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Low level laser therapy (LLLT) dates to early ‘70 to induce hair and wound regeneration then to reduce inflammation, edema and chronic pain and in present times is widely used for cosmetic fat reduction but despite the presence of many LLLT devices on the market the exact biochemical mechanism to explain its therapeutic effects is yet to be fully understood. Published data from treatments used to achieve fat layer reduction were pooled and reviewed to assess efficacy, safety and patient satisfaction and proposed models of LLLT biological action are discussed.