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Neil S Sadick - One of the best experts on this subject based on the ideXlab platform.
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treatment for Cellulite
International Journal of Women's Dermatology, 2019Co-Authors: Neil S SadickAbstract:Abstract Cellulite is a multifactorial condition that is present in 80% to 90% of postpubertal women and is one of the most intolerable esthetic imperfections. There are several theories on the pathophysiology of Cellulite, and a number of different therapeutic regimens have been developed, from topical treatments to mechanical or energy-based devices. In this brief review, we summarize the scientific landscape to determine the clinical evidence with regard to the safety and efficacy of Cellulite treatment options. Clinical protocols and the author’s experience using a combination of internal and external procedures are also discussed. Studies using laser and light modalities along with radiofrequency have shown improvements in Cellulite and a good safety profile, but acoustic wave therapy, subcision, and the 1440-nm Nd:YAG minimally invasive laser have demonstrated the most beneficial results in Cellulite reduction. Although there is paucity of scientific evidence for treatments that improve Cellulite, future emerging options and their combination may pave the way to eradicate this primarily cosmetic esthetic concern.
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efficacy of multipolar radiofrequency with pulsed magnetic field therapy for the treatment of abdominal Cellulite
Journal of Cosmetic and Laser Therapy, 2017Co-Authors: Rungsima Wanitphakdeedecha, Angkana Sathaworawong, Woraphong Manuskiatti, Neil S SadickAbstract:ABSTRACTIntroduction: Cellulite is a metabolic condition, predominately seen in females, that affects the subcutaneous tissue of the posterolateral thighs, buttocks, pelvic region, and abdomen. It is characterized by skin dimpling and lumpiness resembling an orange peel. Despite the wide range of treatment options for patients with Cellulite, there is a paucity of empirical data supporting their efficacy. The objective of this study was to evaluate the efficacy of a new-generation multipolar radiofrequency (RF) device for the treatment of Cellulite. Methods: A multipolar RF device with pulsed magnetic fields was used to treat abdominal Cellulite. Twenty-five healthy adult females with stage II or stage III abdominal Cellulite underwent 8 weekly treatments. Assessments were performed at baseline and at weeks 1, 4, and 12 following the final treatment. Results: Reduction in subcutaneous thickness in the axial and sagittal plane of the abdomen was observed at 1 week following treatment initiation. Results fr...
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Cellulite: An Evidence-Based Review
American Journal of Clinical Dermatology, 2015Co-Authors: Stefanie Luebberding, Nils Krueger, Neil S SadickAbstract:Background Cellulite is a multifactorial condition that is present in 80–90 % of post-pubertal women. Despite its high prevalence, it remains a major cosmetic concern for women. A wide range of products and treatments for Cellulite reduction is available; however, no systematic review has been performed so far to evaluate the efficacy of the available treatment options for Cellulite. Objective The objective of this review is to provide a systematic evaluation of the scientific evidence of the efficacy of treatments for Cellulite reduction. Methods This systematic review followed the PRISMA guidelines for reporting systematic reviews and meta-analyses. Only original articles in English or German reporting data on the efficacy of Cellulite treatments from in vivo human studies were considered. In total, 67 articles were analyzed for the following information: therapy, presence of a control group, randomization, blinding, sample size, description of statistical methods, results, and level of evidence. Results Most of the evaluated studies, including laser- and light-based modalities, radiofrequency, and others had important methodological flaws; some did not use Cellulite severity as an endpoint or did not provide sufficient statistical analyses. Of the 67 studies analyzed in this review, only 19 were placebo-controlled studies with randomization. Some evidence for potential benefit was only seen for acoustic wave therapy (AWT) and the 1440 nm Nd:YAG minimally invasive laser. Conclusion This article provides a systematic evaluation of the scientific evidence of the efficacy of treatment for Cellulite reduction. No clear evidence of good efficacy could be identified in any of the evaluated Cellulite treatments.
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Cellulite an evidence based review
American Journal of Clinical Dermatology, 2015Co-Authors: Stefanie Luebberding, Nils Krueger, Neil S SadickAbstract:Background Cellulite is a multifactorial condition that is present in 80–90 % of post-pubertal women. Despite its high prevalence, it remains a major cosmetic concern for women. A wide range of products and treatments for Cellulite reduction is available; however, no systematic review has been performed so far to evaluate the efficacy of the available treatment options for Cellulite.
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treatment of Cellulite part i pathophysiology
Journal of The American Academy of Dermatology, 2010Co-Authors: Misbah Khan, Frank Victor, Neil S SadickAbstract:Cellulite is a topographic skin change that is nearly ubiquitous in postpubertal women. Treatment remains elusive. The various treatments currently available are only partially or temporarily effective. Newer therapeutic modalities continue to evolve without much understanding of the complex nature of Cellulite. The successful treatment of Cellulite will ultimately depend upon our understanding of the pathophysiology of Cellulite adipose tissue. Part I of this two-part series on Cellulite reviews how the concept and perception of Cellulite has evolved over time and its proposed etiologies. The article also focuses on the physiology of human adipose tissue, particularly regarding Cellulite. Learning objectives After completing this learning activity, participants should be able to differentiate adipocyte physiology between the Cellulite-prone areas and other parts of the body, understand the spectrum of conventional and interventional treatment modalities available, including their modes of action and controversies that dominate and question their long-term efficacy based on published studies, and discuss newer horizons for the treatment of Cellulite.
Doris Hexsel - One of the best experts on this subject based on the ideXlab platform.
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validated assessment scales for Cellulite dimples on the buttocks and thighs in female patients
Dermatologic Surgery, 2019Co-Authors: Doris Hexsel, Gerhard Sattler, Rolf Bartsch, Kimberly J Butterwick, Gabriela Casabona, Yates Yen Yu Chao, Joseph Eviatar, Sabrina G Fabi, Joana Costa, Thorin L GeisterAbstract: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.
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Acoustic wave therapy for Cellulite, body shaping and fat reduction
Journal of Cosmetic and Laser Therapy, 2017Co-Authors: Doris Hexsel, Fernanda Oliveira Camozzato, Aline Flor Silva, Carolina SiegaAbstract:ABSTRACTBackground: Cellulite is a common aesthetic condition that affects almost every woman. Objective: To evaluate the efficacy of acoustic wave therapy (AWT) for Cellulite and body shaping. Methods: In this open-label, single-centre trial, 30 women presenting moderate or severe Cellulite underwent 12 sessions of AWT on the gluteus and back of the thighs, over six weeks. The following assessments were performed at baseline, and up to 12 weeks after treatment: Cellulite Severity Scale (CSS), body circumference measurements, subcutaneous fat thickness by magnetic resonance imaging (MRI), quality of life related by Celluqol® and a satisfaction questionnaire. Results: The treatment reduced Cellulite severity from baseline up to 12 weeks after the last treatment session (subjects presenting severe Cellulite: 60% to 38%). The mean CSS shifted from 11.1 to 9.5 (p < 0.001). Hips circumferences reduced from 99.7 and 103.2 cm to 96.2 and 100.3 cm (respectively, p < 0.001). The average thickness of the subcutaneo...
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cosmeceuticals for Cellulite
Seminars in Cutaneous Medicine and Surgery, 2011Co-Authors: Doris Hexsel, Mariana SoirefmannAbstract:Cellulite is characterized by alterations to the skin surface, presenting as dimpled or puckered skin of the buttocks and posterior and lateral thighs. It mainly affects women. Cellulite occurrence is believed to be due to structural, inflammatory, morphological and biochemical alterations of the subcutaneous tissue. However, its pathogenesis is not completely understood. Topical treatments for Cellulite include many agents, such those that increase the microcirculation flow, agents that reduce lipogenesis and promote lipolysis, agents that restore the normal structure of dermis and subcutaneous tissue, and agents that scavenge free radicals or prevent their formation. There are many cosmetic and medical treatments for Cellulite. However, there is little clinical evidence of an improvement in Cellulite, and none have been shown to lead to its resolution. The successful treatment of Cellulite will ultimately depend upon our understanding of the physiopathology of Cellulite adipose tissue. Semin Cutan Med Surg 30:167-170 © 2011 Elsevier Inc. All rights reserved.
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side by side comparison of areas with and without Cellulite depressions using magnetic resonance imaging
Dermatologic Surgery, 2009Co-Authors: Doris Hexsel, Marcelo Abreu, Ticiana Da Costa Rodrigues, Mariana Soirefmann, Debora Zechmeister Do Prado, Maryelle Moreira Lima GamboaAbstract:BACKGROUND Cellulite is characterized by alterations in the relief of the skin surface. Magnetic resonance imaging (MRI) is recognized as a reliable technique for measuring adipose volume according to body site and for the visualization of the subcutaneous structures. OBJECTIVE To compare subcutaneous tissue in areas with and without Cellulite on the buttocks of same subjects using a noninvasive technique. METHODS AND MATERIALS Thirty female patients with Cellulite on the buttocks underwent MRI. An area with Cellulite and another without Cellulite on the contralateral buttock were selected. Two soft gelatin capsules of different sizes were used as skin markers to differentiate the areas with and without Cellulite. RESULTS Fibrous septa were visualized in 96.7% of the area with Cellulite depressions; most of them were ramified (73.3%) and presented a high-intensity signal on T2 images (70%). All fibrous septa found in the examined areas were perpendicular to the skin surface. The average fibrous septa thickness was 2.18 ± 0.89 in the area with Cellulite and 0.27 ± 0.64 in the area without Cellulite. CONCLUSION Results of the MRI analysis showed that Cellulite depressions on the buttocks were significantly associated with the presence of underlying fibrous septa.
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a validated photonumeric Cellulite severity scale
Journal of The European Academy of Dermatology and Venereology, 2009Co-Authors: Doris Hexsel, Taciana Dalforno, Camile L HexselAbstract:Background With recent advances in the treatment of Cellulite and localized fat, a comprehensive objective method of measuring Cellulite can be potentially useful, especially since important morphological aspects of Cellulite are not part of the current classification. Objective To develop and to validate a new photonumeric Cellulite severity. Methods Based on standardized photographs of 55 patients with Cellulite, five key morphological aspects of Cellulite were identified. A new photonumeric severity scale was developed and validated. Results The five key morphological features of Cellulite were identified and included the number of depressions, depth of depressions, clinical appearance of evident raised lesions, and presence of flaccidity and the grade of Cellulite. Each item was graded from 0 to 3, allowing final classification of Cellulite as mild, moderate, and severe. Results for validation of the scale are statistically significant ( P 0.7; correlation item-total > 0.7, with the exception of the right buttock; intraclass correlation coefficients 0.881-0.922; Cronbach's alpha 0.851-0.989 and factor analysis 68-76%. Conclusion The proposed photonumeric scale is a consistent, comprehensive, reliable, and reproducible tool for the standardized and objective assessment of the severity of Cellulite.
Axel Voss - One of the best experts on this subject based on the ideXlab platform.
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can Cellulite be treated with low energy extracorporeal shock wave therapy
Clinical Interventions in Aging, 2008Co-Authors: Fiorenzo Angehrn, Christoph Kuhn, Axel VossAbstract:The present study investigates the effects of low-energy defocused extracorporeal generated shock waves on collagen structure of Cellulite afflicted skin. Cellulite measurement using high-resolution ultrasound technology was performed before and after low-energy defocused extracorporeal shock wave therapy (ESWT) in 21 female subjects. ESWT was applied onto the skin at the lateral thigh twice a week for a period of six weeks. Results provide evidence that low-energy defocused ESWT caused remodeling of the collagen within the dermis of the tested region. Improving device-parameters and therapy regimes will be essential for future development of a scientific based approach to Cellulite treatment.
Michael S Kaminer - One of the best experts on this subject based on the ideXlab platform.
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Updates on the understanding and treatment of Cellulite.
Seminars in Cutaneous Medicine and Surgery, 2018Co-Authors: Sara Hogan, Mara Weinstein Velez, Michael S KaminerAbstract:: Cellulite is a common dermatologic condition and frequent cause of cosmetic concern among women. This paper aims to update what is known about the pathogenesis of Cellulite and reviews targeted treatment modalities that address its underlying components of microvascular dysfunction, endocrine-mediated inflammation, and connective tissue fibrosclerosis.
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efficacy using a modified technique for tissue stabilized guided subcision for the treatment of mild to moderate Cellulite of the buttocks and thighs
Dermatologic Surgery, 2018Co-Authors: Omer Ibrahim, Adele Haimovic, Michael S KaminerAbstract: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.
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Cellulite: a review of pathogenesis-directed therapy.
Seminars in Cutaneous Medicine and Surgery, 2017Co-Authors: Daniel J. Callaghan, Deanne Mraz Robinson, Michael S KaminerAbstract:Cellulite is a condition that affects the majority of postpubertal women and can negatively impact quality of life. This review discusses several proposed pathophysiologies of Cellulite, and examines treatment options that have been utilized, focusing on the etiologic factor targeted by the therapies. This approach aims to help clarify the pathogenesis of Cellulite and provide a road map for developing effective treatment paradigms for patients.
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therapeutic approaches to Cellulite
Seminars in Cutaneous Medicine and Surgery, 2015Co-Authors: Jeremy B Green, Joel L Cohen, Joely Kaufman, Andrei I Metelitsa, Michael S KaminerAbstract:Cellulite is a condition that affects the vast majority of women. Although it is of no danger to one's overall health, Cellulite can be psychosocially debilitating. Consequently, much research has been devoted to understanding Cellulite and its etiopathogenesis. With additional insights into the underlying causes of its clinical presentation, therapeutic modalities have been developed that offer hope to Cellulite sufferers. This review examines evidence for topical treatments, noninvasive energy-based devices, and recently developed minimally invasive interventions that may finally provide a solution.
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Technology advances Cellulite treatment
Dermatology Times, 2015Co-Authors: Jeremy B Green, Joely Kaufman, Michael S KaminerAbstract:We finally have effective interventions that address the root cause of Cellulite (fibrous tethers). Now, patient education and selection becomes paramount. Long horizontal lines and the infragluteal cleft or bulge, the so-called “banana-roll” cannot be corrected with these interventions. Prior to performing Cellulite procedures we must impart this knowledge to our patients to ensure realistic expectations.
Mitchel P. Goldman - One of the best experts on this subject based on the ideXlab platform.
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Laser, light, and energy devices for Cellulite and lipodystrophy.
Clinics in Plastic Surgery, 2011Co-Authors: Jennifer D. Peterson, Mitchel P. GoldmanAbstract:: Cellulite affects all races, and it is estimated that 85% of women older than 20 years have some degree of Cellulite. Many currently accepted Cellulite therapies target deficiencies in lymphatic drainage and microvascular circulation. Devices using radiofrequency, laser, and light-based energies, alone or in combination and coupled frequently with tissue manipulation, are available for improving Cellulite. Laser assisted liposuction may improve Cellulite appearance. Although improvement using these devices is temporary, it may last several months. Patients who want smoother skin with less visible Cellulite can undergo a series of treatments and then return for additional treatments as necessary.
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a single center randomized comparative prospective clinical study to determine the efficacy of the velasmooth system versus the triactive system for the treatment of Cellulite
Lasers in Surgery and Medicine, 2006Co-Authors: Pavan K Nootheti, Angela Magpantay, Gail Yosowitz, Steve Calderon, Mitchel P. GoldmanAbstract:Background and Objectives One area of cosmetic concern for women of all races is the unsightly appearance of Cellulite in the buttocks area and lower extremities. Two modern technological advances claim to improve Cellulite and provide reproducible results, TriActive and VelaSmooth. The TriActive laser is intended to reduce the appearance of Cellulite through the combination of low-energy diode laser, contact cooling, suction, and massage. The VelaSmooth is based on a combination of two different ranges of electromagnetic energy: infrared light and radio frequency (RF) combined with mechanical manipulation of the skin. This single center study was designed to evaluate the efficacy of the VelaSmooth versus TriActive in the reduction of the appearance of Cellulite. Study Design/Materials and Methods Twenty female patients were treated twice a week for 6 weeks with the randomization of TriActive on one side and VelaSmooth on the other side. Patients were evaluated with photographs and circumferential thigh measurements before treatment and after the final treatment. Results Although there was improvement in the reduction of Cellulite for each device individually, there was no significant difference between VelaSmooth or TriActive devices in the following categories: reduction of thigh circumference, photographic evaluation, and perceived change in before and after photographic grading. There was a statistically significant increase in the incidence of post-treatment bruising with the VelaSmooth compared to TriActive. Conclusions In conclusion, both the TriActive and VelaSmooth provide improvement of Cellulite. When comparing differences in efficacy, the average mean percent change calculated was roughly the same for both treatments and showed no statistical difference. Lasers Surg. Med. 38:908–912, 2006. © 2006 Wiley-Liss, Inc.
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clinical evaluation of a device for the treatment of Cellulite triactive
The American Journal of Cosmetic Surgery, 2005Co-Authors: Sarah M Boyce, Anju Pabby, Prapai Chuchaltkaren, Benedetta Brazzini, Mitchel P. GoldmanAbstract:Introduction:Cellulite has always been a difficult condition for patients and cosmetic physicians to treat. Even if improvement is made in the appearance of Cellulite, no machine or topical treatment exists that can provide long-term results in the treatment of Cellulite. We evaluated a technique that increases lymphatic drainage and vascular permeation to assist in decreasing the appearance of Cellulite.Materials and Methods:Sixteen female patients underwent 12 treatments with a device called Triactive, which has a triple-pronged mechanism of action consisting of low-level suction, diode laser, and contact cooling. We measured results by waist, hip, and thigh circumference as well as elasticity, thermography, and blinded photograph evaluations.Results:We found a small decrease in hip and thigh circumference as well as an increase in elasticity of the treated Cellulite. Evaluation of the photographs yielded an overall 21% average improvement in the appearance of Cellulite. There was no change in thermogra...
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a double blinded randomized trial testing the tolerability and efficacy of a novel topical agent with and without occlusion for the treatment of Cellulite a study and review of the literature
Journal of Drugs in Dermatology, 2004Co-Authors: Kristina E Paabo, Mitchel P. GoldmanAbstract:Cellulite is the unsightly dimpling and nodularity frequently found on the thighs and buttocks of post-adolescent women. The anatomy and pathophysiology of this unwanted condition is poorly understood. The paucity of research studies to date has led to a dormancy of scientifically based therapeutic options that are effective and tolerable. The purpose of this study is to evaluate the tolerability and efficacy of a novel topical agent based on a plausible pathophysiologic mechanism in the treatment of Cellulite, and to compare the efficacy of this agent used in combination with an occlusive bioceramic-coated neoprene garment, to the agent used alone without occlusion. We will also review the current understanding of the etiology and nature of Cellulite and summarize available treatment options. Twenty women with a moderate degree of Cellulite were entered into a four-week, double-blinded, randomized trial where an anti-Cellulite cream was applied to the affected sites on a nightly basis. Each subject was randomized to receive occlusion by a bioceramic-coated neoprene garment on either the right or left leg, with the contralateral side serving as a control with no occlusion. High-quality digital photography was taken before treatment and after four weeks at various angles, with tangential full-spectrum lighting. Four blinded, independent dermatologist reviewers assessed the photographs for improvement. Subjects completed questionnaire forms to assess tolerability and efficacy. Of the 17 subjects who completed the study, 76% noticed an overall improvement in their Cellulite, with 54% reporting greater improvement in the thigh that received garment occlusion. The average measured decrease in thigh circumference was 1.2 cm, noting a 1.3 cm reduction with occlusion and a 1.1 cm reduction without occlusion. Upon review of the pre- and post-study photographs, the dermatologist evaluators found an improvement in 65% of treated legs with occlusion, and 59% of treated legs without occlusion. Further, the evaluators found the occluded thighs to show greater improvement than the non-occluded thighs in 65% of subjects. The topical agent used in this study was found to be effective in reducing the appearance of Cellulite. Bioceramic-coated neoprene garment occlusion potentiates the effect of this topical agent in Cellulite reduction. The success of this study validates the pathophysiologic mechanism used to formulate the topical agent used.