This in vivo study shows histologic evidence of laser-induced damage of fat. With further development, this might become a useful treatment for disorders involving the fat and/or lower dermis.

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Background and Objectives: Use of thermal heating in microscopic zones has been applied for a number of applications. The objective of this study was to evaluate the benefits of using a 1,440-nm Nd-YAG laser (Affirm(TM), Cynosure, Westford, MA) using a different approach for microscopic heating. This device utilizes a microarray of lenses delivering a 10-mm beam as hundreds of regions of treatment distributed into high and low energy exposure. Study Design/Materials and Methods: Thirty-nine subjects (N ¼ 39) with superficial rhytides or scars received three to six treatments at 4-week intervals using the lens array. Total fluence ranged from 6.0 to 7.5 J/cm 2 . Zimmer air cooling was used for all treatments. No topical anesthetic was required. Results: Post-auricular histology showed areas of thermal injury up to approximately 250 m deep and 150 m wide. Of 80% patients who completed at least five treatments, 81% showed clinical improvement of 26-50% (on a quartile scale). The remainder showed less than 25% reduction in scars or rhytides. For the three treatment group, improvement in rhytides was 20%. Side effects were minimal and included mild post-treatment erythema and edema resolving within 24 hours. Pain during treatment was minimal.Conclusions: A 1,440-nm microlens array is a promising new approach to induce non-ablative neocollagenesis in the remodeling of scars and rhytids. Histologic evidence confirms the micro-columnar nature of collagen heating using this novel microlens array.