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SONOFOCUS LIPOCAVITATION
Sonofocus lipocavitation 

Sonofocus is focused cavitation equipment which produces high intensity focused ultrasound energy for the treatment of localized fat and non-invasive body remodeling.

Sonofocus presents frequency of 1,8 MHz, modulated by PWM in 31 kHz and maximum power of 30 W.

The Sonofocus device has a concave transducer which allows the concentration of ultrasound energy on the focal point at controlled depth (between 1 and 1.5 centimeters), the ideal depth to reach the adipose tissue without any risks to the patient.

Sonofocus is efficient, safe, easy to operate and accurate.

High Intensity Focused Therapeutic Ultrasound was originally developed for the treatment of tumors by ablation.

In that case, the high energy on the focal point must be enough to destroy the tumor cells and treat cancer (Ter Haar e Coussios, 2007). HIFU for aesthetic consists of the propagation of ultrasonic energy through biological tissues without causing damage; the ultrasound beams carry energy which converges inside the volume or in the focal area, which may cause a local increase in cavitation and in temperature in a magnitude sufficient to cause lesion of the subcutaneous adipose tissue with subsequent degradation of the adipocytes in the treatment area. This happens without damage to the surrounding or overlying tissues. When the adipose tissue of the focal area receives these massive doses of energy, a strong cavitation associated with acoustic shock waves occurs. This combination of mechanical effect associated with thermal effects produces the emulsification of the fat contained in the adipocytes without significantly affecting the adjacent structures. This mixture of mechanical and thermal stress and triggers a cascade of events in the adipose cells which induces apoptosis or programmed cellular death. Specialized cells digest, by liberation of enzymes, part of the lipids released and rests of dead cells in the area treated. This process is subclinical and is usually asymptomatic.
     Focused ultrasound                       flat ultrasound

Differences Between Flat and Focused Ultrasound.

The SONOFOCUS focused cavitation uses principles which are similar to therapeutic ultrasound and HIFU. The flat therapeutic ultrasound is a mode of energy frequently used in physiotherapy and physical rehabilitation and by means of its mechanical and thermal effects promotes the repair and regeneration in osteomuscular skeletal tissues and/or permeation of actives through sonophoresis/phonophoresis. Low intensities of energy are generally used in these modes of treatment. Using a flat transducer, but associated with therapeutic electric currents, high intensities of energy (up to 3 W/cm2) are used in aesthetic treatments with the objective of favoring lipolysis and tissue drainage.

High Intensity Focused Ultrasound (HIFU) was designed to treat tumors by tissue heating and ablation. The ability of HIFU in reaching cellular volumes and controlled depths appeared as an attractive proposal for use in aesthetic treatments to achieve a non-invasive modeling of the body contour.

SONOFOCUS focused lipocavitation was manufactured with a curved transducer and frequency of 1,8 MHz modulated in 31 kHz with controlled depth of the focal area between 1.0 and 1.5 cm, which allows 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 liberated in the circulation. To achieve this provision, lipolysis mechanisms are activated through the liberation of lipolytic hormones such as the catecholamines (adrenaline, 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 liberated glycerol can be used for the synthesis of glicose, 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.

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What is the difference between low (ultrasonic cavitation) and high (focused lipocavitation) frequency 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, increasing the cost/benefit ratio.

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Sudies demonstrate that when compared, the 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, whereas 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.

  sonofocus ultrasound

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 causes liberation of 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 works 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.  ilustracao_web