Comparing safety and efficacy of acoustic subcision at two different rapid acoustic pulse rates to improve the appearance of cellulite.

BACKGROUND: A recent study showed the safety and efficacy of a noninvasive acoustic subcision device to improve the appearance of cellulite via delivery of rapid acoustic pulses in a single treatment visit. OBJECTIVE: To evaluate and compare the safety and efficacy of a single rapid acoustic pulse treatment visit using an equivalent number of rapid acoustic pulses at a pulse rate of 100 or 50 Hz. METHODS: This single-center, prospective study enrolled 15 adult women with moderate to severe cellulite according to the Cellulite Dimple-At Rest Scale. Each participant would receive nominally 72,000 rapid acoustic pulses at a pulse rate of 50 Hz on the left buttock and thigh, and nominally 72,000 rapid acoustic pulses at a pulse rate of 100 Hz on the right buttock and thigh within one treatment visit. Efficacy was assessed by the ability of blinded, independent reviewers to correctly distinguish the pre- and post-treatment photos, participant satisfaction, and the change in Cellulite Dimple-At Rest scores for each treatment side. Safety was monitored throughout the conduct of the study. RESULTS: For both 100 and 50 Hz pulse rate treated areas, the majority (two out of three) of blinded reviewers correctly identified 100% of the pre/post-treatment photos. For both the 100 and 50 Hz treated areas, 80% of participants agreed/strongly agreed that their cellulite appeared improved at the 12-week follow-up visit. Significant improvements in Cellulite Dimple-At Rest scores were seen for both the 100 and 50 Hz treated areas. All participants thought both the 100 and 50 Hz pulse rate treatments were tolerable, and the pain (mean score ± SD; 2.2 ± 1.2) associated with each was identical. No unexpected or serious adverse events occurred. CONCLUSION: Acoustic subcision delivered via rapid acoustic pulses at 100 Hz, compared to 50 Hz, provides equivalent improvement in the appearance of cellulite while maintaining a similar safety and efficacy profile. For both pulse rates, treatment pain was minimal, and participant satisfaction was high.

Does electrophysical agents work for cellulite treatment? a systematic review of clinical trials.

Cellulite, a perceived alteration in skin topography, is predominantly found in adipose tissue-rich body regions such as the hips, buttocks, thighs, and abdomen. Contrary to common belief, the etiology and pathophysiology of cellulite are not well-established or universally agreed upon. This lack of understanding about the actual etiology of cellulite directly influences the selection of suitable treatments that can address both the aesthetic and inflammatory aspects of the condition. Various treatment methods, including electrophysical agents like electric currents, radiofrequency, ultrasound, and photobiomodulation, have been tested. However, the questionable methodological quality of many studies complicates the determination of effective treatments for cellulite. In this study, we conducted a systematic review of clinical studies that utilized electrophysical agents in cellulite treatment. METHODS: We employed the PICO (population, intervention, control, and outcome) process to develop our search strategy and establish inclusion/exclusion criteria. We searched five databases: Medline, Central, Scopus, Lilacs, and PEDro, for studies conducted between 2001 and July 2021 that involved cellulite treatment with electrophysical agents. To ensure systematicity and guide study selection, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. RESULTS: Our initial search yielded 556 articles: 379 from Medline, 159 from Central, and 18 from Lilacs. After applying our inclusion criteria, only 32 studies remained. Of these, only two (6.2%) were evaluated as having strong and good methodology via the QualSyst tool. CONCLUSIONS: Our findings indicate that the quality of evidence from clinical studies on the use of electrophysical agents for cellulite treatment remains subpar. Further studies with robust experimental designs and more precise assessment techniques are necessary. While our study does not refute the effectiveness of the techniques used for cellulite treatment, it underscores the need for additional well-designed trials.

Use of a microwave device for the treatment of cellulite and localized fat adiposity: a 1-year follow-up study.

BACKGROUND: The body contour market has grown steadily over the last years, due to the persistent demand for non-invasive treatments for localized fat adiposities, cellulite, and skin laxity. MATERIALS AND METHODS: The purpose of this observational study was to evaluate the efficacy and safety of a new device delivering microwaves (MWs) energy for unwanted fat and cellulite reduction after a full cycle of treatments and 1 year later. A total of 45 patients with localized adiposity and/or cellulite in different body areas (inner thigh, upper arm, abdomen, culotte de cheval, buttocks), received four treatment sessions, 4 weeks apart. Photographic records and global aesthetic improvement scale (GAIS) score were performed. RESULTS: For the treatment of cellulite the average GAIS score passed from 3.65 ± 0.49 at 1-month follow-up (1MFU) to 2.7 ± 0.66 at 1-year follow-up (1YFU). For the treatment of localized adiposity, the average GAIS score passed from 3.52 ± 0.51 at 1MFU to 2.82 ± 0.88 at 1YFU. No particular red area was detected either during or after the treatment. There was no mention of assessment of pain or side effects. CONCLUSIONS: The study findings showed that MWs allow for the treatment of cellulite and localized fat adiposity in a safe and effective way, with results lasting over time up to 1 year after the end of the treatment.

Cellulite Pathophysiology and Psychosocial Implications.

BACKGROUND: Cellulite is a highly prevalent aesthetic condition in postpubertal women. OBJECTIVE: The objective of this article was to describe the latest data on the pathophysiology of cellulite and to highlight the psychosocial aspects that should be considered when treating cellulite. METHODS: A roundtable meeting was convened to discuss and share views on the latest data on the pathophysiology and psychosocial aspects of cellulite. The participants' experience helped guide a narrative review on this topic. RESULTS: The pathophysiology of cellulite primarily involves fibrous septal changes. Strategies targeting the fibrous septa have shown the most consistent efficacy, while showing inconsistent or short-term results when targeting the other components of cellulite, such as decreased dermal thickness, vascular alterations, and inflammation. Female sex, increased age, and high body mass index contribute to cellulite pathophysiology. CONCLUSION: Patients seeking treatment for cellulite are willing to endure numerous treatments, high cost, temporary and/or delayed results, and invasive procedures with potential adverse effects. Psychological discomfort has been reported among patients with cellulite, and understanding their behaviors and psychological characteristics can help clinicians provide better care to these patients seeking treatment.

Collagenase Clostridium Histolyticum-aaes Injections for Volumetric Change of Cellulite Dimples and Gluteal Contouring.

BACKGROUND: Collagenase clostridium histolyticum-aaes (CCH) is approved for the treatment of moderate-to-severe cellulite. OBJECTIVE: This is a retrospective image review of subjects previously enrolled in Cohort 2 of the EN3835-305 trial to determine the effects of CCH on volumetric changes of cellulite dimples and overall gluteal contouring. METHODS: In this retrospective analysis, photographs from Day 90 and Day 180 were superimposed on baseline images and the volumetric change of each treated cellulite dimple was quantified. Side-by-side photographs of the buttocks were also evaluated for change in gluteal contour using the Physician Global Aesthetic Improvement Scale (PGAIS). RESULTS: Fifty-eight female subjects and 403 cellulite dimples were evaluated. Three-dimensional imaging analysis revealed a significant improvement in total negative dimple volume at both Day 90 and Day 180 of 27% and 26%, respectively ( p < .001 and p = .002, respectively). At Day 90, the overall gluteal contour, as signified by the mean PGAIS among the 3 blinded dermatologists, was rated as +1 (improved) in 27% ( n = 17) of the subjects. At Day 180, the mean PGAIS was +1 (improved) or +2 (very much improved) in 39% ( n = 26) of the subjects. CONCLUSION: CHH is an effective tool for treating cellulite dimples and improving gluteal contour.

The safety and effectiveness of low-level light therapy (LLLT) with light-emitting diode (LED) bed system and a novel topical anti-cellulite gel on grades 1-2 thigh/buttock cellulite: a randomized, comparative-controlled split-thigh/buttock IRB study.

BACKGROUND: Cellulite of the upper lateral and posterior thighs and lower buttocks represents a common unwanted condition. OBJECTIVES: The author sought to comparea LLLT-LED bed therapy and a novel topical anti-cellulite gel on one thigh/buttock cellulite vs light therapy for cellulite to the opposite side. METHODS: Eight healthy female subjects were randomly treated with a LLLT-LED bed twice weekly for 20 minutes in prone/supine positions with twice daily application of a novel anti-cellulite gel to one randomized thigh/buttock. RESULTS: At the end of the 3-month trial, skin elasticity increased after combined therapy on one thigh but decreased with only LLLT-LED bed treatments on the opposite thigh. Thighs treated with active gel and LLLT-LED bed, were downgraded to a lower cellulite grade, while monotherapy did not demonstrate any change from their baseline cellulite grading. Changes in thigh circumference did not correlate with either treatments regimens.Subject and investigator questionnaire evaluations at month-3 were assessed as "satisfactory" results. There were no adverse reactions to treatments. CONCLUSIONS: The use of LLLT-LED bed therapy and an anti-cellulite gel demonstrated an efficient alternative in the treatment of cellulite-involved thighs/buttocks over similarly affected thighs/buttocks that were treated only with LLLT-LED bed therapy.

Update: Cellulite Therapies and Optimizing Treatment Combinations.

Cellulite in the proximal lower extremities is a reported concern among many adult females. The unsightly appearance of cellulite leads many affected individuals to seek treatment by trained specialists. The objective of this review is to provide the reader with an update on new and innovative therapies for cellulite including various treatment combinations to maximize therapeutic outcomes, and strategies for minimizing adverse events. The availability of new technologies and the results from recent clinical trials provide additional tools and data to consider when creating treatment plans for cellulite patients. This update to previous treatment recommendations is based on the most recent developments in cellulite management including the personal experiences of the authors with an emphasis on injectable enzymes, acoustic subcision, targeted verifiable subcision, and biostimulators. Formal clinical studies are warranted to compare various treatment modalities and further investigate combination regimens.

Infrared thermography as valuable tool for gynoid lipodystrophy (cellulite) diagnosis.

Cellulite is a morphological alteration of the tegument tissue, directly interfering in self-esteem with etiology and pathophysiology far from being a consensus. Although the visual diagnosis of cellulitis is well known, it does not represent the real pathological condition of the subcutaneous tissue. The aim of the study was to investigate the hypothesis that the more heterogeneous tissue pattern analyzed by infrared thermography, the more severe is the cellulite grade. Forty female participants were selected and 60 thighs were analyzed by clinical anamnesis and infrared thermography. Classical visual analysis was correlated to the tissue heterogeneity measured by thermography. R Spearman's correlation between visual evaluation and thermography was 0.92. Phototype presented a negative significant correlation of 0.67 with classical visual analysis. In the present study, we presented a simple method based on infrared thermography that can be adopted in any esthetics office with a correlation of 0.92 with the visual classic evaluation, but, besides, may be very helpful to the clinician to decide which treatment will be adopted, i.e., an aggressive and inflammatory approach such as the radiofrequency of shockwave therapy or an anti-inflammatory approach such as photobiomodulation, depending on the inflammatory status of cellulite.

Comparison of Cellulite Severity Scales and Imaging Methods.

Cellulite is characterized by dimpled contour alterations of the skin and is present in approximately 85% to 90% of postpubertal females. Although the pathophysiology of cellulite remains to be fully elucidated, experimental evidence indicates a multifactorial process involving the number and types of fibrous septae, microvascular dysfunction, subcutaneous inflammation, decreased dermal thickness with age, and fat deposition. Cellulite is a major cosmetic concern for many women, and a number of both noninvasive (eg, massage, cosmeceuticals, laser therapy) and minimally invasive techniques (eg, subcision, collagenase injection) have been evaluated to improve the appearance of the affected skin. However, evidence for many of these treatments is limited, largely due to the lack of a validated, convenient tool for the standardized evaluation of cellulite severity. Various imaging modalities have been employed to characterize cellulite severity and the impact of treatment, but only 2-dimensional and 3-dimensional digital photography have been adequately validated. However, in many cases, imaging findings do not correlate with subjective measures of cellulite severity. A number of cellulite rating scales have been developed; some provide only a qualitative measure, whereas others do not fully capture all clinically relevant aspects of cellulite, including the perspective of the patient. There remains an unmet need for global adoption of a validated scale that can be utilized easily by clinicians and patients in clinical and research settings. We propose features that should be included in an ideal rating scale for assessment of cellulite severity.

Insights Into the Pathophysiology of Cellulite: A Review.

BACKGROUND: The etiology of cellulite is unclear. Treatment of cellulite has targeted adipose tissue, dermis, and fibrous septae with varying degrees of success and durability of response. OBJECTIVE: Results from clinical trials that target different anatomical aspects of cellulite can provide insights into the underlying pathophysiology of cellulite. MATERIALS AND METHODS: A search of the PubMed database and ClinicalTrials.gov website was conducted to identify clinical trials that have investigated treatments for cellulite. RESULTS: A lack of trial protocol standardization, objective means for quantification of improvement and reported cellulite severity, and short-term follow-up, as well as variation in assessment methods have made comparisons among efficacy studies challenging. However, the lack of durable efficacy and inconsistency seen in clinical results suggest that dermal or adipose tissue changes are not the primary etiologies of cellulite. Clinical studies targeting the collagen-rich fibrous septae in cellulite dimples through mechanical, surgical, or enzymatic approaches suggest that targeting fibrous septae is the strategy most likely to provide durable improvement of skin topography and the appearance of cellulite. CONCLUSION: The etiology of cellulite has not been completely elucidated. However, there is compelling clinical evidence that fibrous septae play a central role in the pathophysiology of cellulite.

Development and Validation Clinician and Patient Reported Photonumeric Scales to Assess Buttocks Cellulite Severity.

BACKGROUND: The Clinician Reported Photonumeric Cellulite Severity Scale (CR-PCSS) and Patient Reported PCSS (PR-PCSS) are newly developed tools for assessing cellulite severity. OBJECTIVE: To report on the reliability, validity, and ability to detect a change in cellulite severity on the buttocks of adult women with the CR-PCSS and PR-PCSS. MATERIALS AND METHODS: Content validity of both scales was established through concept elicitation and cognitive interviews. Test-retest reliability was evaluated, and intra-rater (both scales) and inter-rater (CR-PCSS only) reliability were estimated using intraclass correlation coefficients (ICCs) for agreement and consistency. Ability to detect a change was determined using the Subject-Global Aesthetic Improvement Scale (GAIS) or Investigator-GAIS as anchors. RESULTS: For the CR-PCSS (n = 6) at baseline and Day 2, the mean interrater ICCs were ≥0.70 and mean intrarater ICCs (95% confidence interval [CI]) were ≥0.81 (0.72-0.90) for both buttocks. For the PR-PCSS (n = 99) at baseline and Day 14, the mean test-retest reliability ICCs (95% CI) were ≥0.86 (0.79-0.91) for both buttocks. A clinically meaningful change was 1.0 point on the PR-PCSS and 1.0 on the CR-PCSS. CONCLUSION: The CR-PCSS and PR-PCSS reliably assess cellulite severity of the buttocks and can detect a clinically meaningful change after treatment for cellulite.

Objective and subjective reduction of cellulite volume using a localized vibrational massage device in a 24-week randomized intra-individual single-blind regression study.

Cellulite occurs in females and is a common condition of altered connective tissue matrix and increased adipogenicity with visible dimples and orange-peel appearance on the skins surface. Whilst advancements in methods continue to help our understanding, attempts to correct the appearance of cellulite topically have yielded limited success. Various kinds of non-invasive body contouring methods such as whole body vibration have been reported with demonstrable visible improvements in the cellulite condition. The aim of this study was to evaluate volume reduction and improvement of the visible appearance of cellulite as judged both objectively (AEVA-HE phase-shift 3-D fringe projection, macrophotography image grading) and subjectively (questionnaires) after application of a hand-held localized vibrational device over 24-weeks. The study was conducted on 40 healthy female volunteers who were instructed how to use the device on defined areas of cellulite of the outside and rear of the thighs (iliotibial band, and over biceps femoris region respectively). The initial 12 weeks of continuous massage application of the study were followed by a 12 week phase in which volunteers were split into 2 subgroups - one for assessment of regression effects and one for continuous application effects. AEVA (skin surface volume) measurements of cellulite-related dimples correlated with questionnaires and visual image evaluation scoring, in that in the iliotibial region cellulite was significantly reduced at 12 weeks. In the regression subgroup cellulite returned to initial values soon after cessation of treatment, whereas in the continuous application subgroup, cellulite remained diminished. The effect of this device to reduce cellulite as observed in this study proves that continuous use of vibrational massage is beneficial to mitigate visible signs of cellulite.

La cellulite se produit chez les femmes et est un état d'altération courant de la matrice du tissu conjonctif et d'une adipogenèse accrue se manifestant par l´apparition des fossettes visibles et un aspect de peau d'orange à la surface de la peau. Bien que les progrès des méthodes approfondissent notre compréhension, les tentatives de corrections de l'apparence de la cellulite par voie topique ont produit des résultats limités. Divers types de méthodes non invasives du body contouring, telle que la vibration entière de celui-ci, ont été rapportées, et ce, avec des améliorations visibles et démontrables de l'état de la cellulite.L'objectif de cette étude était d'évaluer la réduction du volume et l'amélioration de l'apparence visible de la cellulite, comme jugées à la fois objectivement (AEVA-HE phase-shift 3-D projection de franges, gradation d'images par macrophotographie) et subjectivement (questionnaires) après application localisée d'un appareil vibratoire manuel pendant 24 semaines. L'étude a été menée sur 40 femmes volontaires en bonne santé qui ont reçu des instructions à-propos de comment utiliser l'appareil sur des zones externes et bien définies de la cellulite et à l'arrière des cuisses (bande iliotibiale et sur la région du biceps fémoral respectivement). Les 12 premières semaines d'application de massage continue ont été suivies d'une phase de 12 semaines au cours de laquelle les volontaires ont été divisés en deux sous-groupes - un pour l'évaluation des effets de régression et un pour l'évaluation des effets de l'application continue.Les mesures AEVA (volume de la surface de la peau) des capitons liés à la cellulite corrélées avec les questionnaires et le score visuel d'évaluation d'images, dans laquelle, la cellulite dans la région iliotibiale, était significativement réduite à 12 semaines. Dans la régression du sous-groupe, la cellulite est revenue aux valeurs initiales peu après l'arrêt du traitement, tandis que dans le sous-groupe d'application continue, la cellulite est restée diminuée. L'effet de ce dispositif pour réduire la cellulite tel qu'observé dans cette étude prouve que l'utilisation continue du massage vibratoire est bénéfique pour mitiger les signes visibles de la cellulite.

Cellulite: Patient Selection and Combination Treatments for Optimal Results-A Review and Our Experience.

BACKGROUND: More than 90% of women have reported concerns of cellulite on their skin. Both commercially advertised creams and topical pharmacological agents have shown limited improvement. Thus far, there has been a paucity of thorough review articles on how to address and treat this condition. OBJECTIVE: To investigate how the etiology and pathogenesis of cellulite can help guide treatment combinations and provide a more algorithmic approach to comprehensively address a condition that affects so many women. MATERIALS AND METHODS: A review of the literature surrounding treatment options for cellulite and the authors' experience in this area are provided. CONCLUSION: This review summarizes available treatment options for cellulite, including topical agents, controlled subcision, energy-based devices, dermal fillers, and new injectable medications. Furthermore, the various ways that these treatments can be combined in an algorithmic and sequential approach based on the degree of volume loss, skin laxity, and excess adiposity associated with cellulite are addressed. These combination therapies for cellulite are supported both in the published literature and the authors' experience to help clinicians tailor a comprehensive treatment plan for the multiple factors that contribute to cellulite. Further clinical trials are needed to compare various devices and techniques for cellulite as well as combination treatments.

Validated Assessment Scales for Cellulite Dimples on the Buttocks and Thighs in Female Patients.

BACKGROUND: New treatment methods for cellulite require globally accepted scales for aesthetic research and patient evaluation. OBJECTIVE: To develop a set of grading scales for objective assessment of cellulite dimples on female buttocks and thighs and assess their reliability and validity. MATERIALS AND METHODS: Two photonumeric grading scales were created and validated for dimples in the buttocks in female patients: Cellulite Dimples-At Rest, and Cellulite Dimples-Dynamic. Sixteen aesthetic experts rated photographs of 50 women in 2 validation sessions. Responses were analyzed to assess inter-rater and intra-rater reliability. RESULTS: Overall inter-rater reliability and intra-rater reliability were both "almost perfect" (≥0.81, intraclass correlation efficient and weighted kappa) for the At Rest scale. For the Dynamic scale, inter-rater reliability and intra-rater reliability were "substantial" (0.61-0.80). There was a high correlation between the cellulite scales and body mass index, age, weight, and skin laxity assessments. CONCLUSION: Consistent outcomes between raters and by individual raters at 2 time points confirm the reliability of the cellulite dimple grading scales for buttocks and thighs in female patients and suggest they will be a valuable tool for use in research and clinical practice.

Whole-body vibration in the reduction of the cellulite.

OBJECTIVE: Evaluate the effects of the whole body vibration in improving of cellulite in the women's gluteal region. METHODS: Controlled clinical trial performed with 42 women, with cellulite in the gluteal region, detected by means of clinical examination. After evaluation, the women were divided into two groups: Whole-Body Vibration (WBV_G) and control (C_G). The evaluations were performed at the beginning and the end of 10 sessions and superficial skin temperature, perimetry in the gluteal region, analysis of body contouring, analysis of improvement by blind reviewers and instrument of satisfaction, by numeric scale were investigated. RESULTS: In the thermographic analysis, the WBV_G obtained significant increase of superficial skin temperature on the right (p = 0.02) and left (p = 0.02) gluteal region. There was no difference in intra- and intergroups in perimetry and the analysis of body contour. The WBV_G obtained a higher percentage of improvement by assessment of the blind reviewers (p = 0.003) and greater aesthetics satisfaction (p = 0.006), when compared to C_G. CONCLUSION: WBV provided an improvement in the aspect of the cellulite when assessed by blind reviewers and greater participants' satisfaction, providing a significant increase in the superficial skin temperature in the gluteal region.

Multicenter study of vacuum-assisted precise tissue release for the treatment of cellulite in a cohort of 112 Italian women assessed with cellulite dimples scale at rest.

Objectives and background: Tissue stabilized-guided subcision (TS-GS) treatment has emerged as a single session treatment for cellulite dimples. To date, studies on a few patients were reported. We present data concerning efficacy and safety of TS-GS for cellulite in a cohort of Italian patients.Patients and Methods: This is a retrospective study involving 122 patients requiring cellulite treatment, classified according to validate cellulite dimples scale at rest, at T0. TS-GS technique is assessed in terms of efficacy (masked evaluations of pre- and post-treatment pictures, satisfaction of patients and variations in cellulite dimples scale at rest), safety of results at 12 months follow-up (T1). U nivariate and multivariate analyses were carried out to evaluate variables associated with the size effect.Results: Masked evaluations of 112 patients completing the study resulted in the correct selection of pre- and post-treatment images in all cases and all patients were satisfied. The mean cellulite dimples scale at rest score improved ≥1 point at T1. We found a significant association between size effect, higher satisfaction (p < .01), cellulite grading at T0 (p < .01), higher BMI (p = .037); a higher BMI was correlated to an increased cellulite grading at T0 (p = .02). Only minor and temporary adverse events were reported.Conclusions: We confirm herein the clinical efficacy and safety of TS-GS for cellulite dimples treatment in a cohort of Italian patients assessed with the validated cellulite dimples scale at rest.

Prospective Multicenter Clinical Trial of a Temperature-Controlled Subcutaneous Microneedle Fractional Bipolar Radiofrequency System for the Treatment of Cellulite.

BACKGROUND: A bipolar fractional radiofrequency (RF) device was developed to generate cutaneous thermal injuries using a temperature-controlled microneedle electrode array. OBJECTIVE: Evaluate safety and efficacy of a novel subcutaneous microneedle RF for treatment of posterolateral thigh cellulite. METHODS: The study design was an institutional review board-approved multicenter clinical trial after a per-protocol analysis. Fifty subjects with Nurnberger-Muller Grade II or III cellulite were enrolled at 4 treatment centers and received 1 subcutaneous microneedle RF treatment (67°C/4-second duration). Efficacy was evaluated by blinded grading by 3 dermatologists using randomized, standardized photographs and investigator grading at baseline, 1-, 3-, and 6-month follow-up. As per the Food and Drug Administration, treatment success was defined by ≥1-point improvement on dimple number or severity of undulation irregularities scales by at least 2 of 3 blinded physicians. Study subjects' self-assessments and satisfaction questionnaires and procedural pain levels and adverse events were monitored. RESULTS: Blinded physician evaluations revealed a procedural success rate of 93% at 6-month follow-up. Procedural pain level was 3.74 ± 1.96 on a 10-point scale. There were no adverse events. Seventy-five percent of subjects were satisfied with the results at 6-month follow-up. CONCLUSION: The results indicate that subcutaneous microneedle RF treatment is safe and effective for long-term treatment of Type II and III cellulite in a single session.

Efficacy Using a Modified Technique for Tissue Stabilized-Guided Subcision for the Treatment of Mild-to-Moderate Cellulite of the Buttocks and Thighs.

BACKGROUND: Cellulite can be significantly improved using vacuum-assisted tissue stabilized-guided subcision (TS-GS). However, the treatment of shallow and linear cellulite has remained problematic. OBJECTIVE: In this retrospective study, we describe a modified technique of vacuum-assisted TS-GS. The aim is to demonstrate that this new limited-release technique is an effective treatment for long ripples and interconnected shallow dimples, which are characteristic of mild-to-moderate cellulite. METHODS: Patients with mild-to-moderate cellulite were treated with limited-release vacuum-assisted TS-GS. All subcisions were performed at the 6-mm depth and a minimum of 3 mm between each dimple. Using a 4-point scale, 2 raters graded cellulite improvement on evaluation of prephotographs and postphotographs. RESULTS: A total of 23 female patients were included in this study. The pre- and post-treatment photographs were correctly identified in 22 of the 23 patients (95.6%). The average cellulite improvement was 2.9 of 4 for the buttocks and 2.8 of 4 for the posterior thighs. Global cellulite improvement was reported at 3.1 of 4. CONCLUSION: The results demonstrate that modified, limited-release, vacuum-assisted TS-GS can be an effective and safe method for the treatment of long ripples and shallow dimples that are characteristics of mild-to-moderate cellulite.