Cellulaze - a new laser treatment for cellulite?

Just this week, the FDA has given their approval to the marketing of a new laser from Cynosure called Cellulaze.  Like the name suggests, it's a surgical laser treatment for cellulite.  Here's how it works:

With the help of local anesthesia, several small incisions are made near the area of cellulite.  A laser fibre is inserted under the skin, and a 1440 nm wavelength side-firing laser is used to treat the area of cellulite.  The laser helps by both melting the excess fat, and releasing the tethering bands that give cellulite its indentations.  And it seems to work, with a high degree of patient approval in preliminary studies.  Before and after pictures (shown above) seem to show a nice improvement - but of course, these are on the corporate website, so one would only expect to see their best results!

Nevertheless, this is the first laser treatment specifically proven to improve cellulite, with at least a one year follow-up study showing positive results and minimal side effects.  Dr. Barry diBernardo, fellow ASAPS member and plastic surgeon, presented his experience with this device at last year's scientific meeting, and he seemed impressed with the technology.

So, it looks intriuging...time will tell if it's really as good as the marketing hype suggests, and whether it is better than our current selection of skin tightening devices.  For now, we're seeing nice improvements in cellulite with our Venus Freeze RF device - no incisions required!

Want smoother, firmer skin? And less cellulite?

There's a lot of machines in the medical marketplace that claim to be "the answer" for non-surgical skin tightening.  Many of them work...a little bit.  But I wanted something that would give my patients real and measurable results.

In addition, it had to be painless, have no side effects, and be FDA cleared.

Now, I'm pleased to tell you that following a lot of comparison shopping, it's now here, sitting shiny and new, in my Orlando office.  Although you've probably never heard of the "Venus Freeze" before, I think it's going to be a name that you'll want to know.  It's proven to firm and tighten skin, reduce fat, and improve cellulite.  And it's painless - unlike the Thermage, the Accent, and a number of previously hyped gadgets.

You'd guess, with a name that has "Freeze" in the title, that the machine would work by cooling the tissue, much like the Zeltiq machine does.  Nope.  It actually works by heating the dermis and subcutaneous tissue, using something called radiofrequency energy, or RF for short.

Turns out this RF heating process activates the production of new collagen and elastic fibers in the skin, which is a good thing.  It also activates a lipase enzyme - a fat melter - and so it can be used for modest contouring improvements, too.

Now this RF technology has been around for a number of years.  There are couple of unique things that make this machine better than previous efforts, like the design of the handpiece.  Instead of only 1 or 2 electrodes (as in earlier designs), the Venus Freeze uses an 8 electrode design.  This divides up the treatment energy more evenly, achieving uniform heating (good!) and avoiding painful heat spikes.  This makes the treatment safe, painless and pleasant.  The new design and higher power output allows the RF energy to go about an inch into the tissues - much more than previous designs on other machines.

Also, unlike laser or IPL, this kind of treatment can be safely used whether you are tanned or not, and on skin of all shades and types.  Almost all areas of the face and body can be treated.  Typically, treatments are done once a week, 6-8 times for the face and 8-10 times for areas on the body.  Depending on the area, treatments take about 25-45 minutes.

Our test patients have commented on smoother, firmer feeling skin, an improvement in their cellulite, and even a loss of about an inch around the waist and bra fat area....and that's after 3 or 4 treatments, not even the whole series.  Three benefits in one!

Of course, this isn't a magic wand.  It doesn't compare to what can be done with surgery, such as a facelift, tummy tuck or liposuction.  But it very favorably compares with any other non-surgical machine currently on the market.  I predict that it will become very popular in our Orlando office - already, all my staff have told me they want a treatment!

Come on in and give it a try.  We've got a special introductory package available for the next 3 months.

Cellulite: non-invasive treatment round-up 2010

Let's face it - if modern medical science had an effective treatment for cellulite, the world would beat a path to its door. Even slender women can have the dimples and irregular skin contours with this cosmetic issue. So what can be done about it?

Modern cellulite treatments really began with the Endermologie and later, the Synergie machines. Both of these combine massage by the treatment head of the machine with a gentle vacuum on the area being treated. The Endermologie machine has mechanical rollers, the Synergie does not. While these machines both temporarily help with cellulite, I feel their best application is to reduce swelling following liposuction.

The next major breakthrough was the addition of some form of energy to the treatment head. Energy can be applied to the skin and subcutaneous fat using ultrasound, radio-frequency (RF) energy or infra-red energy, or all of the above. All methods achieve the same goal - heating of the tissue, with activation of collagen production and tissue shrinkage. Early pioneers in this area were Thermage (RF energy) and Titan (infra-red). Some people got a reasonable improvement, others had little response - and frankly, it was hard to predict who would get which result.

Now, manufacturers are offering machines that combine treatment types. BTL's Exilis machine combines RF and ultrasonic energy. Smoothshapes combines mechanical massage with laser and light. Velashape II uses RF, infra-red and massage. The Vaser Shape MC1 combines modulated ultrasound and massage. Viora's Reaction combines several different RF frequencies and vacuum.

These companies, and the many others that are on the market, all have glossy websites that show some lovely before-and-after photos. All the machines work, to some degree. Most have FDA clearances, showing their safety. Each company has pitchmen-physicians that love and use their particular product. Often, there are corporate-sponsored studies that document some improvements due to treatment.

Yes, there are visible improvements in cellulite. However, I feel that the results shown are fairly mild, for most of the machines. It's better, but it's no magic wand. And of course, I'm sure the manufacturers are showing their very best results ever on their webpages. Scientifically, we don't really yet know which machine or treatment method is best - as there aren't any comparison, head-to-head type studies. We don't really know exactly how much energy or which ultrasonic or RF frequency is optimal. We don't really have a good handle on who will respond effectively to the treatments, something that is rarely discussed on a manufacturer's webpage!

I'm still waiting for the "new, improved world-champion" cellulite treatment device to come along. Currently, I'm continuing to evaluate the new technologies that are on the market - and I promise to keep PSB readers updated with any new or exciting developments I find here.

Recent bulletin on Carboxytherapy and Mesotherapy

Here is a recent press release from the Physicians Coalition for Injectable Safety - a group of 7 American, Canadian and International Surgery groups, including plastic surgeons, facial plastic surgeons and ophthalmic surgeons - who review & study the latest and best methods regarding injectable cosmetic products. For the record, I agree with this bulletin, and do not currently recommend mesotherapy and carboxytherapy, based on lack of proven efficacy.

PHYSICIAN GROUP URGES CONSUMERS TO BE AWARE OF NON-APPROVED COSMETIC INJECTIONS

July 29, 2009 - The Physicians Coalition for Injectable Safety today issued a consumer warning about carboxytherapy and mesotherapy injections. These products, touting everything from cellulite treatment to weight loss are not FDA approved, and do not have clinical data that demonstrates results or safety.

Carboxytherapy uses carbon dioxide gas injected under the skin to reduce the look of cellulite, treatment of dark under-eye circles, and stretch marks and is also touted for fat sculpting on the face and the body. “Although many websites or providers claim carboxytherapy is safe and FDA approved, it has not been clinically tested or FDA approved for these purposes,” says Coalition leader Robert Weiss, MD of Baltimore, MD. “Carboxytherapy for use around the eyes is especially dangerous. It could potentially release gas bubbles into blood vessels causing blindness. In addition, the risks of putting carbon dioxide in your body are currently unknown.”

Mesotherapy, also known as injection lipolysis, is a mixture of vitamins, drugs and enzymes that are compounded (mixed together) to make the injected substance. “There is no conclusive, authoritative information that exists, such as unbiased, peer-reviewed clinical studies that meets the standards of an accepted medical journal, measuring both the efficacy and safety of mesotherapy,” says Coalition leader Mark Jewell, MD, Eugene, Oregon. “We don’t know the safety or efficacy of these compounds and, until there exists credible evidence, consumers are advised not to have these injections.”

The Coalition urges consumers to be very selective about cosmetic treatments, and the individuals who provide them. “Only accept treatment prescribed by a qualified physician and administered under that physician’s supervision. Whether an injection or treatment is to treat aging conditions, to treat cellulite or a similar body contouring condition, whether it sounds reasonable or too good to be true, you should always be aware of false claims,” says Coalition leader Jeffrey Kenkel, MD of Dallas, TX. “Verifying that the drug or device that is recommended for your injection is FDA approved is an important first step. It should be approved specifically for cosmetic use as prescribed or similarly to what is prescribed for you.”