Wednesday, February 18, 2015

What should I do about my Cellulite?

With Spring and Summer approaching, that means warmer weather and it means more of your skin will be visible as it escapes the confines of winter clothing.   For many women, cellulite, veins, hairs and brown spots are common concerns.  Fortunately, there are some simple ways to help you enjoy the warmer weather with confidence.  Veins can be treated with sclerotherapy or laser, hairs can be zapped away with lasers too, and brown spots do great with, you guessed it, lasers, too.
But cellulite-- how do we deal with the lumpy areas and indentions under our skin?  Not even liposuction is overly successful at removing cellulite.  Cellulite is a combination of 1) Thinning of the skin-- with age collagen is not as tightly wound up; 2) Overgrowth of fat lobules which poke through the thinned skin—they cause constriction to the vessels traveling through the fibrous septae; and 3) Constriction of the fibrous septae due the overgrown fat lobules near the skin surface.  To address cellulite successfully, all three aspects need to be addressed.

We have two methods of treatment.  The first are the noninvasive treatments.  These include Velashape, Thermage and Exilis Elite.  Velashape uses a combination of suction, infrared head and radiofrequency energy to heat and knead the skin.  The idea is to achieve localized fat apoptosis, to lengthen the fibrous septae and to stimulate collagen in the skin.  When performed diligently by an experienced and dedicated clinician, the results are actually very good.  Periodic maintenance after a series of treatments is a good idea to keep the areas smooth. Thermage and Exilis Elite both use monopolar radiofrequency to deeply heat the tissue to induce apoptosis of the fat cells and stimulate collagen in the skin, essentially achieving very similar results.  Thermage is an excellent treatment and can be accomplished in a single visit (though a repeat treatment after 3-6 months would yield heightened results), but it is painful.  Exilis Elite is performed in a series of 4 weekly treatments.   Hydration is very important with all these procedures as well hydrated skin allows for delivery of higher temperatures through the skin for greater efficacy. 

The second method are the minimally invasive technologies which include Cellulaze, VaserSmooth, and the latest ThermiTight.   With all three procedures, the skin is first numbed using a local anesthetic solution.  All of these procedures require wearing a compression garment immediately following treatment for 1-2 weeks and all three follow a single treatment protocol.  With Cellulaze, a spagethetti thin canula is threated back and forth through the cellulitic areas to 1) melt and destroy fat cells, 2) pop and break through the fibrous septae and 3) stimulate collagen via heat delievered directly under the skin.  VaserSmooth works in an identical fashion, but instead of laser energy, uses the gentler power of ultrasound to accomplish the same three goals.  The advantage of VaserSmooth is less disruption to the vessels and nerves, where the laser cauterizes through these structures.  Therefore the recovery time is a bit faster with less bruising and less swelling.  The third method called Thermitight again accomplishes all three end goals, but utilizes Radiopfrequency instead.  The greatest advantage with Thermitight is the strict temperature control of the device both internally and on the skin.  An infrared camera is constantly watching the skin temperature to keep it in a safe therapeutic zone and the tiny probe under the skin also allows delivery of exact therapeutic temperatures to effectively destroy fat cells, break through the fibrous septae and tighten the skin.  Of all three technologies, Thermitight yields the best skin tightening effects and effectively treats the fat and septae as well.  These minimally invasive treatments are perhaps more permanent than the noninvasive options.   Recovery time is typically one to two days with return to exercise after 2-3 weeks. 

Which method to choose can become a challenge, especially when there are so many great options.  The first consideration would be whether a minimally invasive option is acceptable for the patient.  If so, VaserSmooth or ThermiTight would both be great permanent treatments.  If minimally invasive doesn’t sound appealing and there is no time for wearing a garment or recovery, the noninvasive options are all great choices.   The newest of the noninvasive procedures is Exilis Elite.  Even though it is a series of treatments, patients prefer the price point and the comfort during treatment (compared to Thermage which can be painful while being administered). 

We highly recommend doing some research and then coming in for a consultation for further discussion.


 Results from ThermiTight

VaserSmooth Results

Exilis Elite Results

Thermage Results