WO2014097288A2

WO2014097288A2 - Large area body shaping applicator

Info

Publication number: WO2014097288A2
Application number: PCT/IL2013/000094
Authority: WO
Inventors: Shimon Eckhouse; Avner Rosenberg
Original assignee: Syneron Medical Ltd
Current assignee: Syneron Medical Ltd
Priority date: 2012-12-21
Filing date: 2013-12-19
Publication date: 2014-06-26
Anticipated expiration: 2015-06-21
Also published as: CN104869971B; WO2014097288A4; KR20150099715A; WO2014097288A3; CN104869971A

Abstract

Apparatus comprising an array of individually controlled skin treatment units to be applied to a skin segment with each of the units comprising: a housing defining a cavity that fluidly communicates with a source of vacuum pressure, having an inner side terminated by a rim facilitating sealing of the cavity when the unit is applied to the skin, dimensions of the cavity being sufficient to accommodate a volume of a skin segment drawn into the cavity by the source of vacuum pressure to create a skin protrusion; wherein application and release of vacuum pressure to the unit generates a back and forth massaging movement of at least a portion of a volume of skin against the rim, and wherein each of the units of the array has at least two degrees of rotational movement with respect to an adjacent unit so that the array can conform to skin segment topography.

Description

LARGE AREA BODY SHAPING APPLICATOR TECHNOLOGY FIELD

[001] The present invention relates to an applicator for large area body shaping and to a method of operating the same. Such an apparatus relates to the field of equipment for non-invasive aesthetic treatments.

BACKGROUND

[002] Skin massage is a type of manipulation of superficial and deeper layers of skin and subcutaneous tissue layers. Massage involves acting on and manipulating the skin with pressure. The skin may be manipulated, typically kneaded, manually or with mechanical aids. Whether the massage is done manually or with mechanical aids it is applied to a segment of skin or tissue defined by the hands of the caregiver or the size of the mechanical aids. The remaining segments of the skin are treated by moving the hands or repositioning the mechanical aid across a larger skin segment. Target tissues may include muscles, tendons, adipose tissue and other segments of the skin and body. Because of the need to apply pressure to the skin and then repositioning the source of pressure during the treatment (i.e., moving the therapist hands or mechanical aid to a different area of the body), massage is associated with a significant amount of effort and attention that the caregiver has to apply.

[003] Adipose tissue is frequently treated non-invasively by different energies coupled to the skin. Typical types of energies that may be found in use for skin treatment include ultra sound (US) energy, Radio Frequency (RF) energy, or radiation energy emitted by a source of light or heat. The skin treatment energy is coupled to the skin by an applicator or skin treatment unit. The size of the applicator defines to some extent the segment of skin or tissue to which the skin treatment energy is transferred. In order to treat other skin segments, the applicator is repositioned across a large segment of the skin and activated to couple treatment energy to this segment of skin.

[004] Different types of energy are frequently used for circumference

reduction, adipose tissue removal, and other cosmetic procedures where application of skin treatment energy could bring a desired beneficial treatment effect. [005] Skin treatment systems normally include different units or applicators configured to massage skin including subcutaneous tissue. There could be units or applicators configured to couple to the skin different energies such as ultra sound (US) energy, Radio Frequency (RF) energy, or radiation energy emitted by a source of light or heat. In general, in the operation of the known existing treatment systems and devices, the size of the skin treatment unit or applicator defines the segment of skin or tissue size to which the treatment could be applied. For example, the size of a skin treatment unit could be 20x40mm or 40x80mm. In order to treat other or additional skin segments, the skin treatment unit is repositioned across a large segment of the skin and activated to couple to this additional segment skin treatment energy.

[006] Repositioning of the skin treatment unit requires a sensible effort on behalf of the caregiver. It complicates his or her work and because the service of providing a massage and/or providing other energy to skin application treatment sessions can take on the order of about 30 to 90 minutes, the time absorbed by repositioning the skin treatment unit decreases the treatment quality and efficiency.

[007] The skin treatment across a large skin segment also becomes nonuniform, because it is difficult for the caregiver to keep accurate and consistent skin treatment unit or applicator repositioning movement and treatment timing over a large skin segment.

[008] Repositioning of the skin treatment unit requires certain time and it depends on the skills of the caregiver. Faster applicator repositioning could to some extent improve homogeneity of the skin treatment results and reduce the treatment inefficiency, but the speed with which the caregiver manually repositions the applicator could be insufficient to achieve proper skin treatment homogeneity. In addition to this, the efficiency and precision of the caregiver changes during the course of the day or working shift and causes appearance of additional treatment artifacts. As a result, some skin segments are thus treated differently than other skin segments.

[009] There is thus a need to provide a skin treatment apparatus suitable for a large skin segment which improves, at least partially, skin treatment homogeneity. SUMMARY

[010] The present disclosure describes an apparatus and method, as well as variant features and aspects thereof, to effectively utilize a vacuum pressure to massage a volume of the skin and one or more types of skin treatment energies coupled to the massaged volume to treat the skin and

subcutaneous adipose tissue and produce a desired treatment effect.

[011] According to a first aspect an apparatus for large area body shaping is described. The apparatus comprises an array of individually controlled skin treatment units to be applied to a skin segment. Each of the skin treatment units comprises a housing defining a cavity that fluidly communicates with a source of vacuum pressure, with an inner side of the housing terminated by a rim facilitating sealing of the cavity when the skin treatment unit is applied to the skin, dimensions of the defined cavity being sufficient to accommodate a volume of a skin segment drawn into the defined cavity by the source of vacuum pressure to create a skin protrusion and wherein application and release of vacuum pressure to the skin treatment unit generates a back and forth massaging movement of at least a portion of a volume of skin against the rim and wherein each of the skin treatment units of the array has at least two degrees of rotational movement with respect to an adjacent skin treatment unit so that the array can conform to topography of the skin segment.

[012] According to this aspect, vacuum pressure is applied in a desired sequence to the cavities of the skin treatment units. Suction produced by the vacuum pressure draws volumes of skin into the cavities and, subsequently, venting the cavity with atmosphere or air releases the volumes of skin from the cavities. Further according to this aspect and due to the fact that each of the skin treatment units of the array has at least two degrees of rotational movement with respect to an adjacent skin treatment unit, the array may conform the topography of a treated skin segment which is usually not flat.

[013] It should nevertheless be understood that the way vacuum is created to draw volumes of skin into the cavities and, subsequently, the way the cavity is ventilated with ambient air (or any other air delivery source) in order to release the volumes of skin from the cavities is independent from the fact that the skin treatment units (and thus its cavities) are grouped together forming an array in which each skin treatment unit has at least two degrees of rotational movement with respect to an adjacent skin treatment unit. [015] In some embodiments, a valve is capable of switching between vacuum and atmosphere or a source of air pressure facilitates evacuating air from the cavity to draw the volume of skin therein and facilitating air into the cavity entry so that the volume of skin is released. The volumes of skin drawn and released are smaller than the treated skin segment to which the array is applied. The sequence of applying vacuum pressure and then releasing or reducing of the vacuum pressure generates a back and forth massaging movement of the skin segment tissue against the flared rims of the skin treatment units. The operational sequence of applying the vacuum pressure and the releasing or reducing of the vacuum pressure in the cavities along with the application of skin treatment energy to the volumes of skin can produce various patterns of skin treatments and subcutaneous movements.

[016] In some embodiments, the apparatus and method are based on coupling an array, or a number of arrays, as an assembly of skin treatment units with each skin treatment unit including a hollow cavity and a number of different energy to skin applying elements that are configured to receive skin treatment energy from a source of such energy and couple or apply the received energy to a treated segment of skin.

[017] In some of these embodiments, the apparatus and method couple skin treatment energy to the application/release of vacuum pressure during a massage treatment. Thus, embodiments of the apparatus and method operate to provide an automated massaging of a segment of skin either alone, or in conjunction with the application of skin treatment energy. The skin treatment energy may be selected from a group of energy types including, but not necessarily limited to light, RF, ultrasound,

electrolipophoresis, iontophoresis and microwaves. Each of these energy types, combinations thereof and in some examples, maybe even additional and/or alternative energy types may be delivered to the skin by energy to skin applying elements. The energy to skin applying elements may be located in one or more locations including inside the cavities, the flared rims of the cavities, separate units used in conjunction with the vacuum pressure apparatus or any combination thereof.

[018] In some embodiments, each of the skin treatment units of the array may have at least two degrees of translational movement with respect to an adjacent unit and skin treatment units connecting joints may allow stretching and tensioning of the array. For instance, the joints may allow movement of the element that connects two skin treatment units to each other and/or, the connecting element may be constructed of a material that can be stretched, such as a material with some level of flexibility or that has elastic like characteristics.

[019] In some embodiments, the array itself may have either a fixed or variable length. In some embodiments, the array may include a mount that has a variable length, the mount may be sized and shaped to couple and fix the array to a treated skin segment. In further embodiments, the skin treatment units may have any of the following, or combinations thereof, movement capabilities: two directional rotation, three directional rotation, vertical movement (up and down as in telescoping motion), etc. In addition, in some embodiments, the skin treatment units may be mounted on a flexible substrate thereby allowing the flared rims to settle on the non-uniform surface of the skin treatment area.

[020] In some embodiments, the skin treatment units may be made of thermally conductive material and may be operative together with the massaging action to reduce or eliminate hot spots and homogenize skin treatment energy across the large treated skin segment distribution. A control unit may control delivery of different types of skin treatment energy that could be delivered in pulse or continuous mode according to a skin treatment protocol. The control unit may synchronize the delivery of skin treatment energy with the application of vacuum pressure to create a massaging skin movement caused by alternating vacuum. The control unit may be operative to control the alternating sequence of vacuum application to the cavities of the skin treatment units as well as the air pressure that in some embodiments could be applied in order to release the skin drawn into the cavity.

[021] The possibility to provide a desired skin treatment protocol to a large segment of skin may facilitate homogenous skin treatment energy distribution across a large skin segment. The energy may be mechanical, such as massage or skin stimulating or heating energy. Different skin massage and skin treatment energy application patterns may facilitate selective treatment of a large segment of skin. They may also release the caregiver from an effort related to displacement of a skin treatment device across the treated skin segment, tracking previous skin treatment device location and determining its next location.

[022] Another aspect provides a method for operating an apparatus substantially as hereinbefore described.

[023] Additional objects, advantages and features of embodiments of the present apparatus will become apparent to those skilled in the art upon examination of the description, or may be learned by practice of the invention.

GLOSSARY

[024] The term "skin" as used in the present disclosure includes the outer skin layers such as stratum corneum, dermis, epidermis, and the deeper subcutaneous layers such as adipose tissue.

[025] The term "skin treatment energy" as used in the present disclosure means any one of energies facilitating achievement of a desired skin treatment effect. Such energies could be a mechanical energy, a thermal energy, and a mix of them.

[026] The term "energy to skin applying element" as used in the present disclosure means an element operative to receive skin treatment energy from a source of said energy and couple or apply the received energy to a treated segment of skin. An electrode applying RF energy to skin, an ultrasound transducer, a mechanical element, a source of light could be such elements.

BRIEF DESCRIPTION OF THE DRAWINGS

[027] Particular embodiments of the present invention will be described in the following by way of non-limiting examples, with reference to the appended drawings, in which:

[028] FIG. 1 A shows a simplified block diagram of an apparatus according to an embodiment;

[029] FIG. 1 B shows side view of an array of skin treatment units according to an embodiment;

[030] FIG. 2 is a simplified plan view of an array of skin treatment units according to an embodiment;

[031] FIGS. 3A-3G, collectively referred to as FIG. 3, illustrate a non-limiting example of the adaptability of an array of skin treatment units to the contour of target skin being treated;

[032] FIG. 3A is a perspective view illustrating the stretching movement of skin treatment units according to an embodiment;

[033] FIGS. 3B and 3C are simplified illustrations of an array of skin

treatment units respectively applied to a concave and a convex segment of skin according to an embodiment;

[034] FIGS. 3D and 3E are simplified illustrations of an array of skin

treatment units applied to an uneven segment of skin according to an embodiment;

[035] FIGS. 3F and 3G are simplified illustrations of an array of skin

[036] FIG. 4 is a simplified side view of a skin treatment unit according to an embodiment;

[037] FIG. 5 is a simplified illustration of a skin treatment unit showing the unit cavity according to an embodiment;

[038] FIG. 6 is a simplified cross section of a skin treatment unit of FIG. 4;

[039] FIG. 7 is a simplified illustration of a skin treatment unit showing the unit cavity according to an embodiment;

[040] FIG. 8 is a simplified illustration of a skin treatment unit showing the unit cavity according to an embodiment;

[041] FIGS. 9A and 9B, collectively referred to as FIG. 9, are simplified illustrations of RF electrode connections and operation according to an embodiment;

[042] FIG. 10 is a schematic illustration of a subject that wears an array according to an embodiment;

[043] FIG. 11 is a schematic illustration of a subject that wears a plurality of arrays according to an embodiment;

[044] FIG. 12 is a schematic illustration of a massaging action of an array according to an embodiment; and

[045] FIG. 13 is a schematic illustration of a massaging action of an array combined with application of skin treatment energy according to an embodiment.

DETAILED DESCRIPTION OF EMBODIMENTS

[046] Referring now to FIG. 1 A there is shown a simplified plan view of an apparatus according to an embodiment. Apparatus 100 comprises a control unit 104, an array 108 of individually controlled skin treatment units 112 connected between them by a joint 114 facilitating relative displacement and rotation of one skin treatment unit with respect to an adjacent unit, and interconnection umbilical cable 116 connecting between array 108 and control unit 104. It should be appreciated that the control unit 104 can be a processing unit attached as described to the array 108 or can be

incorporated into the array 108 itself, as a processing unit, a hardware device, etc. Control unit 104 could incorporate one or more sources of vacuum, e.g. vacuum pumps 120 and optionally one or more sources or air pressure such as air pressure pumps 124, and one or more skin treatment energy sources 128. Skin treatment energy sources 128 could be such as RF power sources, ultrasound driving power source or supply operative to drive ultrasound transducers, optical energy sources and other types of sources and a processor or processing unit 132. The processing unit PU 132 may be a personal computer or any other device consisting of hardware, firmware or processing capabilities and could include a memory 134 and be operative to govern operation of the sources of vacuum pump 120, air pressure pump 124 and skin treatment energy sources 128. Memory 134 could be operative to store a number of skin treatment protocols. The skin treatment protocols could be retrieved, when desired, by a caregiver or supplied for the treatment in an automatic way. PU 32 could accept temperature sensor 524 (see FIG. 5) reading signal from each of skin treatment units 112 cavities 408 (FIG. 4 to FIG. 9), and control according to the temperature sensor 524 reading energy sources that supply to each of skin treatment units 112 skin treatment energy. A display 136, which could be a touch display, could display the treatment process progress and could include a number of soft keys to set the skin treatment protocol or retrieve from memory 134 the skin treatment protocol. Alternatively a keypad or a keyboard could be used to set the skin treatment protocol. Both control unit 104 and array 108 could include a patient emergency button 140, facilitating instant stop of skin treatment procedure/s by the caregiver or by treated subject.

47] In addition, although the control unit 104 is shown as a separate unit connected by means of the umbilical cord 116, it will be appreciated that in some embodiments, the control functions and in particular the processing unit 132 could be arranged on board of the array 108 with an interface to a vacuum source and an air source or, the entire control unit 104, along with the vacuum source and air pressure source, vacuum and air valves, etc., could be incorporated into the array 108 as well as a combination of any of these configurations as well as other anticipated configurations. In addition, the vacuum source and/or air pressure source could be external and controlled/regulated by processor 132 that may be mounted on the array and operates to control the amount of pressure applied to the cavities of the skin treatment units.

[048] According to an embodiment, the control unit 104 may further comprise a splitter card 144 distributing and controlling activation of a vacuum pump 120, an air pressure pump 124, and at least one skin treatment energy source to each of the individually controlled skin treatment units 112 of array 108. The splitter card 144 also accepts temperature sensor reading signal from each of the cavities, and controls, according to the temperature sensor reading, energy sources that supply skin treatment energy to each of skin treatment units 112. The distribution and activation of vacuum, air pressure, and skin treatment energies could follow a desired skin treatment protocol and activate, as non-limiting examples, all of the skin treatment units 112, a group of skin treatment units 1 2, or selected skin treatment units 112. Although shown as a single unit, each of the vacuum pumps, air pressure pumps, and skin treatment energy sources could include a plurality of vacuum pumps, air pressure pumps, and skin treatment energy sources. An emergency button 140 may communicate with the splitter card 144 or PU 132 and activation of the emergency button 140 instantly discontinues supply of vacuum, air pressure, and skin treatment energies to all of the skin treatment units or applicators 112 of the array 08.

[049] According to the embodiment shown in fig. 1B, each of the of

individually controlled skin treatment units 112 of the array 108 may further comprise two RF electrodes 150 located in an interior of cavity 154, an electrically controlled RF switch 158 configured to connect RF energy provided by an electrically controlled RF power source 128 operative to deliver RF energy to RF electrodes 150, an electrically controlled vacuum valve 164 configured to connect the interior of cavity 154 to a source of vacuum, such as vacuum pump 120 operative to deliver vacuum to the interior of cavity 54. Control unit 04 may be configured to control RF switches 158, RF power source 128, and vacuum pump 120 to supply and release vacuum to and from the interior of cavity 154. Alternatively the above control functions could be supported and operated by splitter card 144. The RF energy is delivered to the RF electrodes 150 by wires (not shown) connected at one end to RF power source 128 and RF switches 158 connected in parallel to the other end of the wires. In a similar way one end of a vacuum tubing 162 is connected to the vacuum pump 120 and all of the vacuum valves 164 are connected in parallel to a second end of the vacuum tubing 162.

[050] Each of the individually controlled skin treatment units 112 of the array 108 could optionally include an electrically controlled air valve 166

(associated with the housing) configured to connect the interior of cavity 154 to a source of air. The source of air could be the ambient free air or an air pressure supply pump 124. The ambient air vents the cavity. Air entry into the cavity restores the skin drawn into the cavity to its initial position by releasing vacuum from inside the cavity. The pump 124 may be operative to deliver air pressure to the interior of the cavity 154, release the vacuum and force or push the skin out of the interior of cavity 154 and restore the skin drawn into the cavity to its initial position. The air pressure may be delivered through a tubing 170 with one end of the tubing connected to air pressure supply pump 124 and all of the air valves 166 connected in parallel to the second end of the air pressure supply tubing 170. Alternatively, and as it will be shown later a single three way valve 406 (see FIG. 4) could be used instead of two valves 164 and 166 maintaining the rest of the apparatus substantially the same. Furthermore, these alternatives are independent from the degrees of rotational movement in between adjacent skin treatment units.

[051] According to an embodiment, illustrated in FIG. 2, a splitter card 144 distributing and controlling activation of vacuum, air pressure, and skin treatment energies to each of array 108 of skin treatment units 112 could be associated with the array 108. It could control the vacuum valves 164 and vacuum pump 120, air valves 166 and air pressure pump 124, accept a temperature sensor reading signal from each of the cavities, and control according to the temperature sensor reading energy sources that supply to each of skin treatment units 112 skin treatment energy. Associating a splitter card 144 with the array 108 could simplify the interconnection umbilical cable 116. The distribution and activation of vacuum, air pressure, and skin treatment energies could follow a desired skin treatment protocol that could be retrieved from memory 134 or entered with the help of the keyboard or touch screen. Processor 132 or /and splitter card 144 could be configured to activate all of skin treatment units 112, a group of skin treatment units 112, or selected skin treatment units 112. In addition to this, a simpler control unit or a controller could be attached to each individual skin treatment unit 112. Emergency button 140 may communicate with splitter card 144 and activation of the emergency button 140 can be configured to instantly discontinue supply of vacuum, air pressure, and skin treatment energies to all of the skin treatment units or applicators 112 of the array 108.

[052] The treatment protocol stored in memory 134 or entered with the help of a keyboard or touch screen could include one or more of the following actions:

opening and closing of a vacuum valve 164 associated with a particular cavity 154;

switching ON and OFF RF switch 158 controlling RF energy supply to the particular cavity 154;

switching ON and OFF RF power supply 128;

switching ON and OFF the vacuum valve 166 controlling vacuum supply to the particular cavity 154;

switching ON and OFF RF the vacuum pump 120;

switching ON and OFF air valve 166 controlling air supply to the particular cavity 154, and

switching ON and OFF RF air pressure supply pump 124.

[053] The treatment protocol could also include sequence of the different actions and their duration. The treatment protocol could further include switching sequence of individual cavities 154 of the array and sequence of actions for each of the switched cavities 154. The sequence of the actions could be dependent on the RF energy supply to the particular cavity. For example, the treatment protocol defined sequence could be such as:

- selecting a first cavity to become operative;

- switching ON vacuum valve in first cavity;

- switching ON RF switch to first cavity;

- switching OFF RF switch to first cavity;

- switching OFF the vacuum valve in the first;

- switching ON air valve to first cavity;

- selecting a second cavity and repeating the same sequence.

[054] In another embodiment, the treatment protocol could include sequence of ultrasound driving power supply:

- selecting a first cavity to become operative;

- switching ON vacuum valve in first cavity; - switching ON switch controlling ultrasound driving power supply to the first cavity;

- switching OFF switch controlling ultrasound driving power supply to the first cavity;

- switching OFF the vacuum valve in the first;

- switching ON air valve to first cavity;

- selecting a second cavity and repeating the same sequence.

[055] Splitter card 144 could include and additional PU (not shown),

controlling the treatment processes performed by array 108. Such processes could include switching between the application of vacuum pressure or air pressure, switching on and off a particular skin treatment energy supply, selecting between various skin treatment energy supplies, or delivery between the individually controlled skin treatment units, accepting of valve 604 (FIG. 6) signal, accepting temperature sensor reading signals from each of the cavities, detection of the actuation of the emergency button and array release signals, and others.

[056] As shown in fig. 2, a mount 208 may be sized and shaped to couple and fix the array 108 to a treated skin segment. The mount 208 could be a belt type mount, such that a treated subject could wear array 108 when it is attached and fixed to a segment of skin. Although shown as a belt type, mount 208 could be in form of braces. In one embodiment both belt type mount and braces could be implemented. In yet another embodiment, the array 108 can be incorporated into a massage table or chair and allow a subject to recline on the table. In such an embodiment, the array 108 would conform to the shape of the subject's body in response to the gravitational force of the body against the array 108. In yet another embodiment, the array 108 may simply be laid across the subject and be weighted such that sufficient pressure is applied to the array 108 to force it to conform to the subject's body. In yet another embodiment, the array 08 can be incorporated into a wearable device, such as a jacket type device, a sleeve for sliding over a limb, etc. Other embodiments and variations will be apparent to the reader and these described ones are provided as non- limiting examples only.

[057] FIG. 3A shows a perspective view illustrating the stretching movement of skin treatment units according to an example. The figure shows an array 108 of skin treatment units 112 or applicators applied to a flat surface 300. The number of skin treatment units 112 has been given for illustration purposes only and it could be a larger or a smaller number than what is illustrated. Skin treatment unit 112-3 has been displaced relative to adjacent unit 112-2 in the directions indicated by arrow 304 (i.e., unit 112-3 would move in the opposite direction from or relative to unit 1 2-2) opening a gap 308 wider than the gap between units 112-1 and 112-2. The length and flexibility of joint 114 as well as the size of joint nests 312 determine the magnitude of the displacement or stretch. Joint 114 could be a dog-bone type joint that facilitates such a movement. Springs 316 could operate to apply in course of treatment certain tension or stretch to array 108 reducing the gap between the skin treatment units 112 and further attaching the skin treatment units 112 to the skin and upon completion of a treatment session to return skin treatment units 112 to their initial position. In one embodiment, the joint 114 may be made of a resilient material extending the magnitude of the displacement. In such a joint implementation, the joint is subject to a stretch sufficient to support the desired magnitude of the displacement extension and return skin treatment units to an initial position.

[058] Skin however has a complicated topography and to conform to the topography of the treated skin segment, each of the skin treatment units may have a number of rotational, torsional, and linear movement freedoms. FIGS. 3B and 3C are simplified illustrations of an array of skin treatment units applied to a concave surface 328 and a convex surface 332, such as segments of skin according to an embodiment. Each of the skin treatment units 112-1 through 112-3 of array 108 has a freedom of rotation as shown by arrows 336 and 340 (FIG. 3B) and arrows 342 and 344 (FIG. 3C) with respect to an adjacent unit. These rotational freedoms facilitate array 108 conformance to the topography of the treated skin segment and in particular to a concave skin segment 328 and a convex skin segment 332.

Displacement of skin treatment units 112 along joint 114, as explained above could further improve conformance of array 108 to the topography of the treated skin segment.

[059] FIGS. 3D and 3E show simplified illustrations of an array of skin treatment units applied to an uneven segment of skin according to an example. Each of the skin treatment units 112-1 through 112-3 of the array 108 has a freedom of translational movement as shown by arrows 346 and 348 (FIG. 3D) and arrows 352 and 354 (FIG. 3E) with respect to an adjacent unit. These translational movements are in different planes, which for simplicity of the explanations are shown as perpendicular planes. These planes are also different from plane 300 (see FIG. 3A) although translational movements indicated by arrows 346 and 352 could be in plane 300, but at an angle to translational movement 304.

[060] FIGS. 3F and 3G show simplified illustrations of an array of skin treatment units applied to an uneven segment of skin according to an example. Each of the skin treatment units 112-1 through 112-3 of array 108 has a freedom of rotational movement as shown by arrow 356 (see FIG. 3F) and arrow 360 (see FIG. 3G) with respect to an adjacent unit. These rotational movements are in a plane different from planes in which rotational movements indicated by arrows 336, 340, 342, and 344 take place (see FIGS. 3B and 3C).

[061] The joint 114 (see FIGS. 1 and 3) may be a dog-bone type joint that facilitates above-described movements. Joint 114 is subject to a stretch sufficient to support these translational and rotational movements between skin treatment units 112. Other types of joints such as Cardan joint, Hooke joint, resilient elements, and other similar elements facilitating at least two degrees of rotational movement, translational movement and some of the stretch between the adjacent units may also be used. In addition, rather than utilizing joints to create the flexibility of the array, the individual units can be mounted to a flexible substrate which would allow any or all of the aforementioned movements. In addition, the array can be created as illustrated in a single dimension, or the array can also be expanded to include two or more rows of individual units by employing any of the jointed or mounted techniques described herein as well as other techniques.

[062] To summarize, the array 108 may conform to the topography of the treated skin segment since each of the skin treatment units 112 possesses at least two rotational movements. Additional translational or linear movements of each of the skin treatment units 112 could further facilitate the ability of array 108 to conform the topography of the treated skin segment. The dog-bone type joint, or a similar joint supporting spatial movement in almost any direction in space with respect to the adjacent skin treatment unit may also help in conforming array 108 to the topography of the treated skin segment.

[063] FIG. 4 shows a non-limiting example of a simplified side view of a skin treatment unit 112. Skin treatment unit 112 is illustrated in this example as including a housing 404, which includes a hollow interior or cavity 408 formed inside of housing 404. Cavity 408 includes an aperture or outlet located in the wall of the skin treatment unit (i.e., such as at a first end 412 or elsewhere), to connection nipple 428 to fluidly interface with a source of negative pressure such as for example, a vacuum pump 120 or a source of positive air pressure, which could be ambient atmospheric air pressure or a higher pressure produced by pump 124. A suitable valve, such as a three way valve 406, controlled by the control unit 104 or splitter card 144 could simplify the communication. Alternatively, two valves similar to valves 164 and 166 (see FIG. 1) could be used instead of valve 406. These two valves 164 and 166 may also be controlled by the control unit 104 or the splitter card 144. A flexible hose (not shown) may connect between first end 4 2 of skin treatment unit 112 and sources of negative pressure or vacuum pump 120 and positive air pressure pump 124. A rim 416 terminates the second end of skin treatment unit 112. Rim 416 could have a width similar to the thickness of walls 420 of skin treatment unit housing 404; it could terminate by a gasket or other material that has a surface 424 that is substantially the same size as the rim 416 or, in other embodiments, a surface that is substantially larger than walls 420 and/or the rim 416 can be utilized.

Connectors 432 and 436 schematically shown as rectangles to simply illustrate their existence, facilitate delivery of different skin treatment energies from energy sources 128 to the treated segment of skin. It should be appreciated that any of a variety of connectors can be used for this interface.

[064] In use, surface 424 of rim 416 is applied to a treated skin segment and as such, the surface of the skin segment mated with the surface 424 operates to seal the hollow interior or cavity 408. The size of cavity 408 could be, as a non-limiting example, 20x40 or 40X80mm in size. Surface 424 of walls 420 could be flared outwardly to increase contact area with the surface of skin to provide a better seal between surface 424 and the skin. Operating the skin treatment unit 112 includes the application and release of vacuum pressure or negative pressure to cavity 408 of the skin treatment unit 112 through the valve 406 (o by using the two valves 164 and 166), connecting nipple or nozzle 428 with respective sources of vacuum pressure or negative pressure or air pressure source. Such operational sequence generates a back and forth massaging movement of the treated skin volume to which the surface 424 of rim 416 of the cavity is being pressed. Surface 424 of rim 416 could be coated with a low friction coating to enhance massaging of the treated skin.

[065] In a non-limiting example, the release of the vacuum pressure to cavity 408 of the skin treatment unit 112 (which facilitates in the back and forth massaging movement of the treated skin volume against the rim of the cavity) can be assisted by venting the cavity to the surrounding ambient air. The venting could be done through the outlet connecting nipple 428.

Alternatively positive air pressure may be delivered through outlet connecting nipple 428 or through another conduit or nipple (not shown). Such operation of skin treatment unit 112 would further enhance the intensity of the massaging movement. Control unit 104 (FIG. 1) could set the sequence, intensity and duration of application of the selected type of air pressure and vacuum to cavities 408.

[066] According to an example as illustrated in FIG. 5, energy to skin applying elements may be located on the inner surface of walls 420 of hollow interiors or cavities 408. Energy delivery elements could be such elements like RF electrodes 508, ultrasound transducers 512 (FIG. 5), light emitting objects such as Light Emitting Diodes (LEDs) 516 or laser diodes, optical fibers conducting laser light into the cavities, and other elements delivering different types of skin treatment energy to the skin. A skin temperature sensor 524, such as a thermistor, a thermocouple or a non-contact sensor such as an optical pyrometer as non-limiting examples, could be located in the hollow interior or cavity 408. The temperature sensing elements 524 can also or alternatively be located at other locations in the cavities or on the rim to get a sensing of skin temperatures at different locations. In another embodiment, the cavity or parts of the cavity and/or the energy delivery surfaces can be made of thermally conductive materials. During the treatment procedure, these parts made of thermally conductive material come to a thermal equilibrium with the skin. Temperature sensors can be inserted into these parts made of thermally conductive materials and can give indication of average skin temperature over these areas, which is useful for treatment control. Numeral 312 (see FIG. 3) and illustrated as element 520 in FIG. 5 refer to nests or a receptacle for accepting dog-bond type joints 114 or similar joints connecting between individual skin treatment units 112 of array 108 (FIG. 1) and facilitating the at least two degrees of rotational movement and two translational movements in different planes between skin treatment units 12 such that their spatial location can conform array 108 to the topography of the treated skin segment.

[067] FIG.6 shows a cross section view of the skin treatment unit of FIG. 5 at the line L-L Valve 604, which could be such as a valve disclosed in Patent Cooperation Treaty Publication WO2010/007619 by the same inventor and assigned to the same assignee and incorporated by reference, may be an assembly of a plate 608 and plunger 612, with spring 620 and a stopper disk 624. Alternatively, the valve 604 could be a solenoid valve or other valve mechanism. Plate 608 and plunger 612 of valve 604 have a freedom of linear movement in the axial direction as indicated by arrow 628. When the source of negative pressure 120 is applied to the valve 604, a negative force or vacuum is created within the hollow interior or cavity 408 such that if the rim of the skin treatment unit is pressed against the surface of the skin, a volume of skin is drawn into the cavity 408 forming a skin protrusion shown by broken line 632. The protrusion pushes plate 608 and plunger 612 with stopper disk 624 in the direction indicated by arrow 628A until it closes outlet connection nipple 428. As the negative pressure in cavity 408 falls, the protrusion recedes restoring the fluid/air connection with vacuum pump 120 (FIG. 1 ) thereby again opening the valve 604 to allow the application of the negative pressure. This repeated action of valve 604 may regulate the level of vacuum pressure in the cavity and thus, the magnitude of the protrusion of skin being drawn into the cavity. Other valve 604 structures such as two mated cones or two mated spheres may also be possible.

[068] According to the embodiment shown in fig. 7, RF electrodes 508 could be located on the external surfaces of the skin treatment unit such as for example, surface 424. According to the embodiment shown in fig. 8, RF electrodes 808 may extend beyond the inner surface of the cavity walls 420, sealing edges 424 of which could be flared outwardly to provide extended RF energy delivery surfaces and apply RF energy to heat not only the tissues within cavity 408, but to adjacent skin tissue about to be drawn into the cavities as well. In some cases, RF electrodes 508 could be located almost along the entire perimeter surface 424 (FIG. 7).

[069] FIG. 9 is a simplified illustration of RF electrode connections and operation according to an example. Array 108 is applied and fixed to a large segment of skin 900 such that it conforms to the large segment of skin topography. Vacuum pump 120 (see FIG. 1) generates a negative pressure within the hollow interiors or cavities 408 of skin treatment units 112 of about -0.1 bar to -0.9 bars, as a non-limiting example. The negative pressure or vacuum draws individual skin volumes into the cavities 408 of the skin treatment units 112 of array 108 and forms skin protrusions 632 within the cavities 408. As skin protrusion 632 grows in size, it occupies a larger volume of the cavity 408, and spreads in a uniform way inside of the cavity. Control unit 104 or splitter card 144 (illustrated in FIG. 1 and 2) may activate the supply of skin treatment energy to the RF electrodes only when a firm contact between the skin protrusion 632 and the RF electrodes 508 is established. The proximate electrodes 508 located on the inner surfaces of hollow interiors or cavities 408 of adjacent skin treatment units 112 may be connected together (FIG. 9B) by a connection 904 and switching done independently and symmetrically for each of the cavities. The RF energy may be delivered to the RF electrodes 508 by wires 906 and 908 connected at one end to RF power source 128 and RF switches 158 connected in parallel to other end of the wires.

[070] Such a connection of adjacent RF electrodes may increase the effective surface of the electrode and may facilitate homogenous heat in the treated skin segment distribution. The back and forth massaging movement of the skin (see FIG. 12) may further contribute to homogenous heat within the skin distribution and may prevent formation of "hot spots." Control unit 104 or splitter card 144 (FIG. 1 ) could control the RF energy supply to RF electrodes and the RF electrodes switching process. To avoid erroneous or the inadvertent supply of RF energy to the skin, a hardware interlock of RF delivery to RF electrodes could be implemented. Protrusion signal generated by valve 604 (FIG. 6) operative in each of cavities 408 could serve to activate/de-activate the supply of RF energy and also increase the treatment process safety.

[071] One of the applications of the present array may be the massaging of large segments of skin. FIG. 10 is a schematic illustration of a subject that wears array 1008 similar or identical to array 108. The subject lies on a massage bench 1004. Array 1008 may be applied to a large segment of skin, for example, to the abdomen of a treated subject and may be attached to the skin with the help of a mount 208. The mount may be sized and shaped to couple and fix array 1008 to a treated skin segment. Mount 208 could be a belt type mount. Proper cables and tubing could be employed to connect the array to control unit 104 and each of the skin treatment sources. Since belt mount 208 couples and fixes array 1008 to a treated skin segment, the caregiver maintains mobility and his hands are free. The caregiver could concurrently be involved in additional activities without affecting the treatment process. [072] Although shown as a one dimensional array, apparatus could include arrays which are two dimensional arrays or matrix type arrays and arranged in a variety of patterns

[073] FIG. 11 shows a schematic illustration of a subject that wears a similar array according to an embodiment. Array 1108 may be similar to array 108. It may comprise a plurality of skin treatment units 112 and may be configured to be worn on a limb, in this case a leg, of the treated subject. In a similar manner the array could be configured to be applied to a large segment of skin and treat or massage the lower or upper back, chest or other segments of the treated subject body. Proper cables and tubing could be employed to connect each skin treatment unit of the array to control unit and each of the skin treatment sources. Since array 1108 may be coupled and fixed to a treated skin segment, the caregiver can maintain mobility and his hands are free. The caregiver could concurrently be involved in additional activities without affecting the treatment process.

[074] As further shown in FIG. 11 , more than one array could be used to treat simultaneously or, according to a pretreatment protocol, a plurality of large skin segments of the treated subject. For instance, in FIG. 11 , the array 1108 is illustrated as providing treatment to the upper portion of the subjects' leg, while array 108 including skin treatment devices 112 connected to mount 208 may treat the torso.

[075] FIG. 12 shows a schematic illustration of a massaging action of an array according to an example. Array 108 is applied and fixed to a large segment of skin 1200 such that it may conform to the topography or contour of the large segment of skin. Vacuum pump 120 (illustrated in FIG. 1 ) may generate a negative pressure within the hollow interiors or cavities 408 of skin treatment units 112. As a non-limiting example, the negative pressure may be about -0.1 bar to -0.9 bars. Each of the cavities 408 may be individually controlled and connected to vacuum pump 120 and as such vacuum pressure could be supplied simultaneously to all of the cavities 408 or according to a selected treatment protocol to a number of cavities 408. The negative pressure or vacuum may draw individual skin volumes into cavities 408 of array 108 and may form in appropriate cavities skin protrusions 1204. As skin protrusion 1204 grows, it occupies a larger volume of cavity 408, and spreads inside the cavity and eventually pushing the valve 428 closed by moving plunger 508. Adjacent or more remotely located skin treatment units are subject to similar sequential application and release of vacuum. This sequential application and release of vacuum to the cavities 408 of the skin treatment units 112 may generate suction that draws and releases volumes of skin into the cavities generating in respective cavities skin protrusions 1204. The volumes of skin drawn and released are smaller than the treated skin segment 1200 to which array 108 may be applied and fixed. The sequential application and release of the vacuum pressure may generate (as shown by arrows 1208) a back and forth massaging movement of at least a portion of the large skin segment against the flared rims 416 of the skin treatment units 112. Sequential application of the vacuum pressure alone achieves or imparts the massaging movement of skin to a large segment of skin. Additional positive pressure produced by a pump 124 (as illustrated in FIG. 1) to a cavity when the vacuum phase is finished can enhance skin movement out of the cavity and therefore enhance the massage action. No other mechanical actuators and/or any moving parts are used in these illustrated embodiments. The massaging movement of skin could be applied simultaneously to a large segment of skin or according to a selected skin massaging protocol.

[076] Skin massaging imparts on the skin a mechanical massaging energy. According to an embodiment of the method additional types of skin treatment energy could be coupled to a large segment of skin 1200 concurrently with the application of vacuum pressure and massage. Such a skin treatment energy could be energy heating the skin. As a non-limiting example, the energy could include RF energy, ultrasound driving power, microwaves energy, and light energy. Different forms of energy according to different skin treatment protocols could be concurrently applied in each cavity and in different cavities.

[077] FIG. 13 shows a schematic illustration of a massaging action of an array combined with application of skin treatment energy according to an example. Safety of the application of the skin treatment energy to a subject's skin is a paramount requirement in every aesthetic and medical energy based treatment. Firm contact between energy to skin applying elements, which could be RF electrodes 508 or ultrasound transducers 512 and protrusion 1204 facilitates good energy transfer, avoids formation of hot spots on the RF electrodes, and other adverse effects. Such contact conditions may exist only when skin protrusion 1204 sufficiently fills cavity 408. Sensing of protrusion magnitude (or status) could provide feedback to control unit 104 or selector card 144 (FIG. 1 and 2) that controls one or more sources of skin treatment energy124 supplying RF energy to electrodes 508. Valve 604 could send such "protrusion status signal" to control unit 104 (FIG. 1 ) when the volume of skin sufficiently fills the cavity as required for safe skin treatment energy application or coupling. Alternatively, optical, resistive, capacitive, inductive sensors or any other types of sensors that may be suitable for the direct or indirect detection of the protrusion magnitude could be implemented.

[078] When firm contact between skin protrusion 1204 and electrodes 508 may be established, control unit switches ON skin treatment energy source 128 (FIG. 1 ), which could be an RF generator as a non-limiting example. RF generator could be a single generator supplying RF energy to the skin treatment units according to a desired skin treatment protocol or it could be a plurality of RF generators with each generator providing RF energy to a corresponding skin treatment unit. RF energy is supplied to drawn into cavity 408 skin volume or protrusion 1204. RF induced current may heat the skin volume 1204 and may produce or enhance the desired skin treatment effect, which could be adipose tissue reduction, body shaping, skin tightening and rejuvenation, contraction of collagen fibers and other aesthetic skin treatment effects. Firm contact between electrodes 508 and skin protrusion 1204 could be detected during the RF energy treatment by monitoring skin impedance between electrodes 508. The lower the skin impedance at the beginning of treatment, the better the contact between the RF electrodes and the skin forming protrusion 1204 may be.

[079] Commonly RF frequency could be in the range from 50KHz to 200MHz. Typically, RF frequency is from 100KHz to 10 MHz or from 100KHZ to 100MHz or, alternatively, from 300KHz to 3MHz. The RF power could be in the range from 0.5W to 300W. Typically, the range of the RF power is from 1 W to 200W or from 10W to 100W and it could be coupled into the skin in a pulsed or continuous mode or some other form of modulated delivery. RF induced current may heat the individual skin volumes 1204. The heating could be non-homogenous and different skin volumes could be heated to different and sometimes not desired temperatures. The control unit may be operative to govern the source or sources of skin treatment energy, which in this example are one or more RF generators. The control unit may set a skin treatment protocol and may synchronize the skin treatment protocol with the massaging movement, such that it may homogenize the skin treatment energy distribution across the large segment of skin. In addition housings 404 of skin treatment units 112 may be made of thermally conductive material that further enhances and homogenizes heat distribution across the large segment of skin.

[080] In some embodiments, the skin treatment units 112 in addition to RF electrodes 508 could include energy to skin applying elements operative to apply other or additional types of skin treatment energies. Such energies could be for example, ultrasound driving power applied to the protrusion or volume of skin drawn into cavity 408 by transducers 512 (FIG. 5) or Light energy applied by LEDs 516 or other devices.

[081] Further, in some embodiments, control unit 104 or selector/splitter card 144 (FIG. 1 ) switches ON skin treatment energy source 128, which could be an ultrasound driving power supply, only when firm contact between skin protrusion 1204 and transducers 512 is established. Ultrasound energy may be supplied to the skin volume 1204 that has been drawn into cavity 408. In one example, ultrasound could be used to preheat the treated skin volume 1204 and reduce its resistance, such that induced RF current will preferentially pass through preheated skin volume 1204 segments and enhance the desired skin treatment effect, which could be adipose tissue reduction, body shaping, skin tightening and rejuvenation, contraction of collagen fibers and other aesthetic skin treatment effects. Firm contact between transducers 512 and skin protrusion 1204 could be detected during the ultrasound energy treatment by depositing on the transducers a thin conductive layer not attenuating the ultrasound energy and monitoring skin impedance between the transducers.

[082] In some embodiments, moderately focused ultrasound may be used to impart a movement on the adipose tissue cells constituents that have a different density. The movement may cause rupture of the cell walls and may destroy the adipose tissue cells.

[083] Typically, the range of ultrasound driving power frequency may be from 500 kHz to 5MHz. Typically, the range of ultrasound power density may be 0.1W/cm2 up to 5W/cm2.

[084] The above-described apparatus and method could be used for aesthetic treatments such as adipose tissue reduction, body shaping, skin tightening and rejuvenation, contraction of collagen fibers and other aesthetic skin treatment treatments.

[085] It should be noted, however, that other and additional combinations of skin treatment energy and massage could be used to for skin treatment. These other forms of energy and massage are within the scope of the present disclosure and the claims.

[086] For reasons of completeness, various aspects of the present invention are set out in the following numbered clauses:

[087] Clause 1. An apparatus comprising:

an array of individually controlled skin treatment units to be applied to a skin segment with each of the skin treatment units comprising:

a housing defining a cavity that fluidly communicates with a source of vacuum pressure, with one side of interior of the housing terminated by a rim facilitating sealing of the cavity when the skin treatment unit is applied to the skin, dimensions of the defined cavity being sufficient to accommodate a volume of a skin segment drawn into the defined cavity by the source of vacuum pressure to create a skin protrusion and wherein application and release of vacuum pressure to the skin treatment unit generates a back and forth massaging movement of at least a portion of a volume of skin against the rim, and at least one energy to skin applying element to apply a skin treatment energy to the skin segment; and

wherein each of the skin treatment units of the array has at least two degrees of rotational movement with respect to an adjacent skin treatment unit so that the array can conform to topography of the skin segment.

[088] Clause 2. The apparatus according to clause 1 , wherein each of the skin treatment units of the array is configured to allow at least two translational movements with respect to the adjacent skin treatment unit and wherein the translational movements are in different planes.

[089] Clause 3. The apparatus according to any of clauses 1 or 2, wherein adjacent skin treatment units of the array are connected by a joint configured to allow spatial movement of the skin treatment units in multiple directions in space with respect to each other.

[090] Clause 4. The apparatus according to clause 3, wherein adjacent skin treatment units of the array are connected by a joint that can be stretched thereby allowing movement of the adjacent skin treatment units with respect to each other.

[091] Clause 5. The apparatus according to any of clauses 1 -4, wherein the array of individually controlled skin treatment units is a variable length array.

[092] Clause 6. The apparatus according to clause 5, wherein the variable length array further comprises a mount sized and shaped to couple and fix the variable length array to a treated skin segment such that the array can be worn.

[093] Clause 7. The apparatus according to any of clauses 1-6, wherein the array is configured to treat at least one of a group of skin segments consisting of abdomen, limbs, shoulder, lower back, and upper back.

[094] Clause 8. The apparatus according to any of clauses 1-7, wherein the rim of the defined cavity is coated with a low friction coating to enhance the massaging movement of the treated skin segment.

[095] Clause 9. The apparatus according to any of clauses 1-8, wherein the skin treatment unit includes a valve that regulates pressure level of the vacuum in the defined cavity and thus affects magnitude of the protrusion drawn into the defined cavity.

[096] Clause 0. The apparatus according to any of clauses 1-9, wherein the skin volume drawn into the defined cavity of the skin treatment unit is released by at least one action selected from a group actions comprising releasing of the vacuum pressure, reduction of the vacuum pressure, venting the defined cavity or applying a positive air pressure to the defined cavity.

[097] Clause 11. The apparatus according to any f clauses 1-10, further comprising a processing unit operative to govern operation of at least the source of vacuum pressure and at least one skin treatment energy source in accordance with a skin treatment protocol.

[098] Clause 12. The apparatus according to clause 11 , wherein the skin treatment protocol is at least one of a group of protocols consisting of a continuous delivery of the skin treatment energy and pulse delivery of the skin treatment energy.

[099] Clause 13. The apparatus according to clause 11 , wherein the control unit controls each of the skin treatment units and synchronizes delivery of the skin treatment energy and the application of vacuum pressure to homogenize the skin treatment energy distribution across a large segment of skin.

[100] Clause 14. The apparatus according to clause 13, wherein the housing of the skin treatment unit is constructed of a thermally conductive material to further facilitate the skin treatment energy distribution and homogenization across the large segment of skin.

[101] Clause 15. The apparatus according to any of clauses 1-14, wherein the energy to skin applying elements apply to the skin protrusion at least one of a group of skin treatment energies consisting of RF energy, ultrasound energy, microwave energy, and light energy.

[102] Clause 16. The apparatus according to clause 15, wherein the energy to skin applying elements are at least one of a group of elements consisting of RF electrodes, ultrasound transducers, LEDs, incandescent lamps, Xenon lamps and lasers.

[103] Clause 17. The apparatus according to clause 15, wherein RF

electrodes of adjacent skin treatment units are operated simultaneously to increase effective electrode surface.

[104] Clause 18. The apparatus according to any of clauses 1-17, further comprising a skin temperature sensor operative to sense the skin

temperature.

[105] Clause 19. The apparatus according to clause 18, wherein the skin temperature sensor is one of a group of sensors consisting of a thermistor, a thermocouple, or a non-contact optical sensor.

[106] Clause 20. The apparatus according to clause 18, wherein the skin temperature sensor is located in one of a group of locations consisting of the defined cavity and on a rim of the defined cavity.

[107] Clause 21. The apparatus according to clause 18, further comprising a processing unit and wherein based at least in part on the skin temperature sensor reading, processing unit controls energy sources to supply skin treatment energy to each of skin treatment units.

[108] Clause 22. The apparatus according to any of clauses 1 -21 , wherein massaging movement of the large segment of skin simplifies and reduces caregiver effort by reducing the amount of movements of the array by the caregiver.

[109] Clause 23. A method comprising the actions of:

coupling to a large segment of skin to be treated, a variable length array of individually controlled skin treatment units with each of the skin treatment units in the array comprising a housing that defines a cavity that fluidly communicates with a source of vacuum pressure and wherein each of the skin treatment units of the variable length array has at least two degrees of rotational movement with respect to an adjacent skin treatment unit;

sequentially applying and releasing vacuum pressure to the defined cavity to draw into the cavity volumes of skin and release the volumes of skin to generate a back and forth movement of the volumes of skin; and

wherein the rotational movement of the skin treatment units allows the variable length array to conform to topography of the treated skin segment and further, wherein the back and forth movement of the volumes of skin imparts a massaging movement to a large segment of skin.

[110] Clause 24. The method according to clause 23, further comprising the action of applying to the volumes of skin at least one skin treatment energy in accordance to a skin treatment protocol.

[I l l] Clause 25. The method according to clause 24, wherein the skin treatment protocol is at least one of a group of protocols consisting of a continuous delivery of the skin treatment energy and a pulsed delivery of the skin treatment energy.

[112] Clause 26. The method according to clause 24, further comprising the action of synchronizing the skin treatment protocol with the massaging skin movement to homogenize skin treatment energy distribution across the large segment of skin.

[113] Clause 27. The method according to any of clauses 23-26, further comprising facilitating the conformance of the array to the topography of the skin segment by providing an array that has a variable length and wherein each of the skin treatment units of the variable length array is able to move in at least two translational directions and wherein the translational movements are in different planes.

[114] Clause 28. The method according to any of clauses 23-27, further comprising facilitating the conformance of the variable length array to the topography of the skin segment by providing an array wherein the skin treatment units of the variable length array are connected by a joint supporting spatial movement in multiple directions in space with respect to an adjacent skin treatment unit.

[115] Clause 29. The method according to any of clauses 23-28, further comprising facilitating the conformance of the variable length array to the topography of the skin segment by providing an array wherein the skin treatment units of the variable length array are connected by a joint that can be stretched.

[116] Clause 30. The method according to any of clauses 23-29, wherein the housing of the skin treatment unit is constructed of a thermally conductive material that further facilitates the skin treatment energy distribution and homogenization across the large segment of skin.

[117] Clause 31. The method according to any of clauses 23-30, further comprising the action of applying skin treatment energy, through one or more energy to skin applying elements, to the volumes of skin wherein the skin treatment energy is at least one of a group of skin treatment energies consisting of RF energy, ultrasound energy, microwave energy, and light energy.

[118] Clause 32. The method according to any of clauses 23-31 , wherein the volumes of skin form a protrusion and the action of applying skin treatment energy to the protrusion through the one or more energy to skin applying elements apply the skin treatment energy to the protrusion when a firm contact between the protrusion and the energy to skin applying elements is established.

[119] Clause 33. The method according to any of clauses 23-32, further comprising the actions of applying skin treatment energy, through one or more energy to skin applying elements, to the volumes of skin, sensing the temperature of the volumes of skin through a temperature sensor and controlling the application of the skin treatment energy based at least in part on the temperature of the volumes of skin.

[120] Clause 34. The method according to any of clauses 23-33, wherein massaging movement of the large segment of skin simplifies and reduces caregiver effort.

[121] Clause 35. The method according to any of clauses 23-34, wherein a caregiver maintains mobility and is concurrently involved in additional activities without affecting a current skin treatment process.

[122] Clause 36. The method according to any of clauses 23-35, further comprising attaching more than one array to a treated subject and treating simultaneously a plurality of large skin segments.

[123] Clause 37. A device to provide automated massaging of a skin segment, the device comprising:

a housing that defines a cavity, an interface to the skin segment and pressure source interface, the interface to the skin segment includes a rim which when pressed against the skin segment substantially seals the defined cavity such that negative pressure applied to the pressure source interface draws a portion of the skin segment into the defined cavity and, releasing of the negative pressure allows the portion of the skin segment to at least partially vacate the defined cavity.

Clause 38. The device of clause 37, wherein the device includes an interface for connecting the device to additional similar devices but, that allows movement of the connected devices relative to each other to facilitate conformation of the connected devices to topography of the skin segment. [124] Clause 39. The device of clause 38, further comprising:

an interface to a source of skin treatment energy;

one or more surfaces on the housing that come in contact with the skin segment; and

connectivity between the interface to the source of skin treatment energy and the one or more surfaces such that skin treatment energy can be applied to the skin segment through the one or more surfaces.

[125] Although only a number of particular embodiments and examples of the invention have been disclosed herein, it will be understood by those skilled in the art that other alternative embodiments and/or uses of the invention and obvious modifications and equivalents thereof are possible. Furthermore, the present invention covers all possible combinations of the particular embodiments described. Reference signs related to drawings and placed in parentheses in a claim, are solely for attempting to increase the intelligibility of the claim, and shall not be construed as limiting the scope of the claim. Thus, the scope of the present invention should not be limited by particular embodiments, but should be determined only by a fair reading of the claims that follow.

Claims

1. An apparatus (100) comprising:

an array (108, 1008, 1108) of individually controlled skin treatment units 5 (112) to be applied to a skin segment with each of the skin treatment units (112) comprising:

a housing (404) defining a cavity (154, 408) that fluidly communicates with a source of vacuum pressure, with an inner side of the housing (404) terminated by a rim (416) facilitating sealing of the0 cavity (154, 408) when the skin treatment unit (112) is applied to the skin, dimensions of the defined cavity (154, 408) being sufficient to accommodate a volume of a skin segment drawn into the defined cavity (154, 408) by the source of vacuum pressure to create a skin protrusion (632, 1104, 1204) and wherein application and release of vacuum5 pressure to the skin treatment unit (112) generates a back and forth massaging movement of at least a portion of a volume of skin against the rim (416), and

wherein each of the skin treatment units (112) of the array (108, 1008, 1108) has at least two degrees of rotational movement (336, 340, 342, 344) with o respect to an adjacent skin treatment unit so that the array (108, 1008, 1108) can conform to topography of the skin segment.

2. The apparatus according to claim 1 , wherein each cavity (154, 408) comprises:

5 at least one electrically controlled vacuum valve (164) associated with each cavity (154, 408) and configured to connect the cavity (154, 408) to the source of vacuum pressure, the source of vacuum pressure being operative to deliver vacuum to the cavity (154, 408);

a vacuum tubing (162) with one end connected to the source of0 vacuum pressure wherein two or more vacuum valves (164) are connected in parallel to a second end of the vacuum tubing (162); and

at least one electrically controlled air valve (166) associated with each cavity (154, 408) and configured to connect the cavity (154, 408) to an air delivery source, wherein

5 the source of vacuum pressure is operative to draw skin into the cavity (154, 408) when the cavity (154, 408) is applied to the skin and the air delivery source is operative to restore skin drawn into the cavity to its initial position.

3. The apparatus according to claim 2, wherein the air delivery source is selected among the group of sources consisting of ambient air and an air pressure supply pump (124).

4. The apparatus according to claim 3, wherein ambient air restores skin drawn into the cavity (154, 408) to its initial position by releasing vacuum in the cavity (154, 408) and air pressure restores skin drawn into the cavity (154, 408) to its initial position by pushing it out of the cavity (154, 408).

5. The apparatus according to any of claims 3 or 4, wherein the air pressure supply pump (124) provides air pressure to the cavity (154, 408) through a tubing (170) having one end connected to the air pressure supply pump (124) and wherein two or more air valves (166) are connected in parallel to the other end of the tubing (170) not connected to the air pressure supply pump (124).

6. The apparatus according to claim 1 , wherein each cavity (154, 408) comprises:

at least one electrically controlled valve (406) associated with each cavity (154, 408) and configured to connect the cavity (154, 408) to the source of vacuum pressure when vacuum is to be delivered into the cavity or to ambient air to vent the cavity (154, 408) when vacuum is to be released from the cavity, and

a vacuum tubing (162) with one end connected to the source of vacuum pressure wherein two or more valves (406) are connected in parallel to a second end of the vacuum tubing (162).

7. The apparatus according to claim 1 , wherein each cavity (154, 408) comprises:

at least one electrically controlled valve (406) associated with each cavity (154, 408) and configured to connect the cavity (154, 408) to the source of vacuum pressure when vacuum is to be delivered into the cavity or to an air pressure supply pump (124) operative to deliver air pressure to the cavity ( 54, 408) when vacuum is to be released from the cavity, and

a tubing with one end connected to the air pressure supply pump (124) wherein two or more valves (406) are connected in parallel to a second end of the tubing.

8. The apparatus according to any of claims 1-7, further comprising at least one energy to skin applying element to apply skin treatment energy to the skin segment.

9. The apparatus according to claim 8, wherein the energy to skin applying element is two RF electrodes (150, 508) located in the interior of the cavity (154, 408) and the apparatus further comprises:

an electrically controlled RF switch (158) configured to connect RF energy to the RF electrodes (150, 508), and

an RF power source (218) operative to deliver RF energy to the RF electrodes (150, 508),

wherein the RF energy is delivered to the RF electrodes (150, 508) by wires (906, 908) connected at one end to the RF power source (128) and the RF switches (158) are connected in parallel to the other end of the wires (906, 908).

10. The apparatus according to claim 9, further comprising at least

one ultrasound transducer (512) configure to irradiate the interior of the cavity (154, 408),

an electrically controlled ultrasound driving power supply operative to deliver electrical power to the ultrasound transducer (512), and

an electrically controlled switch configured to connect the ultrasound driving power supply to the ultrasound transducer (512),

wherein the ultrasound driving power is supplied to the ultrasound transducer (512) by wires connected at one end to the ultrasound driving power supply and the electrically controlled switches are connected in parallel to the other end of the wires.

11. The apparatus according to any of claims 1-10, further comprising a control unit (104) configured to control at least the vacuum valves (164) and the source of vacuum pressure to supply and release vacuum to the cavity (154, 408), and the air valves (166) to deliver and release air to the cavity (154, 408) and/or configured to control at least the RF switches (158) and the RF power source (128) and/or configured to control at least the ultrasound driving power supply and the electrically controlled switches according to a predetermined treatment protocol.

12. The apparatus according to claim 11 , wherein a processor (132) of the control unit (104) comprises a memory (134) operative to store at least one skin treatment protocol and a unit facilitating treatment protocol entry and treatment protocol indication is selected from the group consisting of a keypad or keyboard and a touch screen.

13. The apparatus according to any of claims 1-12, wherein each of the skin treatment units (112) of the array (108, 1008, 1108) is configured to allow at least two translational movements (346 and 348, 352 and 354) with respect to the adjacent skin treatment unit and wherein said translational movements are in different planes.

14. The apparatus according to any of claims 1-13, wherein adjacent the skin treatment units of the array are connected by a joint configured to allow spatial movement (356, 360) of the skin treatment units in multiple directions in space with respect to each other.

15. The apparatus according to any of claims 1-14, wherein the array of individually controlled skin treatment units is a variable length array, and wherein the variable length array further comprises a mount (208) sized and shaped to couple and fix the variable length array to a treated skin segment such that the array can be worn.

16. The apparatus according to any of claims 1-15, wherein the array is configured to treat at least one of a group of skin segments consisting of abdomen, limbs, shoulder, lower back, and upper back.

17. Method for operating the apparatus according to claim 9 comprising:

selecting a first cavity to become operative;

switching ON vacuum valve controlling vacuum supply to the first cavity,

switching ON RF switch controlling RF power supply to the first cavity, switching OFF RF switch controlling RF power supply to the first cavity, switching OFF vacuum valve controlling vacuum supply to the first cavity,

switching ON air valve to first cavity, and selecting a second cavity and repeating the same sequence.

18. Method according to claim 17 for operating the apparatus according to claim 10 further comprising:

switching ON switch controlling ultrasound driving power supply to the first cavity, and

switching OFF switch controlling ultrasound driving power supply to the first cavity,

before switching OFF vacuum valve controlling vacuum supply to the first cavity.