New tx option for cellulite

A bipolar radiofrequency, infrared heat and pulsatile suction device is a non-surgical and minimally invasive cosmetic option that can improve body contouring, circumferential measurement reduction and smoothness associated with a bumpy and dimpling appearance of the skin, according to a new study.

"A variety of therapies have been proposed for the treatment of cellulite, with only few proven effective therapeutic options, including topical agents, massage, subcision and liposuction," according to the study's author Rungsima Wanitphakdeedecha, M.D., clinical instructor, department of dermatology, at Siriraj Hospital, Mahidol University in Bangkok.

"Although liposuction seems to be the procedure of choice, it is an invasive surgery with adverse effects and downtime. Nonsurgical and minimally invasive procedures, including mesotherapy, endermology and carboxy therapy provide modest and inconsistent body contouring and cellulite outcomes," Dr. Wanitphakdeedecha says.

"Essentially, the device is a combination of light energy, radiofrequency, mechanical rollers and vacuum suction to improve the appearance of cellulite," Dr. Manuskiatti says. "The light energy is a broad spectrum infrared light source, emitting a wavelength of 700 to 2,000 nm. The radiofrequency is intended to deliver heat to adipose tissue to a 5 mm to 10 mm depth, which results in lipolysis and shrinkage of the fat chamber, thereby, reducing the bumpiness of skin."

According to Dr. Manuskiatti, the mechanical action of the rollers kneads the skin inward so the radiofrequency can penetrate deeper in the skin. The repeated kneading of the skin between the rollers temporarily stretches the vertical septa and connective tissue, resulting in improving the dimpled appearance. The negative pressure of suction at 750 mmHg is applied to dilate the blood vessels and acts to improve local circulation to the skin.

The researchers treated 12 female subjects (16 anatomical sites) with cellulite from November 2004 to January 2005. They used a bipolar radiofrequency, infrared heat and pulsatile suction device (VelaSmooth, Syneron) The device delivers bipolar radiofrequency energy, infrared heat energy and pulsatile vacuum suction through a hand-held applicator, administered directly to the skin surface.

They treated all subjects twice weekly for a total of eight to nine treatment sessions. Each treatment consisted of four passes over the treatment sites. Each pass consisted of eight stacking pulses given to a same focal area. Each treatment session lasted 30 to 45 minutes, with the endpoints being significant erythema and warmth. They applied the applicator to the treatment area with full contact to allow the vacuum to be most effective and ensure that the electrode rollers were fully coupled to the skin.

"Our evaluation included assessing standardized photographs, measurements of body weight and circumference of treatment sites at baseline, each treatment session and four weeks after the last treatment," Dr. Wanitphakdeedecha says.

"We always took the circumferential measurements at a specific and consistent distance from an anatomical landmark, the umbilicus of the abdomen and at a superior distance from the upper pole of patella of the thigh. Subjects did not receive any special dietary control, exercise or medication during the treatment period."

Research subjects

The researchers report that of the 12 subjects that started the study, seven subjects and nine anatomical sites completed the treatment protocol and were followed up after four weeks. The subjects' mean age was 38 years. And the average baseline weight of the subjects who completed the treatment protocol was 56.30 kilograms; 56.05 kilograms post-treatment; and 56.23 kilograms four weeks after the last treatment.

For all subjects who completed the study protocol, the average circumferential reduction of the abdomen at the last treatment visit was 5.17 cm, while the thigh reduction was an average 3.50 cm. The average circumferential reductions of the abdomen and the thigh at four weeks after the last treatment were 3.17 cm and 3.50 cm, respectively.

"The photographic evaluation showed significant texture improvement in all subjects," according to Dr. Manuskiatti.

A blister developed on the thigh of one patient following her sixth treatment session, according to the authors. They treated the blister with a topical antibiotic ointment and it resolved without scarring.