(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY(PCT)
`
`(rl
`
`
`
`PCT
`
`UMUCACORAAT
`
`(10) International Publication Number
`WO 2008/060494 A2
`
`(19) World Intellectual Property Organization
`International Bureau
`
`(43) International Publication Date
`22 May 2008 (22.05.2008)
`
`(51) International Patent Classification:
`BO6OL 7/00 (2006.01)
`(21) International Application Number:
`PCT/US2007/023709
`
`(22) International Filing Date:
`9 November 2007 (09.11.2007)
`English
`English
`
`(25) Filing Language:
`(26) Publication Language:
`(30) Priority Data:
`US
`9 November 2006 (09.11.2006)
`60/857,807
`(71) Applicant (for all designated States except US): LUME-
`NIS, INC. [US/US]; 5302 Betsy Ross Drive, Santa Clara,
`CA 95054 (US).
`(72) Inventor; and
`(75) Inventor/Applicant (for US only): AGHION, Joseph
`HILAL]; Kiryat Yam (IL).
`(74) Agent: MIRABITO,A., Jason; Mintz, Levin, Cohn, Fer-
`ris, Glovsky and Popeo PC, One Financial Center, Boston,
`MA 02111 (US).
`
`(81) Designated States (unless otherwise indicated, for every
`kind of national protection available): AE, AG, AL, AM,
`AT, AU, AZ, BA, BB, BG, BH, BR, BW, BY, BZ, CA, CH,
`CN, CO, CR, CU, CZ, DE, DK, DM, DO, DZ. EC, EE, EG,
`ES, FI, GB, GD, GE, GH, GM, G'l. HN, HR, HU, ID, IL,
`IN, IS, JP, KE, KG, KM, KN, KP, KR, KZ, LA, LC, LK,
`LR, LS, LT, LU, LY, MA, MD, ME, MG, MK, MN, MW,
`MX, MY, MZ. NA, NG, NI, NO, NZ, OM, PG, PH, PL,
`PT, RO. RS, RU, SC, SD, SE, SG, SK, SL, SM, SV, SY,
`TJ, TM. TN, TR. TT. TZ, UA, UG, US, UZ, VC, VN. ZA,
`ZM, ZW.
`
`(84) Designated States (unless otherwise indicated, for every
`kind of regional protection available): ARIPO (BW, GH,
`GM, KE, LS, MW, MZ, NA, SD, SL, SZ, TZ, UG, ZM,
`ZW), Eurasian (AM, AZ, BY, KG, KZ, MD, RU, TJ, TM),
`European(AT, BE, BG, CH, CY, CZ, DE, DK, EE,ES, FL,
`FR, GB, GR, HU,IE, IS, IT, LT, LU, LV, MC, MT, NL, PL,
`PT, RO, SE, SI, SK, TR), OAPI (BF, BJ, CF, CG, CI, CM,
`GA, GN, GQ, GW, ML, MR, NE, SN, TD, TG).
`
`[Continued on next page]
`
`(54) Title: APPARATUS AND METHODFOR TREATING TISSUE
`
`(57) Abstract: An apparatus and method used
`for medical and/or cosmetic treatmentof a tis-
`
`sue, such as skin tightening, skin laxity and/or
`wrinkle reduction and or other skin flaws, in-
`cluding an energy source, a vacuum chamber
`and rollers which mayfacilitate easy sliding of
`the apparatus from onetreated area to another.
`The rollers may also prevent excessivefriction
`of the skin during the treatment. The energy
`source can be configured to emit energy based
`on the position of the apparatus onthe skin (.e.,
`the position of the rollers), as well as the pres-
`sure within the vacuum chamber. The vacuum
`
`level and energy emission can be changed or
`pulsed based onthe treatment regime.
`
`18--—~—~42
`
`
`
`
`
`
`
`
`
`wo2008/060494A2IIIIINTENAINTANIMINTIMATETMM
`
`

`

`WO 2008/060494 A2
`
`_IIMIUIMNUNMUIUINIARN INT TAG RITUAYTACTTA Mt
`
`Published:
`
`oe without international search report and to be republished
`upon receipt of that report
`
`

`

`WO 2008/06049+4
`
`PCT/US2007/023709
`
`APPARATUS AND METHODFOR TREATING TISSUE
`
`FIELD OF THE INVENTION
`
`The present invention relates to an apparatus and method useful in
`
`cosmetic or medical treatmentoftissue, in particular skin tissue.
`
`10
`
`BACKGROUND OF THE INVENTION
`
`There are various methods for cosmetic or medical treating of tissue, for
`
`example, a skin tissue, for reduction of wrinkles, skin tightening and other undesirable skin
`
`flaws. Some of these methods may beinvasive, dangerous, or painful.
`
`One non-invasive apparatus for treatment of tissue applies suction to the
`
`15
`
`skin to draw it into a chamber, where the skin is then treated with radio frequency (RF) energy
`
`via plate electrodes. However, in orderto treat large areas, the device must be moved around the
`skin from area to area, which may be painful dueto the friction, which may be aggravated by the
`
`suction. In order to solve this problem, it has been suggested to use a lotion to reducefriction;
`
`however, the lotion may be sucked into the device due to the suction and interfere withits
`
`20
`
`electrical and/or mechanical operation.
`
`It would be advantageous to have a non-invasive method
`
`for destroying or modifying tissue, whichis relatively easy, efficacious, and cost effective to
`
`apply, that solves this and other problems.
`
`SUMMARY
`
`25
`
`In general, in an aspect, the invention provides an apparatus for treating areas of the skin
`
`including a vacuum chamberincluding an opening configured to face an area of skin, a vacuum
`pump configured to add and removeair to and from the vacuum chamber, twoparallel rollers
`
`disposed in proximity to the opening of the vacuum chamberand configured to make contact
`
`with the skin, wherein the surface of at least one of the rollers is an electrical conductor, and the
`
`30
`
`point of contact between eachofthe rollers and the skin inhibits air flow into and outof the
`
`vacuum chamber, and an RF energy source operably coupled to at least one ofthe rollers and
`
`configured to transmit RF energyto theat least oneroller.
`
`Embodiments of the invention may further include one or more of the following features.
`
`The surface of at least one of the rollers can include a conductor portion and a non-conductor
`
`35
`
`portion. A pressure sensor can be configured to sense the air pressure in the vacuum chamber.
`
`

`

`WO 2008/060494
`PCT/US2007/023709
`A system controller can be operably connected to the pressure sensor and the RF energy source
`
`and can be configured to control amount of RF energy transmitted to the at least one roller based
`
`on the air pressure in the vacuum chamber. The surface of at least one roller can include
`
`protrusions. A timer can be operably connected to the vacuum pumpandthe RF energysource.
`
`A position indicator can be operably connectedto at least one roller and can be configured to
`
`determine the rotation rate of the roller as the apparatus moves across the skin. A power
`
`controller can be operably connected to the position indicator and the RF energysource, the
`
`powercontroller can be configured to increase the RF energy transmitted to theat least oneroller
`
`based on the rotation rate of the roller. An optical sensor can be configured to sense movement
`
`10
`
`of apparatus acrossthe skin.
`
`In general, in another aspect, the invention provides a methodoftreating skin including
`
`placing a vacuum chamberagainst the skin of a patient, wherein the vacuum chamberincludes
`
`twoparallel rollers configured to contact the skin and inhibitair flow into and out of the vacuum
`
`chamberas the vacuum chamberrolls across the skin, changingthe air pressure inside the
`
`15
`
`vacuumchamber, and providing energy to the skin throughatleast oneroller.
`
`Embodimentsof the invention mayinclude one or more of the following features.
`
`Providing energy to the skin can include providing energy throughtheat least one roller when
`
`the air pressure inside the vacuum chamberis less than a predefined value. Providing energy to
`
`the skin can include providing energy throughtheat least one roller after a predefined suction
`
`20
`
`time lapses. Providing energy to the skin can includeincreasing the intensity of the provided
`
`energy during a decreaseofair pressure in the vacuum chamber. Providing energy to the skin
`
`can include varying the intensity of the provided energy as the vacuum chamberrolls across the
`
`skin,
`
`25
`
`In general, in another aspect, the invention provides a system for treating skin with
`optical energy including a vacuum control device including a vacuum pump, a vacuum chamber
`with two parallel spaced rollers disposed at the opening of the chamber and configured to contact
`
`the skin, wherein the rollers inhibit air flow into and out of the vacuum chamberas the vacuum
`
`chamberis rolled on the skin, an optical energy source configured to emit optical energy onto the
`
`skin disposed within the vacuum chamber, and an optical control circuit operably connected to
`
`30
`
`the optical energy source and the vacuum control device.
`
`Embodimentsof the invention may include one or more of the following features. The
`
`vacuum control device can includea position sensor connectedto at least one roller and can be
`
`

`

`WO 2008/060494
`PCT/US2007/023709
`configured to detect the rotational position of the roller, wherein the rotational position can
`
`include a count of full rotations. The optical energy can be emitted based onthe rotational
`
`position of the roller. The vacuum control device can include a pressure sensor in the vacuum
`
`chamber, and the optical energy can be emitted based on the pressure in the vacuum chamber.
`
`The optical energy source can be an intense pulsed light (IPL). The optical energy source can be
`
`a laser.
`
`In general, in another aspect, the invention provides an apparatus for applying RF energy
`
`to the skin of a person including an RF energy source, and at least one roller coupled to the RF
`
`energy source, the roller including a circumferential surface disposed on the skin and configured
`
`10
`
`to transfer RF energy to the skin. In an embodiment, a vacuum system including a vacuum
`pumpcanbe configured to removeair from a vacuum chamber, wherein the at least oneroller is
`disposed in proximity to an opening on the vacuum chamber,and a partial vacuum can be
`
`generated in the vacuum chamberwhenthe opening andtheat least one roller are applied to the
`
`skin. The at least one roller can include a conductive portion and a non-conductive portion.
`
`15
`
`In general, in anotheraspect, the invention provides an apparatus for applying optical
`energyto the skin including a roller device with at least two rollers spaced apart, eachroller
`
`including a circumferential surface configured to be disposed on the skin, and an optical energy
`
`source disposed to transmit optical energy into the space betweenthe rollers.
`
`In an embodiment,
`
`a control device can be operably connected to the roller device and can be configured to detect
`
`20
`
`the motionofat least one roller, wherein the optical energy can be transmitted based on the
`
`motion of the at least one roller.
`
`In accordance with implementationsof the invention, one or more of the following
`
`capabilities may be provided. Electrical energy (e.g., RF and optical energy) can be applied to
`skin while the skin is being stretched in a vacuum chamber. Theelectrical energy can be based
`
`25
`
`on pressure within the vacuum chamber. The vacuum chambercan berolled along the skin. The
`
`rollers can act as electrodes. The position of the vacuum chamberandbe recorded, and the
`
`electrical energy can be applied based onthe position.
`
`These and other capabilities of the invention, along with the inventionitself, will be more
`
`fully understood after a review of the following figures, detailed description, and claims.
`
`30
`
`

`

`WO 2008/060494
`
`PCT/US2007/023709
`
`BRIEF DESCRIPTION OF THE FIGURES
`
`Theprinciples and operation of the system, apparatus, and methodaccordingto the
`
`present invention may be better understood with reference to the drawings, and the following
`
`description, it being understood that these drawings are given forillustrative purposes only and
`
`are not meant to be limiting, wherein:
`
`FIG. 1 is a schematicillustration of an apparatus according to one embodimentof the
`
`present invention;
`
`FIG. 1A is a schematic illustration of exemplary roller configurations;
`
`FIG. 2 is a flowchart describing steps of a method for treating tissue, according to some
`
`10
`
`embodiments of the present invention;
`
`FIG. 3 is a flowchart describing steps of a method fortreating tissue, according to other
`
`embodiments of the present invention;
`
`FIG. 4 is a flowchart describing steps of a method fortreating tissue, according to other
`
`embodimentsof the present invention; and
`
`15
`
`FIG. 5 is a flowchart describing steps of a method fortreating tissue, according to other
`
`embodiments of the present invention.
`
`It will be appreciated that for simplicity and clarity of illustration, elements shownin the
`
`drawingshave not necessarily been drawnto scale. For example, the dimensions of someof the
`
`elements may be exaggeratedrelative to other elements for clarity. Further, where considered
`
`20
`
`appropriate, reference numerals may be repeated among the drawingsto indicate corresponding
`
`or analogous elements throughoutthe serial views.
`
`DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
`
`Embodimentsof the invention provide techniquesfor treating of tissue. This treatment is
`
`25
`
`exemplary, however, and notlimiting of the invention as other implementations in accordance
`
`with the disclosure are possible.
`
`An apparatus for treating tissue according to some embodiments of the present invention
`
`may comprise vacuum contro! device including a vacuum pumpfor changing air pressure in a
`
`chamber. The chambermayinclude at least one opening which may be placed, for example, on a
`
`30
`
`treated tissue area. As the air pressure decreases, the treated tissue may be drawninto the
`
`chamber, for example,as a result of the pressure difference. The apparatus may include oneor
`
`two or morerollers installed at the opening of the chamber. The rollers mayrotate freely or
`
`

`

`WO 2008/060494
`PCT/US2007/023709
`substantially frictionlessly, such that when a force is applied to the apparatus, they rotate and the
`
`apparatus is movedalongthetreated tissue area. The rollers can be combined with a mechanical
`
`assembly configured to movethe rollers inwards and outwards across the opening to provide a
`
`massaging motionto the tissue drawn into the chamber. A lotion dispenser can be attached to
`
`the chamberand configured to provide lotion to the tissue. For example, the lotion can be used
`
`to reducefriction, to reduce impedance(e.g., improve electrical coupling), to provide medicine
`
`(e.g., anesthesia, drug), cosmetic material, or other photoactive additives to the treatmentarea.
`
`The vacuum pump mayprovidepulsesof air pressure having predefined period. The vacuum
`
`control device may provide pulses of air pressure having predefined shape.
`
`10
`
`An apparatus according to some embodiments of the present invention may further
`
`include an energy source, for example, an RF energy source. The energy source may provide
`
`energyto the rollers, for example, whenthe air pressure in the chamberis less then a predefined
`
`sufficient value, or after the lapse of a predefined time during which suction is applied. The
`
`rollers may be conductive. The rollers may, for example, conduct the provided energy to the
`
`15
`
`treated tissue, thus, for example, provide heat to the treated tissue. The energy source may
`
`provide increasing energy intensity during decrease ofthe air pressure in the chamber, thus, for
`
`example, providing increasing heatto the treated tissue.
`
`According to some embodiments, the apparatus may comprise at least two energy
`
`transmitting elements. The energy transmitting elements may transmit, for example, energy from
`
`20
`
`the energy sourceto the rollers. The energy transmitting elements may enable energy
`
`transmissionto the rollers during rotation, for example, without a fixed wire connection to the
`
`rollers. For example, the energy transmitting elements maybe electrical brushes.
`
`A methodfortreating tissue according to some embodiments of the present invention
`
`may include changingthe air pressure inside a chamber. The method may further include, for
`
`25
`
`example, providing energyto the treated tissue throughat least oneroller installed at an opening
`
`of the chamber, for example, whenthe air pressure in the chamberis less then a predefined
`
`value. The method may further include, for example, increasing intensity of the provided energy
`
`during decrease ofthe air pressure in the chamber. The method mayfurther include, for example,
`
`sliding the apparatus on the treated tissue by rolling therollers.
`
`30
`
`The following description is presented to enable one of ordinary skill in the art to make
`
`and use the invention as provided in the context of a particular application andits requirements.
`
`Various modifications to the described embodiments will be apparent to those with skill in the
`
`

`

`WO 2008/060494
`PCT/US2007/023709
`art, and the general principles defined herein may be applied to other embodiments. Therefore,
`
`the present invention is not intended to be limited to the particular embodiments shown and
`
`described, but is to be accorded the widest scope consistent with the principles and novel
`
`features herein disclosed. In other instances, well-known methods, procedures, and components
`
`have not been described in detail so as not to obscure the present invention.
`
`In the following detailed description, numerous specific details are set forth in order to
`
`provide a thorough understandingof the present invention. However,it will be understood by
`
`those skilled in the art that the present invention may be practiced without these specific details.
`
`Embodiments of the present invention may provide an apparatus preferably used for
`
`10
`
`medical and/or cosmetic treatmentof a tissue, for example, for skin tightening, skin laxity and/or
`
`wrinkle reduction and or other skin flaws. Other conditions and tissues may be treated using
`
`embodiments of the present invention. The apparatus according to embodiments of the present
`
`invention enables treatment by using kneading, pressuring and/or stretching ofthe treated tissue,
`
`optionally combined with heat induced into the treated tissue, e.g., so as to modify, reduce or
`
`15
`
`destroy undesirable cells in the treated tissue. Preferably, apparatus according to the present
`
`invention mayinclude rollers which mayfacilitate easy sliding of the apparatus from one treated
`
`area to another. The rollers may also prevent excessivefriction of the skin during the treatment.
`
`Reference is now madeto FIG. 1, which illustrates an apparatus 10 to enable treatment of
`
`tissue 51 according to one embodimentof the invention. Apparatus 10 may include a vacuum
`
`20
`
`chamber 12 with a vacuum detection sensor. Pulses of changesin air pressure, e.g., vacuum
`
`pulses, may be delivered into vacuum chamber12, for example by a vacuum pump20. The
`
`vacuum pulses may, for example, effect kneading, pressuring and/orstretching oftissue 51.
`
`Drawing and/or expansion ofa treated section 53 into vacuum chamber 12 may be effected, for
`
`example, whenair ts pumped out of vacuum chamber12.
`
`25
`
`Apparatus 10 may further includerollers 16. Rollers 16 may, for example, facilitate
`
`drawing and/or expansion of treated tissue section 53 into vacuum chamber12, thus, for
`
`example, preventing excessive friction or tearing of the skin when the apparatus is moved along
`
`the skin or when the skin is drawn into the vacuum chamber12. Rollers 16 may enable easy
`
`sliding of apparatus 10 on the surface of tissue 51 from one section of tissue to another without
`
`30
`
`removing apparatus 10 from tissue 51. Therefore, for example, the treatment of a large area may
`
`be continuousand uninterrupted. Rollers 16 may beinstalled, for example, in a way that seals
`
`vacuum chamber12, for example, by inhibiting air-flow between vacuum chamber12 andtheair
`
`

`

`WO 2008/060494
`PCT/US2007/023709
`outside of the system of apparatus 10. The rollers 16 can be disposed on springs and configured
`
`to close into (1.e., pinch) the area of tissue 53 drawn into the vacuum chamber 12.
`
`In an
`
`embodiment, the apparatus 10 include an electro-mechanical assembly configured to movethe
`
`rollers 16 inward and outward across the opening of the vacuum chamber 12. The motion of the
`
`rollers 16 can be coordinated with the level of pressure within the vacuum chamber12 to create
`
`a squeezing or massaging motionas the tissue 53 movesinto and out of the vacuum chamber12.
`
`In some embodimentsof the invention, the surface of the rollers may be partially non-
`
`conducting. For example, the rollers may be divided into sections, for example, two outer
`
`10
`
`sections and an innersection. The outer sections, e.g., near the endsof the rollers, may have
`
`coating from rubber or another non-conducting material.
`
`In an embodiment, with reference to
`
`FIG. 1A, the rollers 16 include alternating bands of conducting 17a, b, c and non-conducting
`
`material configured to apply energy in patterns as the apparatus 10 is moved alongthetissue 51.
`
`For example, the rollers 16 include conductive 17a, b, c material protruding up from on a non-
`
`15
`
`conductive material in a fixed pattern, such as a herringbone, dots, or dashes. Therelative size
`
`and location of the conductive and non-conductive materials can be varied based on the
`
`treatment regime.
`
`In an embodiment,the roller 16 is conductive and includes non-conductive
`
`protrusions 17a, b, c. In general, the roller materials can be high in friction when in contact with
`
`the skin, such that the device can roll with the skin, and not slip or slide thereupon. In another
`
`20
`
`embodiment, the conducting portion of the rollers may not be entirely smooth, for example, they
`
`may haveprotrusionsor the surface of the electrode may be roughened. As an example, and not
`
`a limitation protrusions include small teeth similar to a gear assembly spaced aroundtheroller,
`
`scoring etched aroundtheroller, bumps or small hollow needles (e.g., micro-fabricated micro
`
`needles) disposed on theroller.
`
`25
`
`Apparatus 10 may include, for example, an energy source 18, which mayprovide
`
`electrical energy to at least one of the rollers 16, for example, RF energy. The energy may be
`
`provided from energy sourceto rollers 16 via transmitting elements 14. Rollers 16 may conduct
`
`energy, for example, to provide heat to treated section 53. In an embodiment, energyis
`
`conducted through the conductive material 17a, b, c, disposed on the roller 16. Energy
`
`30
`
`transmitting elements 14 may enable energy transmission to rollers 16 during rotation ofrollers
`
`16, for example, without a fixed wire connection to rollers 16. For example, transmitting
`
`elements 14 maybe electrical brushes or other contact-based electrical elements. As treated
`
`

`

`WO 2008/060494
`PCT/US2007/023709
`section 53 is expanded into vacuum chamber12, the transmitted energy may affect deeper layers
`
`of treated section 53, which may include undesirable cells in the treated tissue. The intensity of
`
`the energy provided to rollers 16 may increase, for example, during increase of the vacuum level
`
`inside vacuum chamber12, thus, for example, providing increasing heat to treated section 53
`
`during drawing of treated section 53 into vacuum chamber12 and therefore providing the
`
`highest level of energy when the deeperlayers of the skin are affected by the energy.
`
`Alternatively, the intensity of the energy provided to rollers 16 may increase as function of the
`
`suction time. The energy may beprovidedto rollers 16 only after treated section 53 is
`
`sufficiently drawn and/or expanded into vacuum chamber12. The heat gradient may be
`
`10
`
`controlled by the systemcontroller (not shown). Sufficient drawing and/or expansion may be
`
`ensured, for example, when the vacuum level is above a predefined sufficient vacuum level or
`after a predefined suction time lapses. The pulses of air pressure may be predefined and/or
`
`synchronized with the rotation of rollers 16 and/or with the energy transmissionto rollers 16.
`
`Preferably, rollers 16 may comprise a material which mayprevent skin burning For example,
`
`15
`
`rollers 16 may comprise conductors such as brass, stainless steel or aluminum, or combination
`
`thereof.
`
`In an embodiment, the rollers 16 include non-conducting material such as rubber,
`
`Teflon, and insulating oxide compositions.
`
`In some embodiments of the invention, there may be a counter attachedto the axle of at
`
`least one of the rollers to count the numberof rotations, and the device may thereby calculate the
`
`20
`
`rate of rotation of the rollers. This may allow for varying the energy based on the movementor
`
`speed of the device. For example, the energy may be increased whenthe device is moving faster
`
`and decreased whenthe device is moving more slowly, in order to provide even exposure of the
`
`tissue to treatment. Additionally or alternatively, there may be an optical sensor to sense
`
`movementof the device across the skin. In some embodiments, there may be a memory to keep
`
`25
`
`track of the location of the device based on its movementon the tissue.
`
`Some embodimentsof the invention may include an additional energy source (not
`
`shown), for example, an optical energy source, such as to emit intense pulsed light (IPL), laser,
`
`LED, orother optical energy,to treat skin drawn into the vacuum chamber.
`
`Reference is made to FIG. 2, which is a flowchart describing steps of a method for
`
`30
`
`treating tissue, according to some embodimentsof the present invention. As indicated in block
`
`110, the method may include changing the air pressure inside vacuum chamber12, for example,
`
`decreasing the air pressure in the chamber. Asindicated in block 120, the method may further
`
`

`

`WO 2008/060494
`PCT/US2007/023709
`include providing energy to tissue 51 through rollers 16, for example, whenthe air pressure
`
`inside vacuum chamber12 is less then a predefined value. Reference is now madeto FIG. 3,
`
`which is a flowchart describing steps of a method for treating tissue, according to other
`
`embodiments ofthe present invention. As indicated in block 130, the method mayinclude
`
`changingthe air pressure inside vacuum chamber12. As indicated in block 140, the method may
`
`include providing energy to tissue 51 throughrollers 16, for example, after a predefined suction
`
`time lapses.
`
`Reference is now madeto FIG. 4, which is a flowchart describing steps of a method for
`
`treating tissue, according to other embodiments of the present invention. As indicated in block
`
`10
`
`150, the method may include changingthe air pressure inside vacuum chamber12. Asindicated
`
`in block 160, the method mayinclude providing energy to tissue 51 through rollers 16. As
`
`indicated in block 170, the method mayinclude increasing the intensity of the provided energy
`
`during decrease of the air pressure in vacuum chamber12.
`
`Reference is now madeto FIG. 5, which is a flowchart describing steps of a method for
`
`15
`
`treating tissue, according to other embodiments of the present invention. Asindicated in block
`180, the method may include changingthe air pressure inside vacuum chamber12. Asindicated
`in block 190, the method mayinclude providing energyto tissue 51 through rollers 16. As
`indicated in block 200, the method mayinclude sliding apparatus 10 on tissue 51 by rolling
`
`.
`
`rollers 16, for example, in order to move apparatus 10 to anothersection ofthe treated tissue.
`
`20
`
`Sliding the apparatus can include movingtherollers 16 in a pinching or massaging motion as
`
`energy is providedto the rollers 16.
`
`The foregoing description of the embodiments of the invention has been presented for the
`
`purposesofillustration and description. It is not intended to be exhaustive orto limit the
`
`invention to the precise form disclosed. It should be appreciated by personsskilled in the art that
`
`25
`
`many modifications, variations, substitutions, changes, and equivalents are possible in light of
`
`the aboveteaching.It is, therefore, to be understood that the appended claims are intended to
`
`coverall such modifications and changesasfall within the true spirit of the invention.
`
`Further, while the description aboverefers to the invention, the description may include
`
`more than one invention.
`
`30
`
`Whatis claimed is:
`
`

`

`WO 2008/060494
`
`PCT/US2007/023709
`
`CLAIMS
`
`1,
`
`An apparatusfor treating areas of the skin comprising:
`
`a vacuum chamberincluding an opening configured to face an area of skin;
`
`a vacuum pumpconfigured to add and removeair to and from the vacuum chamber;
`
`two parallel rollers disposed in proximity to the opening of the vacuum chamber and
`configured to make contact with the skin, wherein the surface ofat least one of the rollers is an
`electrical conductor, and the point of contact between each of the rollers and the skin inhibits air
`
`flow into and out of the vacuum chamber; and
`
`10
`
`an RF energy source operably coupledto at least one of the rollers and configured to
`
`transmit RF energyto the at least oneroller.
`
`2. The apparatus of claim 1 wherein the surface ofat least one ofthe rollers includes a
`
`conductor portion and a non-conductorportion.
`
`15
`
`3. The apparatus of claim 1 further comprising a pressure sensor configured to sense the
`
`air pressure in the vacuum chamber.
`
`4. The apparatus of claim 3 further comprising a system controller operably connected to
`
`20
`
`the pressure sensor and the RF energy source and configured to control amountof RF energy
`
`transmitted to the at least one roller based on the air pressure in the vacuum chamber.
`
`5. The apparatus of claim 1 wherein the surface of at least one roller includes
`
`protrusions.
`
`25
`
`6. The apparatus of claim 1 further comprising a timer operably connected to the vacuum
`
`pumpandthe RF energy source.
`
`7. The apparatus of claim 1 further comprising a position indicator operably connected
`
`30
`
`to at least one roller and configured to determinethe rotation rate of the roller as the apparatus
`
`moves across the skin.
`
`10
`
`

`

`WO 2008/060494
`PCT/US2007/023709
`8. The apparatus of claim | further comprising a power controller operably connected to
`
`the position indicator and the RF energy source, the powercontroller configured to increase the
`
`RF energy transmitted to the at least one roller based on the rotation rate of the roller.
`
`9. The apparatus of claim 1 further comprising an optical sensor configured to sense
`
`movementof apparatusacross the skin.
`
`10. A methodof treating skin comprising:
`
`placing a vacuum chamberagainst the skin of a patient, wherein the vacuum chamber
`
`10
`
`includes twoparallel rollers configured to contact the skin and inhibitair flow into and outofthe
`
`vacuum chamberas the vacuum chamberrolls across the skin;
`
`changing the air pressure inside the vacuum chamber; and,
`
`providing energy to the skin throughatleast oneroller.
`
`15
`
`11. The method of claim 10 wherein providing energy to the skin includes providing
`
`energy throughthe at least one roller whenthe air pressure inside the vacuum chamberis less
`
`than a predefined value.
`
`12. The method of claim 10 wherein providing energy to the skin includes providing
`
`20
`
`energy throughtheat least one roller after a predefined suction time lapses.
`
`13. The method of claim 10 wherein providing energy to the skin includes increasing the
`
`intensity of the provided energy during a decreaseof air pressure in the vacuum chamber.
`
`25
`
`14. The method of claim 10 wherein providing energy to the skin includes varying the
`
`intensity of the provided energy as the vacuum chamberrolls across the skin.
`
`15. A system for treating skin with optical energy, comprising:
`
`a vacuum control device including a vacuum pump, a vacuum chamberwith twoparallel
`
`30
`
`spaced rollers disposed at the opening of the chamberand configured to contact the skin,
`
`wherein the rollers inhibit air flow into and out of the vacuum chamberas the vacuum chamber
`
`is rolled on the skin;
`
`11
`
`

`

`WO 2008/060494
`PCT/US2007/023709
`an optical energy source configured to emit optical energy onto the skin disposed within
`
`the vacuum chamber; and
`
`an optical control circuit operably connected to the optical energy source and the vacuum
`
`control device.
`
`16. The system of claim 15 wherein the vacuum control device includes a position
`
`sensor connectedto atleast one roller and configured to detect the rotational position of the
`
`roller, wherein the rotational position includes a countoffull rotations.
`
`10
`
`17. The system of claim 16 wherein the optical energy is emitted based on the rotational
`
`position of theroller.
`
`18. The system of claim 14 wherein the vacuum control device includes a pressure
`
`sensor in the vacuum chamber,and the optical energy is emitted based on the pressure in the
`
`15
`
`vacuum chamber.
`
`19. The system of claim 14 wherein the optical energy sourceis an intense pulsed light
`
`(IPL).
`
`20
`
`20. The system of claim 14 wherein the optical energy source is a laser.
`
`21. An apparatus for applying RF energyto the skin of a person, comprising:
`
`an RF energy source; and,
`
`at least one roller coupled to the RF energy source, the roller including a circumferential
`
`25
`
`surface disposed on the skin and configured to transfer RF energyto the skin.
`
`22. The apparatus of claim 21 comprising a vacuum system including a vacuum pump
`
`configured to removeair from a vacuum chamber, wherein the at least oneroller is disposed in
`
`proximity to an opening on the vacuum chamber, and a partial vacuum is generated in the
`
`30
`
`vacuum chamber whenthe openingandtheat least one roller are applied to the skin.
`
`23. The apparatus of claim 21 wherein the at least one roller includes a conductive
`
`12
`
`

`

`WO 2008/060494
`
`portion and a non-conductiveportion.
`
`PCT/US2007/023709
`
`24. An apparatus for apply