Development and performance evaluation of an electromagnetic-type shock wave generator for lipolysis

Effect of superficial adipose tissue mitochondrial and cellular functionality induced by extracorporeal shock wave therapy (ESWT)

Due to its regenerative action, extracorporeal shock wave therapy (ESWT) is applied in treating integumentary and musculoskeletal diseases. However, other potential therapeutic interventions are being investigated. It is essential to fully understand its mitochondrial signaling pathway to achieve this, which plays a fundamental role in elucidating the mechanism of action and possible therapeutic interventions. Thus, this study aimed to analyze the effect of ESWT on mitochondrial pathways through the relationship between lipolysis and adipocyte apoptosis, as well as cellular functionality. This is a non-randomized case-control clinical trial where obese women received ESWT sessions in the abdominal region, after which tissue samples were collected for histological and immunohistochemical analyses of adipose tissue. The data demonstrated positivity in the expression of mitochondrial markers related to cell apoptosis, such as FIS1 (p < 0.0203) and OPA1 (p < 0.0283), in addition to the positivity of anti-MFN1, responsible for regulating mitochondrial cell proliferation (p < 0.0003). In summary, this study demonstrates that ESWT was able to activate specific mitochondrial signaling pathways, which may be associated with its ability to stimulate lipolysis and apoptosis in superficial adipose tissue. However, no significant improvements in cellular functionality were observed.

Development of an Omnidirectional-Capable Electromagnetic Shock Wave Generator for Lipolysis

Traditional methods for adipose tissue removal have progressed from invasive methods such as liposuction to more modern methods of noninvasive lipolysis. This research entails the development and evaluation of an omnidirectional-capable flat-coil electromagnetic shock wave generator (EMSWG) for lipolysis. The developed EMSWG has the advantage of omnidirectional-capable operation. This capability increases the eventual clinical usability by adding three designed supports to the aluminum disk of the EMSWG to allow omnidirectional operation. The focal pressures of the developed EMSWG for different operating voltages were measured, and its corresponding energy intensities were calculated. The developed EMSWG was mounted in a downward orientation for lipolysis and evaluated as proof of concept. In vitro tests on porcine fatty tissues have been carried out. It is found that at a 6 kV operating voltage with 1500 shock wave exposures, a 2 cm thick subcutaneous hypodermis of porcine fatty tissue can be ruptured, resulting in a damaged area of 1.39 mm². At a 6.5 kV operating voltage with 2000 shock wave exposures, the damaged area is increased to about 5.20 mm², which can be enlarged by changing the focal point location, resulting in significant lipolysis for use in clinical applications.

Extracorporeal shock wave therapy in situ - novel approach to obtain an activated fat graft

One of the mainstays of facial rejuvenation strategies is volume restoration, which can be achieved by autologous fat grafting. In our novel approach, we treated the adipose tissue harvest site with extracorporeal shock wave therapy (ESWT) in order to improve the quality of the regenerative cells in situ. The latter was demonstrated by characterizing the cells of the stromal vascular fraction (SVF) in the harvested liposuction material regarding cell yield, adenosine triphosphate (ATP) content, proliferative capacity, surface marker profile, differentiation potential and secretory protein profile. Although the SVF cell yield was only slightly enhanced, viability and ATP concentration of freshly isolated cells as well as proliferation doublings after 3 weeks in culture were significantly increased in the ESWT compared with the untreated group. Likewise, cells expressing mesenchymal and endothelial/pericytic markers were significantly elevated concomitant with an improved differentiation capacity towards the adipogenic lineage and enhancement in specific angiogenic proteins. Hence, in situ ESWT might be applied in the future to promote cell fitness, adipogenesis and angiogenesis within the fat graft for successful facial rejuvenation strategies with potential long-term graft survival.