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Being profitable procedures with little disposable costs, a number of noninvasive technologies have gained much popularity in recent years and are permeating the aesthetic marketplace. High-intensity focused ultrasound (HIFU) when focused at a targeted depth of 1.1 to 1.6 cm within subcutaneous tissue raises local tissue temperature at the focal point resulting in almost immediate cell death without damage to the surrounding tissues. Despite having gained popularity, little information is available regarding HIFU use for the treatment of localized fat and aesthetic body sculpturing. The current literature review is intended to investigate evidence-based efficacy of HIFU in aesthetic body contouring. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Subjects with localized fat deposits commonly receive suction lipectomy as a cosmetic procedure. A new office procedure for correction of those superficial fat deposits was applied in 50 patients by injection of phosphatidylcholine. The method itself consists of using a 3OG1/2 insulin needle to inject about 5 ml (250 mg/5 ml) of phosphatidylcholine into the fat, distributing it evenly in an 80 cm2 area. Pre- and posttreatment photographs were taken for technical planning and analysis of the results over the long term. A clear improvement occurred in all, with a marked reduction of the fat deposits without recurrence over a 2-year follow-up period and no weight gain. The injection of phosphatidylcholine into the fat deposits is a simple office procedure that can sometimes postpone or even replace surgery and liposuction.

Syringe liposculpture is a method that combines two relatively new techniques of plastic surgery: syringe liposuction and fat grafting. We can reshape the face and the body by removing localized fat deposits and reinjecting this fat where needed. When we do not reinject, we call the technique reduction liposculpture. In 1989 we introduced a new technique--superficial syringe liposculpture--to treat patients with flaccid skin, superficial irregularities or depressions, "cellulite," and liposuction sequelae. The technique combines syringe liposculpture, superficial liposuction, and our method of treating skin irregularities by breaking the fibrous adherences and injecting fat superficially.