 1 Sonofocus applicator;
  • 1 PVC film roll;
  • 1 Fuse 20AG – 05A;
  • 1 Protection fuse card.

 

Technical characteristics

  • Bivolt 127/220V | 50/60Hz;
  • Frequency 1.8MHz +/- 10%;
  • Frequency of PWM in 31KHz;
  • Shot Time: 2 seconds (1 to 10 seconds);
  • Output Power: maximum 30W +/- 20% | Adjustable from 2 to 30W.

 

Dimensions of the cabinet

  • Width: 30cm;
  • Depth: 30cm;
  • Height: 11cm;
  • Standard weight (with transducer): 6kg.


Treatments


Sonofocus focused lipocavitation presents similar principles to therapeutic ultrasound and HIFU. Flat therapeutic ultrasound consists of a modality of energy frequently uses in physical rehabilitation, and by means of its mechanical and thermal effects, it promotes the repair and regeneration in bone-muscle-skeleton tissue and/or permeation of actives through sonophoresis/phonophoresis. In these treatment modalities, low intensities of energy are generally used.

There is also a flat transducer, but associated with therapeutic electric currents and high intensities of energy (up to 3W/cm²), which are used in esthetic treatments with the purpose of favoring lipolysis, tissue drainage and tissue reorganization.

The ability of HIFU in reaching from cellular volumes to controlled depths appeared as an attractive proposition for use in esthetic treatments, for non-invasive body contour remodeling.

Sonofocus focused lipocavitation was designed with a curved transducer and frequency of 1.8MHz modulated in 31KHz, with controlled depth of focal area between 1 and 1.5cm, providing greater safety in the application.

 

Physiological effects of focused ultrasound.

For the provision of lipids in the form of fatty acids free in the blood circulation to offer energy to the cells (ATP) it is necessary that the triglycerides are cleaved and released in the circulation. To achieve this provision, lipolysis mechanisms are activated through the liberation of lipolytic hormones such as the catecholamines (adrenalin e noradrenalin), glucagon, adrenocorticotropic hormone, growth hormone, thyroid hormones and leptin.

This mechanism activates the hormone-sensitive lipase (LHS) which triggers a series of intra-adipocitary reactions, which result in lipolysis with liberation of glycerol and fatty acids free in the blood circulation. These substrates will serve as a matrix in the production of cellular energy according to the demand.

In the liver, the released glycerol can be used for the synthesis of glucose, and the free fatty acids, if not used, suffer hepatic reesterification or in the adipocyte itself and are stored in the form of triglycerides.

In lipoclasia, once the rupture of the adipocyte is promoted, the cell goes into apoptosis (programmed cell death) and a cascade of events involving cells of the inflammatory process as neutrophils and macrophages are activated. These cells absorb and digest, by enzyme liberation, part of the lipids liberated and debris (rests) of dead cells in the lesion site. Chemical signals activate the fibroblasts which promote the synthesis of new collagen in the fat septum and adjacent skin, finalizing the healing process. This inflammatory process is subclinical and generally asymptomatic.

 

What is the difference between low (ultrasonic cavitation) and high frequency (focused lipocavitation) ultrasound?

The lower the frequency of the ultrasound, the greater will be the depth of penetration of the ultrasonic beam. This happens inclusively with the flat transducers used for cavitation and ultrasonic cavitation which work with low frequencies in KHz.

The application of the transducer for ultrasonic cavitation involves a great depth of penetration of the ultrasonic beam (up to 45 cm). To avoid internal lesions, ultrasonic cavitation must be applied pinching skin and subcutaneous tissue; however, operational errors of positioning may lead to internal lesions of medium and serious consequences, affecting the cost/benefit ratio.

Studies demonstrate that when compared, low frequencies have potential effect in the breaking of fat; however, studies show that lipolysis can also be induced efficiently in high frequencies with a focused transducer. Higher frequencies present more superficial penetration, concentrating the energy in the adipose tissue, which minimizes the risks to the patient, while lower frequencies may reach deeper tissues and compromise safety.

Cavitation is defined as the “phenomena of formation of gas bubbles in a flowing liquid”. The cavitational effect of the ultrasonic wave is well known as it occurs in all ultrasound applications where molecular oscillation in the tissues occurs in a cyclic form.

The cavities or bubbles which are formed may be stable or unstable. The stable bubbles oscillate in size, but maintain integrity; the unstable have a sudden alteration in size and implode with the vibration of the ultrasonic waves. This cavitational implosion releases energy, causing tissue lesion in the area of activation. This lesion causes cell fragmentation, leading to cell destruction, which subsequently is removed by pro-inflammatory specialized cells called macrophages.

Ultrasonic cavitation is based on the use of ultrasound having as its objective a massive mechanic effect which induces lysis of the fat cells. All ultrasound mechanisms work with compression and decompression generating positive and negative energy, respectively, in the treated tissue.

The theory of ultrasonic cavitation considers the idea that fat is a tissue of great volume and low density (0.9 g/cc) susceptible to innumerable bubbles formed by high intensity ultrasonic waves. The compression produces positive pressure and implodes the bubbles, liberating energy which affects the fat cells.

 

Risks

Risks of Liposuction X Focused Lipocavitation

One of the main forms of treatment of these adiposities is liposuction, a surgical method used to remove adipose tissue from some areas of the body using cannulas which may be connected to an aspirator, to needles, to ultrasound equipment or to a vibroaspirator.

The more or less serious post-operative complications and the morbimortality indexes are similar to any of those present in other surgical procedures. The more serious ones are constituted by liponecrosis, cutaneous necrosis, acute lung edema, deep venous thrombosis, fatty embolism, anaphylaxis, thoracic and abdominal perforations, coma, and in some cases, death.

The less serious complications are aesthetic, such as surface irregularities, asymmetry, accentuated flaccidity and prolonged ecchymosis with formation of hyperchromia, persistent edema, hypoesthesia, hyperpigmentation, hematoma or seroma formation. Besides, of course, being admitted to a hospital and the post-operative rest period.

Focused lipocavitation is considered the true “liposuction without cuts”, because the lipolytic response resulting from focused ultrasound promotes the reduction of localized fat and body remodeling, in a conservative form, being the alternative of choice in face of the risky surgical methods.

 

Comparison: Therapeutic Ultrasound, Focused Lipocavitation and Ultrasonic Cavitation

 

Therapeutic ultrasoundFocused lipocavitationUltrasonic cavitation
Form of transducerFlatFocusedFlat
Frequency1 and/or 3MHz1 to 3MHz30 to 60KHz
Depth of application1MHz = up to 5cm

3MHz = 2 to 3cm

1 to 2cmUp to Até 45cm
ApplicationDynamic and perpendicular to skinStationary (punctual) e perpendicular à peleTissue pinch
Operational RiskControl of depth = high safetyControl of depth = high safetyNo depth control = low safety
Indications Cellulitis, localized fat and skin tonificationLocalized fat and body remodelingLocalized fat

 

 

 

How is fat eliminated?

The adipocytes of subcutaneous localized fat present some particularities, their membrane receptors are in low density in the adipocyte membrane and/or are resistant to lipolytic hormones. The triglycerides stored there are of difficult mobilization and this type of regional fat deposit is regarded, by researchers, as emergency fat, little mobilized for the maintenance of the basal metabolism of the body.  It is important to observe that the adipose tissue is not only a fat deposit, but also a true endocrine system with hormones which act in the regulation of metabolism.

Studies point out that those physical resources may induce lipolysis or lipoclasia in subcutaneous fat deposits increasing the availability of circulating lipids, and therefore providing energetic subtract for metabolic functions.

Due to misinformation released by advertisement pieces, that once released they are “naturally eliminated by the organism”, expectations regarding the results are increased. It is important that, once liberated in the organism, this energy is consumed. When energetic mobilization is concerned, it is necessary that the patient is informed about the direct influence of nutrition and physical activity in the results.

Indications


  • Reduction of localized fat
  • Reduction of measures

Contraindications


  • Over areas with subcutaneous adipose layer thinner than 1.5 cm;
  • Implanted electronic device (e.g. cardiac pacemaker, deep brain stimulation device, etc.).
  • Over neoplastic areas;
  • Over the region of the eyes;
  • Over ischemic areas;
  • Over bone epiphyses;
  • Over the cardiac area;
  • Over abdominal Hernia or diathesis of the abdominal rectus muscle;
  • Wound healing déficit;
  • Metabolic or hepatic diseases which compromise the metabolism of fat.

Comparative


Ultrassom Plano de Alta PotênciaUltrassom Focalizado de Alta Potência
ULTRASSOM PLANO DE ALTA POTÊNCIAULTRASSOM FOCALIZADO DE ALTA POTÊNCIA
FREQUÊNCIA: 1,1 MHZ OU 3,3 MHZ (± 10%)FREQUÊNCIA: 1,8 MHZ (± 10%)
MODO: CONTÍNUO, PULSADO (25, 50 E 75%)MODO: PWM MODULADO EM 31KHZ
POTÊNCIA MÁXIMA: 72 WATTSPOTÊNCIA MÁXIMA: 30 WATTS
INTENSIDADE: 3 WATTS/CM²INTENSIDADE: 30 WATTS/CM²
POSSUI CORRENTES: AUSSIE, POLARIZADA E HIGH VOLT
8 CANAIS PARA CORRENTE AUSSIE, 2 PARA POLARIZADA E 2 PARA HIGH VOLT
TERAPIAS ISOLADAS, COMBINADAS E SISTEMA DUET

FAQ


What is the technology principle?

Sonofocus is focused lipocavitation equipment which produces high intensity focused ultrasonic energy for esthetic treatments. It presents frequency of 1.8 MHz modulated by PWM and a concave transducer which allows the concentration of ultrasonic energy on the focal point at controlled depth (between 1 and 1.5 centimeters) This is the ideal depth to reach the adipose tissue without risks to the patient.

The equipment promotes the cavitational effect, which is defined as the “phenomena of formation of gas bubbles in a flowing liquid”.   The cavities or bubbles which are formed may be stable or unstable. The stable bubbles oscillate in size, but keep integrity; the unstable bubbles have a sudden change in size and implode with the vibration of the ultrasonic waves. This cavitation implosion releases energy, causing tissue lesion in the activation site. This lesion causes cell fragmentation, leading to cell destruction, which subsequently is removed by specialized pro-inflammatory cells called macrophages. Focused lipocavitation is able to stimulate this destruction of adipocytes by concentration of high energy on the focal point.

 

In which health facilities can I have the treatment done?

The treatment can be carried out in any clinical practice or health clinic without the need for a surgery room and without anesthesia.

In what areas of the body can I have the treatment done?

The treatment can be carried out in the following areas of the body: abdomen, flanks, gluteus, back of thighs, arms and subscapular area.

Is the treatment painful?

Patients have reported this procedure as being painless.

Who can apply Sonofocus?

The equipment can be operated by physicians, physiotherapists, and/or other dully licensed health and aesthetic professionals.

What are the pre-requisites for the treatment?

Sonofocus is prescribed for healthy patients with thickness of subcutaneous tissue of at least 1.5 cm; maximum BMI lower than 29.9 and patients who seek body remodeling. Light diet is suggested two hours before and after the treatment session and physical activity post-treatment. Physical activities should be kept as a daily routine.

What is the mechanism of physiological elimination of fat?

Studies point out that physical resources can induce lipolysis or lipoclasia in subcutaneous deposits of fat, increasing the availability of circulating lipids and consequently providing energetic subtract for metabolic functions (GONÇALVES et al., 2009; VAN DER LUGT et al., 2009; SANT’ANA, 2010; COSTA et al., 2011).

Due to misinformation released by advertisement pieces, which once liberated they are “naturally eliminated by the organism”, expectations regarding the results are increased. It is important that, once liberated in the organism, this energy is consumed. When energetic mobilization is concerned, it is necessary that the patient is informed about the direct influence of nutrition and physical activity in the results.

 

 

What are the post-treatment recommendations?

There are no recommendations of maintenance or recovery period after the treatment with Sonofocus. The patient may return to normal daily routine immediately after the session. It is recommended that a light diet is followed two hours after the treatment, that the patients follow a balanced diet in their daily lives and that physical activities are performed.

How does Sonofocus destroy the adipocytes using MHz and not kHz? 

Sonofocus uses high frequency (MHz) and the curvature of the transducer to control the depth of Application and guarantee the safety of the treatment. The propagation of the energy produced by flat transducer and low frequencies (kHz) equipment is very deep, which increases operational risks, hence the need to use the tissue pinch during the application.

In Sonofocus, the ultrasonic energy produced in high power is directed to the focal point located approximately 1.3 cm deep, causing unstable cavitation, acoustic shock waves and heating on the focal point, which tends to emulsify the fat and induce apoptosis (programmed cell death – destruction of adipocytes). The application with Sonofocus is stationary and perpendicular to the skin, without the need to pinch the skin, because the depth is controlled and limited to the subcutaneous tissue.

Does Sonofocus promote more significant loss of measures than Heccus?

Sonofocus presents applicability for localized fat with physiological hypothesis for greater efficiency and maintenance of results for a prolonged period of time.  Heccus Turbo is a platform which associates ultrasound and therapeutic currents, presenting a different proposal from Sonofocus.

Heccus Turbo is also indicated for the treatment of localized fat; however, besides that, it allows efficient results for the treatment of cellulitis, post-operative, skin flaccidity and muscle flaccidity. Randomized clinical studies comparing both treatments must be developed so that conclusive claims can be made regarding the comparison of results in the treatment of localized fat.


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