Non-invasive and minimally invasive adipocyte apoptosis–inducing methods for the reduction of localized lipodystrophy in adults: a scoping review

Localized lipodystrophy, commonly known as localized fat, is a frequent aesthetic and clinical concern in adults and is associated with reduced self-esteem and quality of life. In recent years, there has been increasing demand for non-invasive and minimally invasive body-contouring procedures that are safer, more accessible, and capable of producing clinically meaningful reductions in subcutaneous fat. Many of these interventions act by inducing controlled adipocyte apoptosis, leading to a reduction in adipose tissue volume. Several technologies and agents based on this mechanism have been developed, including cryolipolysis, radiofrequency, high-intensity focused ultrasound (HIFU), high-intensity focused electromagnetic field (HIFEM), low-level laser therapy (LLLT), and injectable adipocytolytic agents such as CBL-514. Although primary studies report promising results, the evidence is heterogeneous, with variability in study design, treatment parameters, outcome measures, and populations. The aim of this scoping review is to systematically map and describe the scientific evidence on non-invasive and minimally invasive adipocyte apoptosis–inducing methods for the treatment of localized lipodystrophy in adults. The review will identify the types of interventions, populations, protocols, outcomes, and safety data reported in the literature, in order to summarize the current state of knowledge and identify gaps to guide future research in aesthetic and dermatofunctional physiotherapy.