Cellulite (permanent reduction)
When should lasers/energy-based devices be used to treat cellulite?
If you are bothered by cellulite dimples and feel self-conscious wearing a bathing suit or high hemlines, you may be a candidate for one of the following treatments for this condition.
What devices are used to treat cellulite?
Mechanical, laser and ultrasound energy are used to non-invasively treat cellulite —the irregular contour of bulging fat and indentations seen on women’s buttocks, thighs and abdomens.
Mechanical devices such as Cellfina™ are specifically designed to address the anatomical cause of cellulite. The first of these was cleared by the FDA in 2015, promising the longest lasting results (up to two years) of any cellulite smoothing device currently on the market. The device targets the underlying tissue bands that cause cellulite.1
Laser devices such as the Cellulaze™ use light based energy to break up tissue bands and remove some of the underlying fat. These treatments are minimally invasive and have proven results out to one year.2
High frequency Ultrasound devices such as VASER and Liposonics are either minimally invasive and use high frequency ultrasound waves to immediately destroy fat cells and deliver noticeable results in as little as two weeks. There is limited peer reviewed data for long term outcomes when they are used to treat cellulite. Low and mid frequency ultrasound devices have not been shown to produce long term results.
Description of treatment
All of the current effective treatment use tumescent anesthetic where dilute amounts of lidocaine are used to numb the treatment area. Each of the following outcomes reported are for a single procedure.
For the Cellfina™ procedure, a vacuum device is used during anesthesia and to map out the treatment area. After the area has been properly numbed, the device is used to mechanically break up the connective tissue bands that create cellulite. These procedures are normally associated with minimal side effects such as soreness and bruising although less common infections are also possible. No severe adverse reactions have been reported.
Laser procedures such a Cellulaze current use a 1440 nm wavelength. During these procedures after the treatment area is numbed the laser fiber is passed under the skin to both break up the connective tissue bands as well as remove some of the fat. As with mechanical procedures these treatments are normally associated with mild post procedure bruising and tenderness but rarely more serious side effects such as infection occur.
The limited data currently available for ultrasound treatments focuses on fat and cellulite over the abdomen that are resistant to a good diet and exercise. These technologies selectively target fat cells more than the connective tissue bands. The fat released from the destruction of the fat cells is then carried away by the body to the liver to be processed. Post procedure side effects are similar to those of laser devices.
Success rates/Potential complications
Currently mechanical treatment has the highest long term patient satisfaction rates in peer reviewed studies.
Studies done with mechanical lysis of fibrous bands use a single procedure. These studies showed 85 percent satisfaction at three months, 94 percent satisfaction at one year, and 96 percent satisfaction at two years.
Studies done with laser treatment also employed a single procedure. These showed 92% patient satisfaction at one year.
There is no published peer reviewed data on patient satisfaction for cellulite when treated with either of the ultrasound devices.
1. (Kaminer, Multicenter Pivotal Study of Vacuum-Assisted Precise Tissue Release for the Treatment of Cellulite. Dermatol Surg 2015;41:336–347)
2. (DiBernardo BE, MD. Treatment of Cellulite Using a 1440-nm Pulsed Laser With One-Year Follow-Up. Aesthetic Surgery Journal. 2011)
David M. Verebelyi, MD