clinical data...

Prof. Marco Gasparotti
Specialista in Chirurgia Plastica
Docente di Chirurgia Estetica
Università di Roma Tor Vergata
Member of the American Society of Aesthetic Plastic Surgery
The New York Academy of Science
Honorary Member of the Lipoplasty of North America

CLINICAL EXPERIMENTS ON THE SLIMMING AND MODELLING EFFECTS OF LIPOCONTOUR* SHEATH

* This page refers to the Lipo Contour "Classic"

PRELIMINARY REMARKS

Lipocontour comes from more than 20 years of clinical practice and experience in the field of liposuction and liposculpture.

It was used as an elastic and compressive sheath after liposuction and liposculpture operations in more than 4.000 clinical cases performed by prof. Marco Gasparotti in Italy and in different countries in the world, where he went to surgically demonstrate his technique of superficial liposculpture and by numerous plastic surgeons from different countries.

The sheath was presented in international magazines of Plastic Surgery and in the book Superficial Liposculpture (Gasparotti - Lewis – Toledo) published by Springer-Verlag, New York, worldwide best seller in this field, as well as in the main Worldwide Congresses of Aesthetic Plastic Surgery of the last 14 years.

Particularly, the Sheath, which has been progressively improved, has got very distinctive features:

  • flat seams in order to avoid signs on the skin
  • graded and differentiated compression for the different parts of the body it is intended for, thanks to special supports which allow, on one hand, the lifting of the glutei and, on the other, a specific bearing of the lateral portion of the thighs, of the sub glutei area and of the abdomen.

The clinical observations of liposculpture cases, treated during the years, demonstrated that the properties of the sheath go beyond the mere effect of compression and support of the regions treated with liposculpture. They clearly show the typical effects of the sheath in regions not treated with surgical operation that is to say a reduction in the circumference of the parts of the body clothed with the sheath in order to better the conditions of the so-called “cellulitis”. Results were observed after only 6 days and they were improving with the passing of the weeks and were still present many months later.

They obtained all this without a diet, which is besides what is forbidden for the first 2 months following operations of liposculpture.

And moreover, patients noticed a great increase of diuresis without taking diuretic remedies, an improvement in the heaviness of lower limbs and a better cutaneous tone.

THE PURPOSE OF THE CLINICAL STUDY

Thanks to the clinical results gained with the twenty years use of the sheath after liposuction, they wanted to test the clinical effectiveness of the uninterrupted use of Lipocontour sheath clothed for 12 hours per day for 8 weeks in subjects who didn’t undergo any lipoaspiration operation.

To this end they chose 22 female subjects, aged from 23 to 55, in good health, not pregnant or nursing, not following estrpogestinic or thyroid hormones therapy, not being on a diet or under pharmacologic therapy. The purpose of the study was to consider the slimming and modelling effects of the sheath through the reduction of the circumference of thighs, glutei and abdomen, and the lifting of glutei obtained by clothing it at least for 8 weeks, 12 hours a day.

They evaluated the effects of the treatment even 1 month after the removal of the sheath itself, in order to consider the lasting effects of the results.

More than that, they studied the negative effects of the sheath in patients with varicose veins at their lower limbs. All this through a Doppler study (15/03/02 - 20/05/02) WITH OTHER 10 PATIENTS (group C) not pregnant or nursing, not following pharmacological or hormones therapy, (3 of them had a serious varicose syndrome) which clothed Lipocontour for 8 weeks without changing their food attitudes and sedentary life habit.

MATERIALS AND METHODS

The 22 chosen subjects suffering from oedematous or fibrous cellulites from stadium 1° to stadium 4° were divided into 2 groups of treatment called A and B.

The patients of group A were invited to clothe the Lipocontour sheath for 12 hours each day for 8 weeks without following a diet or changing their sedentary life habit.

The patients of inspection group B didn’t clothe the sheath, didn’t follow any diet nor changed their sedentary life habit.

Both groups underwent a clinical examination before and after the treatment through these testing:

CLINICAL TEST: medical examination in order to exclude pregnancy, any pathology in progress, hormones therapy or pharmacological treatments, and to point out the corporeal weight, the presence of possible cellulites and its stadium ( 1° - 4°).

PLICOMETRIA: they used a manual plicometre to do 3 consecutive measuring in upright position of the regions they afterwards sent to an ecographic examination in order to consider the subcutaneous thickness (see ecography).

MEASURING OF THE CIRCUMFERENCES of hips, thighs, abdomen and glutei in the same areas used for the ecography and plicometria (see ecography).

ECOGRAPHY OF SUBCUTANEOUS: they tested the thickness and the ecogenicità of the subcutaneous tissue in the following areas:

  • Hips (front upper iliac spine)
  • Front thigh ( 23 cm below the front upper iliac spine)
  • External thigh ( 9 cm below the cutaneous projection of the head of the femur)
  • Internal thigh ( 6 cm from the inguinal fold at the Hunter)
  • Epigastrium abdomen ( 5 cm above the navel)
  • Hypogastrium abdomen ( 5 cm under the navel)
  • Glutei (13 cm above the subgluteal fold and 9 cm sidewise the intergluteal groove)

TOTAL BODY MOC-DXA:radiographic test of the corporeal composition ( DXA: Dual X-ray Absorbometry) and of the ratio between thick/thin mass of each corporeal area (head, trunk, abdomen, upper limbs, lower limbs).

DOPPLER OF THE VENOUS VESSELS OF THE LOWER LIMBS AND AN ANGIOLOGY MEDICAL EXAMINATION to test the condition of superficial and deep venous circulation system, the presence of declivous oedema, of subjective sensation of heavy legs, of pain under finger pression and the eventual worsening of the clinical situation in a patient with varicose pathology at the lower limbs ( 1 patient).

CAPILLAROSCOPY of the nail-bed of the big toe. The test, by stereomicroscope Olimpus 20X, showed: the circulation speed, the texture of the bed, periangio, calibre, ansa, number and morphology (normal, minor dystrophy, telangiectasia, mega capillaries and/or microaneurysm).

STANDARDIZED PHOTOGRAPHIC TEST: digital photographs, Polaroid and slides of the patients before and after the treatment, in 4 different projections.

RESULTS

1) PATIENTS OF CONTROL GROUP B:

CLINICAL TEST: in one case they had an increase in the weight of 3,5 kilos and in 2 cases they lost 1 kilo and 2,1 kilo respectively. They noticed no alteration in the cutis morphology.

PLICOMETRIA: the increase and loss in weight correspond to increase and reduction of subcutaneous thickness of the tested areas ( see ecography in methods and materials). The patients who didn’t change their weight (65%) didn’t change the thickness above mentioned.

MEASURING OF THE CORPOREAL CIRCUMFERENCES: the increases and losses in weight correspond to increases and reductions in the studied areas (see ecography in materials and methods). In the cases of patients with constant weight, circumferences didn’t change.

ECOGRAPHY OF SUBCUTANEOUS: the thickness of the subcutaneous membrane in the studied areas did change in accordance with the variations in the weight of the patients, keeping almost identical in the cases of unvaried weight.

TOTAL BODY MOC-DXA: a variation in weight corresponds to a variation in the fat mass homogeneously in all the tested corporeal areas. Nothing changed in the patients who kept their weight.

DOPPLER OF THE VENOUS VESSELS OF THE LOWER LIMBS AND ANGIOLOGY MEDICAL EXAMINATION: neither significant variation of vascular flux, nor of declivous oedema (35%), of eventual sensation of heaviness at the lower limbs (25%) and of pain under finger pression (35%).

CAPILLAROSCOPY: the test of the nail-bed of the big toe didn’t show any prominent variation.

PHOTOGRAPHIC TEST: no change in the patients who kept their weight at the beginning of the experiment. An increase in weight corresponds to harmonious increase in the corporal image in each photographed areas, with a slight worsening, in one case, of the orange-peel look.

2) PATIENTS OF GROUP A

CLINICAL TEST: 6 patients in a group of 11, lost their weight from 0,5 to 2,8 kilos, 5 patients had an increase from 0,5 to 2 kilos.

8 patients (75%) in a group of 11 did improve the orange-peel look of their thighs and glutei, with bigger improvements in the subjects with adipose and fibrous adipose cellulites (stadium 1° - 3°).

Such an improvement was also seen in the patients who had an increase in their weight:

The other 3 patients did improve (25%) all the parameters (see below), but didn’t significantly change morphology (see photographic test).

There were neither cases of allergic reaction, nor skin inflammations caused by an extended use of the sheath.

PLICOMETRIA: all the patients had a reduction from 2 to 5 mm of the subcutaneous adipose membrane in the areas covered by the sheath. The same reduction was also observed in subjects who took weight.

MEASUREMENT OF CORPOREAL CIRCUMFERENCES: all the patients had a reduction of the circumference in the areas covered by the sheath with the following values:

  • Hips: 1 - 2,7 cm
  • Fore thigh: 0,5 – 3 cm
  • External thigh: 1 – 2,1 cm
  • Internal thigh: 0,5 – 2 cm
  • Epigastrium abdomen: 0,3 – 2 cm
  • Hypogastrium abdomen: 0,5 – 4 cm
  • Glutei: 0,5 – 3 cm

ECOGRAPHY OF THE SUBCUTANEOUS:

All the patients had a reduction of the subcutaneous adipose membrane going from 2 mm to 1,7 cm in the areas covered by the sheath.

The less significant reduction concerned the epigastrium, an area with a smaller elastic compression, while the most important one concerned the hypogastrium, the glutei and the lateral region of the thighs, areas in which the sheath exerts a bigger elastic compression and has got a double layer of fabric with the greatest effect of connective and lymphatic micro massage.

3 patients (25%) had a reduction in the ecogenicità of the adipose membrane with a reduction of the fibrous component of the interstitial stroma.

TOTAL BODY MOC-DXA: 6 patients in a group of 11 had a reduction of the fat mass of the lower limbs. The patients who took weight had an increase of the fat mass in the other tested areas (head, trunk, abdomen, upper limbs) while the fat mass of the lower limbs increased with a lower percentage and, in 2 cases, it did slightly lessen.

DOPPLER OF THE VENOUS VESSELS OF THE LOWER LIMBS AND AN ANGIOLOGY MEDICAL EZAMINATION:

The Doppler test of the venous flux in the lower limbs didn’t show any change in the patient with a varicose pathology who clothed the sheath.

7 patients in a group of 11 (65%) had an improvement of the oedema from stasis they presented before the study and a reduction of pain at finger pression.

CAPILLAROSCOPY: the test of the nail-bed of the big toe didn’t show any change. In one case there was an improvement of the calibre of the capillary vessels (irregular before, normal after) and in an other case there was the disappearance of microaneurysm and more evident vascular ansa (insignificant data on the other hand).

There was no case of worsening in the microcirculation.

PHOTOGRAPHIC TEST: it showed a notable reduction of the corporeal circumferences and an improvement of the orange-peel look of the skin in the areas covered by the sheath in 8 patients in a group of 11 (75%) with best results in the patients with cellulites of degree 1° - 2° - 3°.

It is important to point out that there was an improvement of the orange-peel look of the skin and the lifting of the gluteus even in the patients whop were overweight and who had, a fibrous cellulites and didn’t show an objective and photographically taken reduction of the circumference of thighs, glutei and hips, even though it was shown by the clinical tests.

3) PATIENTS OF GROUP C

The specialist angiology medical examination and the Doppler test before and after the use of the sheath for 12 hours a day for 8 weeks didn’t show any change of venous flux and of the morphology of the lower limbs, even in the 3 patients suffering from serious varicose syndrome (see enclosure F).

CONCLUSIONS

The study in order to know the effects of Lipocontour elastocompressive sheath in the circumference reduction of hips, abdomen, thighs and glutei and in the improvement of so called cellulites proved the effectiveness observed in previous clinical analyses and the total absence of pejorative changes in superficial and deep venous circulation in subjects suffering from varicose disease at the lower limbs.

The sheath is made of thin elastic fabric with areolae stitches helping perspiration and, during the daily movement, it induces a lymphatic and connective micro massage for 12 hours per days during a period of 8 weeks. It allows the re-absorption of oedema from the staunching of the interstitial liquids peculiar to the genesis and to the autokeeping of the so called "cellulites", helping the drainage through compressions gradually decreasing, oriented in caudal cranial direction, following the lymphatic vessel course and showing, very clearly, the typical effects of the sheath in the areas it treats, with significant changes in what concerns the circumference reduction of thighs, hips, glutei, and the improvement of the orange-peel look of the skin in 75% of the cases.

In the remaining 25% (fibrous cellulites and cases of strong over weight) the reduction of the subcutaneous tissue ecogenetics, the reduction in the adipose membrane thickness, seen through ecography in the areas covered by the sheath, even in the cases of increase in weight during the study, anyhow demonstrate and prove the clinical effectiveness of Lipocontour.

After all the modelling effect with maintenance and/or increase of cutaneous tonicity of the areas submitted to elasto-compression, seen in all the treated patients, could be explained by the micro massage effect of the connective fibres of derma and the distribution-alignment of the same, following the tension lines of the Langers skin, lines followed by the pattern support of the sheath itself that hold up the reduction of the subcutaneous thickness with a tension towards the up, in order, only to avoid prolapse, but also helping the vertical distribution in particular at the glutei level.

At the best we can also suppose an effect on lipolysis of modulated elastocompression; it would be the consequence of a minor staunching of the interstitial liquids and so of an easier reaching of lipolitic hormones (thyroid-catecolamine…) from the vessel bed directly to the adipociti.

It follows that the sheath operates on the etiopatogenesis of the pannicolopatia fibroedematosclerotica, also called cellulites, that is nothing else but a "Modification of the adipose connective tissue due to a reduced lymphatic and venous microcirculation in the subcutaneous area, with oedema and consequent constriction of the adipociti for the increase of interstitial liquid of the intercellular fibrous septa". (Bartoletti)

The improving effects from the use of the sheath kept steady, even one month after its disuse with constant food and life styles.

In future they will study the effects, at a longer distance, of the interruption in the use of Lipocontour, even if they already studied the effects on patients who underwent an operation of liposuction.

The typical effects of the Lipocontour sheath will be published in the most important and worldwide spread review of Plastic Surgery "Plastic and Reconstructive Surgery" edited by Williams & Wilkins, Baltimore, Usa, official organ of the American Society of Plastic and Reconstructive Surgery.

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