[Lipolysis lasers].

We use lipolysis lasers for around five years. The principle of those lasers is that, for some wavelengths, the fat, located in the adipocytes reacts as a chromophor. In order to allow the direct exposure of the adipocytes to the optical fiber (around 1mm diameter), this has to be inserted in the hypodermis, then move back and forth inside the treated areas. The theorical benefits, compared to the liposuction procedures are related to the fact that the thermal effect of the laser emission allows to avoid laxity, sometimes observed after a liposuction. If we consider the first publications related to this emerging procedure, the profile of tolerance seems good, and even possibly better than the liposuctions. Nevertheless, this procedure with lasers is still a surgical procedure, exposing theorically to the side effects related in and after each surgery: infections, ecchymosis... Recently, some cases of severe side effects (infection of the skin, and necrosis) have been reported. They seem to be related to a homogeneous distribution of the energy inducing an excessive thermal injury. Some new improvements, with the last generation lasers, could allow us to avoid, or at least to dramatically reduce those side effects. The efficacy of those lasers is visibly satisfying; the key question is to precise the optimal modalities of use : in a surgery room, after an optimal training, with the last generation lasers?