Devices Limit Cellulite by Tightening of Skin

MAUI, HAWAII — Laser and radiofrequency-based devices for the treatment of cellulite have gotten more efficient in the last half decade, according to Dr. David J. Goldberg.

Recent rapid advances in device therapy have led to improved regimens featuring fewer treatment sessions and better results, Dr. Goldberg said at the annual Hawaii dermatology seminar sponsored by Skin Disease Education Foundation.

Cellulite is not a disease—it is the product of normal skin exposed to estrogen—so there can be no "cure," said Dr. Goldberg, director of dermatologic laser research at Mount Sinai School of Medicine, New York. "Cellulite is really an annuity, not a disease. You never get rid of it. It always will come back." The improved skin appearance achieved with these devices results primarily from their skin-tightening effect.

The devices that work for cellulite are the same ones that achieve good results for facial skin tightening.

The devices work in the same general way, regardless of whether they utilize low-energy lasers, infrared, or unipolar, bipolar, or monopolar radiofrequency, he said. They achieve skin tightening by combining deep bulk heating with epidermal cooling to prevent blistering.

Dr. Goldberg explained how device therapy for cellulite has improved in the last 5 years.

▸ The early days. A prospective study in 35 women showed measurable improvement in buttock and thigh cellulite using the VelaSmooth (Synernon) device, which combines bipolar radiofrequency and infrared energy with suction (J. Cosmet. Laser Ther. 2004;6:187-90).

But bipolar radiofrequency does not penetrate nearly as deep as unipolar, so the skin-tightening effect was relatively modest, said Dr. Goldberg. "The problem is it took 12-14 treatments biweekly. That's pretty impractical for patients. And the results disappear pretty much as soon as you stop."

▸ Last year. Using the Accent unipolar diffuse radiofrequency device marketed by Alma Lasers, Dr. Goldberg treated 30 women with upper-thigh cellulite. Using 6 treatments spread over 12 weeks, he documented a mean 2.5-cm reduction in thigh circumference at 6 months follow-up. Twenty-seven of the 30 patients showed clinical improvement rated a mean 2.9 on a 1-4 scale. The benefit was achieved with no change in body weight (Dermatol. Surg. 2008;34:204-9).

The treatment sessions were brief and fairly painless, with no blistering, pigmentary changes, or scarring. Patients experienced no changes in blood lipid levels but had some diffuse erythema lasting 30-120 minutes

▸ Today. Dr. Goldberg was an investigator in a just-completed multisite study using a new 16-cm

"It's very time consuming. It takes a good, solid hour. And it's pretty uncomfortable. But you can still see improvement 6 months after a single treatment. So we've gone from 12-14 treatments with the original devices, to 6, to 1," he said.

He disclosed that he receives research grants from, and is on the speakers bureaus of, numerous medical device and pharmaceutical companies. SDEF and this newspaper are owned by Elsevier.

MAUI, HAWAII — Laser and radiofrequency-based devices for the treatment of cellulite have gotten more efficient in the last half decade, according to Dr. David J. Goldberg.

Recent rapid advances in device therapy have led to improved regimens featuring fewer treatment sessions and better results, Dr. Goldberg said at the annual Hawaii dermatology seminar sponsored by Skin Disease Education Foundation.

Cellulite is not a disease—it is the product of normal skin exposed to estrogen—so there can be no "cure," said Dr. Goldberg, director of dermatologic laser research at Mount Sinai School of Medicine, New York. "Cellulite is really an annuity, not a disease. You never get rid of it. It always will come back." The improved skin appearance achieved with these devices results primarily from their skin-tightening effect.

The devices that work for cellulite are the same ones that achieve good results for facial skin tightening.

The devices work in the same general way, regardless of whether they utilize low-energy lasers, infrared, or unipolar, bipolar, or monopolar radiofrequency, he said. They achieve skin tightening by combining deep bulk heating with epidermal cooling to prevent blistering.

Dr. Goldberg explained how device therapy for cellulite has improved in the last 5 years.

▸ The early days. A prospective study in 35 women showed measurable improvement in buttock and thigh cellulite using the VelaSmooth (Synernon) device, which combines bipolar radiofrequency and infrared energy with suction (J. Cosmet. Laser Ther. 2004;6:187-90).

But bipolar radiofrequency does not penetrate nearly as deep as unipolar, so the skin-tightening effect was relatively modest, said Dr. Goldberg. "The problem is it took 12-14 treatments biweekly. That's pretty impractical for patients. And the results disappear pretty much as soon as you stop."

▸ Last year. Using the Accent unipolar diffuse radiofrequency device marketed by Alma Lasers, Dr. Goldberg treated 30 women with upper-thigh cellulite. Using 6 treatments spread over 12 weeks, he documented a mean 2.5-cm reduction in thigh circumference at 6 months follow-up. Twenty-seven of the 30 patients showed clinical improvement rated a mean 2.9 on a 1-4 scale. The benefit was achieved with no change in body weight (Dermatol. Surg. 2008;34:204-9).

The treatment sessions were brief and fairly painless, with no blistering, pigmentary changes, or scarring. Patients experienced no changes in blood lipid levels but had some diffuse erythema lasting 30-120 minutes

▸ Today. Dr. Goldberg was an investigator in a just-completed multisite study using a new 16-cm

"It's very time consuming. It takes a good, solid hour. And it's pretty uncomfortable. But you can still see improvement 6 months after a single treatment. So we've gone from 12-14 treatments with the original devices, to 6, to 1," he said.

He disclosed that he receives research grants from, and is on the speakers bureaus of, numerous medical device and pharmaceutical companies. SDEF and this newspaper are owned by Elsevier.

MAUI, HAWAII — Laser and radiofrequency-based devices for the treatment of cellulite have gotten more efficient in the last half decade, according to Dr. David J. Goldberg.

Recent rapid advances in device therapy have led to improved regimens featuring fewer treatment sessions and better results, Dr. Goldberg said at the annual Hawaii dermatology seminar sponsored by Skin Disease Education Foundation.

Cellulite is not a disease—it is the product of normal skin exposed to estrogen—so there can be no "cure," said Dr. Goldberg, director of dermatologic laser research at Mount Sinai School of Medicine, New York. "Cellulite is really an annuity, not a disease. You never get rid of it. It always will come back." The improved skin appearance achieved with these devices results primarily from their skin-tightening effect.

The devices that work for cellulite are the same ones that achieve good results for facial skin tightening.

The devices work in the same general way, regardless of whether they utilize low-energy lasers, infrared, or unipolar, bipolar, or monopolar radiofrequency, he said. They achieve skin tightening by combining deep bulk heating with epidermal cooling to prevent blistering.

Dr. Goldberg explained how device therapy for cellulite has improved in the last 5 years.

▸ The early days. A prospective study in 35 women showed measurable improvement in buttock and thigh cellulite using the VelaSmooth (Synernon) device, which combines bipolar radiofrequency and infrared energy with suction (J. Cosmet. Laser Ther. 2004;6:187-90).

But bipolar radiofrequency does not penetrate nearly as deep as unipolar, so the skin-tightening effect was relatively modest, said Dr. Goldberg. "The problem is it took 12-14 treatments biweekly. That's pretty impractical for patients. And the results disappear pretty much as soon as you stop."

▸ Last year. Using the Accent unipolar diffuse radiofrequency device marketed by Alma Lasers, Dr. Goldberg treated 30 women with upper-thigh cellulite. Using 6 treatments spread over 12 weeks, he documented a mean 2.5-cm reduction in thigh circumference at 6 months follow-up. Twenty-seven of the 30 patients showed clinical improvement rated a mean 2.9 on a 1-4 scale. The benefit was achieved with no change in body weight (Dermatol. Surg. 2008;34:204-9).

The treatment sessions were brief and fairly painless, with no blistering, pigmentary changes, or scarring. Patients experienced no changes in blood lipid levels but had some diffuse erythema lasting 30-120 minutes

▸ Today. Dr. Goldberg was an investigator in a just-completed multisite study using a new 16-cm

"It's very time consuming. It takes a good, solid hour. And it's pretty uncomfortable. But you can still see improvement 6 months after a single treatment. So we've gone from 12-14 treatments with the original devices, to 6, to 1," he said.

He disclosed that he receives research grants from, and is on the speakers bureaus of, numerous medical device and pharmaceutical companies. SDEF and this newspaper are owned by Elsevier.