The body contouring market is one of the fastest evolving and in-demand markets to date, with new devices appearing regularly.1 Low-level laser therapy (LLLT) – also known as photobiomodulation, cold laser therapy, low-intensity light therapy or soft laser therapy – is a non-invasive, painless, no-trauma light source treatment that has started to be used for aiding fat loss in more recent years.
Here, we will present a case study showing a successful treatment for fat reduction using green laser.
What is LLLT?
Hungarian physician and surgeon Mr Endre Mester is credited with the discovery of the biological effects of low-power lasers, which occurred a few years after the 1960 invention of the ruby laser and the 1961 invention of the helium-neon (HeNe) laser. Mester accidentally discovered that low-level ruby laser light could regrow hair during an attempt to replicate an experiment that showed that such lasers could reduce tumours in mice.2
Since then, studies have shown that LLLT has excellent pain-relieving properties, as well as the ability to improve the functioning of various cells.2,3
For a long time, non-thermal LLLT has been confused with light emitting diode (LED). The main difference is that non-thermal lasers are collimated, unidirectional and monochromatic so this optimises photonic energy into the mitochondria of the fat cell, not losing any photonic energy en route as with a non-coherent light like LED.4 Research has shown the benefits of this modality through mitochondrial actions, cellular proliferation, intra and extra cellular communication, not to mention a restoration of mitochondrial DNA and other essential processes. As such, the benefits of low-level lasers are known to reduce pain, inflammation and oedema, prevent cell death and tissue damage and promote wound healing.3
Laser for fat reduction
In the last few decades, we’ve learnt a lot more about how light treatment, and more recently how green light treatment, works on fat reduction. For example, one study showed that low-powered green lasers in particular can help people lose body weight and achieve a smaller waist size.5 The study recruited 60 participants with a body mass index (BMI) between 25 and 30. All the participants took part in 12 identical LLLT treatments. The green lasers were targeted at the abdomen and central back for 30 minutes during each session. The participants were split into three groups of 20. They examined the participants before the study began and again at weeks four, six and 12. During the study, the participants did not make any drastic diet changes, simply drinking two litres of water and reducing sugar intake. All 60 of the participants lost 1-2kg of body weight. The waist measurements suggested that much of this weight loss came from the abdominal area.5 Other studies have also shown the effectiveness of green light on fat reduction.6,7 There are no reported side effects for this treatment.5-7
In our experience, green light therapy appears to achieve a significant improvement in fat loss treatment. Here, we will present a case study to evidence the positive effect of green LLLT therapy on a female patient and explain how we achieved this result in our practice.
A 54-year-old female patient presented to our clinic citing her main aesthetic concern as being her stomach and legs, as well as generally feeling tired and old. Her primary goal was to look slimmer and feel more confident. The patient was unsure what treatment would be best for her, but she was undergoing a weight loss programme at the time and wanted something that would speed up her progress. The patient had realistic expectations and understood that anything non-surgical was not a miracle, but she opted not to go down the surgical route as she wanted little downtime and found surgery to be less cost-effective. The patient was a non-smoker, had no medical conditions and had also never received any non-surgical aesthetic treatments in the past. The patient walked twice a day as a form of exercise and had a generally healthy diet.
During the consultation, we ran an analysis to record the patient’s weight, skeletal muscle mass and percentage body fat to ensure that this could be monitored throughout the treatment journey. We used the InBody device at our practice, and there are other such analysis machines on the market. Various treatment modalities were discussed with the patient. The options presented to her included LLLT for fat loss, high-intensity focused electromagnetic (HIFEM) therapy for muscle stimulation and strengthening and radiofrequency for skin tightening.
It was discussed during the consultation that LLLT would be the best treatment option over the other modalities available in our clinic because it was found that the patient had a body fat percentage of 44%, a BMI of 30 and a visceral fat score of 19/20. The patient had an overall wellness score of 57/100. The total score reflects the evaluation of composition, based on the weight of total body water (intracellular water and extracellular water), protein, minerals and body fat mass. This patient therefore had to debulk the body first and reduce body fat percentage before we could focus on body contouring, as she would not see optimal results with the other options until this had been done. At our clinic we use Emerald, which has a 532 nm wavelength, and an eight-session treatment programme with once-a-week treatments being advised.
The patient’s lifestyle, water intake and diet were also discussed in the consultation, and she was advised to drink a minimum of two litres of water per day before treatment began for a total of seven days. The patient was also advised to reduce sugar intake and saturated fat intake, but to continue with a balanced diet.
We asked her to keep track of daily changes and she was handed an Emerald Journey Diary whereby change in energy levels, sleep levels and lifestyle changes could be monitored daily. This would then be reviewed every week.
The patient did not require any disinfectant prior to treatment, as this specific laser does not disrupt the skin barrier, nor ever touch the patient’s skin. The patient laid comfortably on the treatment couch, while her abdomen was exposed and 10 low-intensity 532 nm lasers were applied for 15 minutes. The laser diodes target the subcutaneous fat creating a transitory pore in the adipose fat cells. Once this pore opens, the triglycerides and fatty material inside seep out into the interstitial space between the cells, causing the adipocytes to collapse and shrink in size. From there, the lymphatic system safely excretes fatty material through its normal process of detoxification.
The patient then had to lie on her front, where this process was repeated.5,6,7 The same was done for each of the following six sessions. Emerald laser has no pain or downtime, so the patient was able to return to her usual routine straight away following treatment.
Although the patient was advised a programme of eight treatments, she stopped after treatment seven as she was pleased with the results she had already achieved. After seven treatments over a period of seven weeks, the patient’s wellness score increased to 62/100, and her visceral fat decreased with a new score of 17/20. Her body fat percentage decreased to 40% and her BMI also dropped to 27. Our analysis showed her abdomen held 18.8kg of fat prior to treatment, but at the end the results showed 16.6kg – a decrease of 2.2kg in seven treatments. Following treatment, she felt more confident in her appearance, her jeans fit better and her energy levels had increased tremendously.
The patient was advised to live a healthy, balanced, active lifestyle and to continue with ongoing maintenance treatments once every six weeks for as long as the patient deemed necessary, as in our clinical experience, this can prolong and enhance the results. The patient was also advised a series of four HIFEM device treatments using the EMSCULPT NEO device to contour the body and strengthen the core, however, due to personal reasons, she has been unable to undergo the procedure as of yet. We do typically recommend using HIFEM for patients after treatment using laser, because after the fat has been emulsified with the Emerald, HIFEM can help release this emulsified fat from the body.
In recent years, LLLT has been used for many reasons such as to reduce pain, inflammation, and oedema, promote the healing of wounds, deeper tissues and nerves, as well as preventing cell death and tissue damage. More recently, green lasers have been used to tackle fat and fat reduction, with little to no downtime or side effects.
1. IMARC Group, Body Contouring Market, 2022
2. Chung H et al., The Nuts and Bolts of Low Level Laser Therapy, 2011, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3288797/>
3. Shiari R, Biological Effects of Low Level Laser Therapy, 2014, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291815/>
4. Photobiomodulation: Lasers vs Light Emitting Diodes, 2018, Hamblin M, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091542/>
5. Ebbert J et al., Low-level laser therapy for weight reduction: a randomized pilot study, 2019, <https://pubmed.ncbi.nlm.nih.gov/31473867/>
6. Suarez D et al., A double blind sham controlled study demonstrating the effectiveness of low level laser therapy using a 532 nm green diode, 2014
7. Roche G et al., Low-Level Laser Therapy for Reducing the Hip, Waist, and Upper Abdomen Circumference of Individuals with Obesity, 2017