While mechanical subcision of fat septa with a scalpel or a large bore needle is a tried-and-true treatment for cellulite, other technologies have emerged as alternatives.
A noninvasive treatment, rapid acoustic pulse technology , was cleared by the Food and Drug Administration in 2021 for short-term improvement in the appearance of cellulite. The device emits rapid acoustic pulses that are transmitted through the skin to rupture or shear the fibrotic septa; release of the septa results in the smoothing of skin dimples, , director of laser and cosmetic dermatology at the University of California, San Diego, said at the annual Masters of Aesthetics Symposium.
According to Dr. Ortiz, RAP's repetition rate and short rise time provides microscopic mechanical disruption to the targeted cellular level structures and vacuoles, while high peak pressure and the fast repetition rate exploit the viscoelastic nature of tissue. Compressed pulses from electronic filtering and the reflector shape eliminate cavitation, heat, and pain. Researchers "There's no heat to this; it just uses sound," Dr. Ortiz explained."It's also time dependent.
Another device, targeted verifiable subcision , is FDA cleared for temporary reduction in the appearance of cellulite in the buttock and thigh areas of adult women."But studies show lasting results, at least through a year," Dr. Ortiz said. The device features a light-guided probe and a hook. The light enables clinicians to navigate under the skin, while the hook releases a tiny blade that severs the septa.
Previous devices, she said, would"blindly shear the area, so you would find the dimple and blindly cut, so there was no way to verify that you got the target dimple. The results were sometimes mediocre because you didn't really know if you effectively treated the area." She emphasized that TVS is only useful for discreet dimples."Many patients who come in asking for cellulite treatment have a lot of laxity and rippled texture," said Dr. Ortiz, who is also president-elect of the American Society for Laser Medicine and Surgery."This is not going to be appropriate for those cases. Setting expectations is important. If patients have laxity and discreet dimples and it's just the dimples that bother them, that's fine.
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