“ An introduction to Velasmooth®  in  the treatment of Cellulite” Dr. P. Treacy  Ailesbury Clinic  Dublin Ireland
MEDICAL DISCLOSURE: Dr. Patrick J. Treacy is a Cosmetic Doctor registered in UK and Ireland  I have previously been registered in United States, Australia, New Zealand and South Africa. I purchased my own  Velasmooth ®  equipment. I have no financial interest or stock in Syneron  I receive no additional remuneration for equipment bought by you after attendance at this lecture .
What is Cellulite?   Cellulite is a term that is used to describe fat deposits under the skin that give the skin a dimpled like appearance.  It is estimated that up to 80% of women have a problem with cellulite.
Cellulite  is a term originally coined    in European salons and spas in the    1970’s to describe deposits of    dimpled fat found on the thighs and    buttocks of many women The History of the term ‘Cellulite’
P romotion of the concept in U.S. after  publication of  Cellulite: Those Lumps, Bumps and Bulges You Couldn't Lose  by   Nicole Ronsard, the owner of a New York City beauty salon that specialized in skin and body care The Concept of Cellulite Grows
Fat Layer of Skin   The fat layer of the skin  is located in the subcutaneous layer of tissue known as the  hypodermis.
Strands of fibrous tissue    connect the skin to deeper    tissue layers and also separate    compartments that contain fat    cells. When fat cells increase    in size, these compartments    bulge and produce a dimpled    appearance of the skin . The Physiology of Cellulite
What happens during Cellulite?   Cellulite is most often seen in women due to hormonal reasons. The fat is arranged in large chambers of macromolecules separated by columns of collagen fibres.  In people who are overweight excess fat is stuffed in these  fibrotic  compartments causing them to bulge out.
What causes the ‘Dimpling’ of Skin ?   The ‘ dimpling ’ is caused by modification of    the texture of the subcutaneous tissue due to    oedema and fibrosis secondary to impaired    circulation and degradation of the tissue in    this area.
So what exactly is Cellulite?   Cellulite is localised fat ‘ caught    in a jail’  of interstitial connective    tissue  Cellulite is a lack of drainage of    fluid secondary to venous +    lymphatic stasis because of    genetic, hormonal and even    environmental reasons
1. HEREDITY 2. HORMONAL  - premenstrual syndrome, 3. VENOUS  and  LYMPHATIC  stasis 4. NUTRITION   insufficient water intake - excess of sugars, fats What are the Causes of Cellulite?
Stage 1   Problem seems to appear    whenever you press skin   Stage 2  Dimpling of skin only appears    as the patient stands up  The Different Grades of Cellulite
Stage 3  ‘ Peau de orange’  is present    when the patient is lying down Stage 4  You can actually feel knots in    the tissue when you touch it  The Different Grades of Cellulite
The Physiology of Stages 1 & 2   Stage 1 and 2  The problem only appears whenever  you press skin or the patient stands up. This is caused by localised oedema secondary to vascular and capillary extravasation with dissociation of the adipocytes
The Physiology of Stages 3 & 4   Stage 3   ‘ Orange skin’ is seen whenever the    patient is lying down. This is caused    by the formation of   micronodules   of   both normal and larger adipocytes    encapsulated by a network of    collagen fibres   Stage 4   The problem is present at all times    because the micronodules fuse    together to form painful    subcutaneous   macronodules .
1996  Dr. Neil Solomon, conducted a double-blind study of 100 people to see whether cellulite differed from ordinary fat.   The pathologists found  no difference  between the two clinical types of fat The Medical Evaluation of Cellulite begins
1998 , researchers at the Rockefeller Institute used ultrasound, microscopic examinations, and some fat-metabolism studies to see whether “cellulitic" skin and normal skin differed The Medical Investigation of Cellulite
The researchers concluded (a) certain characteristics of skin    make women more prone than men    to develop cellulite (b) there were no differences in the  appearance or  function of the fatty  tissue or the regional blood flow The Medical Concept of Cellulite
Products include special washcloths;  creams and gels, supplements    herbs bath liquids; massagers    rubberised pants; brushes; rollers;  body wraps; and toning lotions . The Market for  Cellulite  products
“ Anticellulite" products include tablets that work while you are awake and others that reduce cellulite….. while you sleep!   The Growing Market for Cellulite Products  135 million Europeans are overweight    50 million Europeans suffer from obesity    This is an increase of 25% in ten years
Body Wrapping The wrapping causes temporary water loss by compression and by perspiration. The water is quickly replaced within 24 hours .  Body wrap claims this technique works because ‘cellulite’ is really water logged fatty tissue..
Herbal Product developed by Italian chemist called Gianfranco Merizzi. Ingredients include compounds clover extract, evening primrose oil, fucus vesiculosis, bioflavanoids, soya lecithin, ginko biloba, iron oxide and fish oil.  Cellasene ®
1998,  FDA approved a French    technique called Endomologie, for temporarily improving the appearance of cellulite Endermologie ®
Endermologie ®  usually takes 10-20  treatments. Monthly maintenance is  required to maintain these effects.  Endermologie ®
Procedure is unable to break down dimpling effect although it can be used in combination therapy Lipodissolve ®
During 1990’s treatments for cellulite    remained largely unsuccessful because    they targeted skin appearance. It    soon was apparent that  dimpling  on    the surface of the skin would require a    deeply acting treatment . The Treatment of Cellulite
VelaSmooth™  is a medical device for the    treatment of cellulite. Using the combined    energy technology —  Bi-Polar Radio Frequency     and  Infrared Light  — plus tissue mobilization and    suction to safely and effectively re-contour the    skin surface Velasmooth ®
Velasmooth ® RF  increases oxygen intracellular diffusion by    heating adipose tissue to a depth up to 10 mm Infrared Light   increases elasticity of skin and    heats subcutaneous fat to a depth of up to 3 mm,    while safeguarding the skin from damage Suction   manipulates and smoothes out the skin
Vela Smooth Design Ergonomic  applicator Intuitive, simple  interface Sophisticated  software  controlling treatment parameters
Vela Technical Specifications Infrared (IR) range 700-2000nm RF power 30 W IR power 30 W Treated area  40x40 mm (for  thighs, buttocks, and abdomen ) 25x30 mm (for  arms, calf, under-chin, and face )
Large Applicator 4 mechanisms : IR, RF, Rollers, Skin Curving (Suction) 3 intensity levels
Small Applicator No rollers
Clinical Indications Temporary reduction in  circumferences   Temporary reduction in the appearance of  cellulite   Improvement in the local blood  circulation Improvement of  skin texture Relief of minor  muscle aches  and pain
Contraindications Current or history of  cancer Pregnancy  and nursing Scarring ,  infection, or fragile skin  at the tx. area History of  keloid  scarring Patients with a  pacemaker  or internal  defibrillator
Contraindications Known  photosensitivity  to near infrared light Use of  medications  known to induce photosensitivity, including Accutane, and anticuagulants Diabetes  (Type I or II), unless under control Varicose veins  in the treated area
Anatomy of Cellulite Fat cells swell and push upwards as septa are rigid Blood and lymph vessels are compresses   Accumulation of intracellular fluids and toxins
Cellulite Treatment Fat deposits caught in chambers of connective tissue (septae) create  phenomenon of  cellulite Velasmooth ®   treatment destroys the fat by acceleration of metabolic process
Cellulite Treatment This leads to an improved skin appearance after about 6-10 sessions
Velasmooth ®  Vacuum pinches the skin and attaches it to the rotating electrodes
Mechanism of Increasing Blood Supply 90% of blood vessels are closed at normal atmospheric pressure. Decreasing the atmospheric pressure vessel cause dilatation and increases blood flow.
Mechanism of Deep Hyperthermia Infrared light heats the tissue up to 5mm depth RF heats tissue from 5 to 15mm depth IR Lamp Parabolic  reflector Infrared filter RF electrodes
Deep Hyperthermia by IR + RF Infrared  (IR)  light heats the tissue down to the  deep dermis RF  heats tissue down to the  subcutis Lamp Parabolic  reflector Infrared filter RF  electrodes
Rollers- Mechanical effect Rollers and Vacuum Suction (150 mbar or 750 mm of Hg) Massaging effect facilitates drainage of trapped intercellular fluid to lymphatics
Rollers- Mechanical effect Breaking connective tissue bonds also helps to reduce  volume of fat chambers in hypo-dermis
Suction Helps Hyperthermia Suction brings the  target  closer to the IR and RF source Target  is the  blood vessels  in the deep dermis and in the subcutaneous fat layer and the  tissue  around
Suction Mechanism for Increased Blood Supply 90% of blood vessels are closed at normal atmospheric pressure Decreasing the atmospheric pressure increases vessel dilation and blood flow Thinning the cell membrane also helps in increased substance exchange between fat cells and vessels
Vela Smooth Idea Re-contouring of skin surface by: Increasing  metabolic rate  in adipose tissue due to: Increased  blood supply   Increased  oxygen diffusivity  and  exchange Between blood vessels and fat cells Reduced fat  chambers size  due to: Reduced  size  of fat cells Mechanical  breakage  of connective tissue bonds  Intercellular  fluid drainage
Hyperthermia Effect on Metabolism Increases substance exchange between fat cells and blood vessels Increase rate of fat metabolic reaction
Oxygen Transport Coefficients in Water Hyperthermia increases diffusivity of oxygen and decreases skin viscosity delivering more oxygen from capillaries to mitochondrion 4.88x10 -5 0.467 60 3.99x10 -5 0.547 50 3.24x10 -5 0.653 40 1.97x10 -5 1.002 20 Diffusivity of O 2  [cm 2 /s] Viscosity of H 2 O [centipoises] Temperature  O C
Hyperthermia Effect on Rate of Metabolism Arrhenius law for yield of chemical reaction Y=At e BT   Where A and B as constant, t is time and T is temperature Rate of metabolic reaction is exponential function of tissue temperature.
Treatment Schedule Number of treatments – 8-10  Treatments frequency - twice a week Supporting treatment - Once in 1 to 3 months Treatment duration 30-40min
Typical improvement curve (based on C. Lee M.D. data) Strong effect Saturating effect Moderate effect
Treatment Indication Cellulite Non proportional fat distribution Post liposuction non-uniformity of adipose tissue
Cellulite Treatment Number of passes and levels of energy should be adjusted to obtain stable erythema over the treated area Slow replacement of applicator or staying on one place not longer then 5 pulses
Velasmooth ® Cellulite treatment
G.Boey M.D.,Canada
Velasmooth ® Cellulite
Dr. Christopher Ho, Vela
Dr. Shah,  Vela
Dr. Shah,  Vela
 
Dr. Shah,  Vela
Tina Alster M.D. , Vela
Dr. Shah,  Vela
Non-proportional Fat Distribution Some parts of the body accumulate more fat and have to be treated more aggressively to improve body contour
Anchor Zones Even small reduction of fat in anchor zones significantly improves the body contouring
Treatment of Anchor Zones The anchor zones should be treated at maximal settings Average number of passes applied to the anchor zones should be higher that for rest of the body at least by 2 passes
Before After Body Contouring H. Akai, M.D. Tokyo, Japan
Treatment of Post Liposuction Patients Improves the results Allows homogenization of adipose tissue Improve healing process Reduce loose skin  Treatment technique Two passes with slow replacement of applicator or with staying on one place during 4-6 pulses Two passes with fast moving the applicator with stronger pressing the skin
Dr. A. Del Giglio, Italy ,  Post Liposuction Treatment
Hyperthermia Effect on Metabolism Heat produced by  IR  increases  oxygen dissociation  from oxy-hemoglobin in heated dermal blood vessels Heat produced by  RF  increases rate of  oxygen  intracellular  diffusion  by deep hypodermal heating Fat  metabolic reaction  in adipocytes mitochondria is increased Use of stored energy from fat cells  (lipolysis)  results in  shrinkage  of cells themselves
Treatment Protocol Treat thighs, buttock and abdomen with  large  applicator, and arms, calf, under-chin, and face with  small  applicator ~ 10  Treatments performed  twice a week (  Patients with lymphatic  drainage  problems need more sessions) Maintenance treatments done monthly, then bi-monthly Average treatment time  30-45 min ~10 mins per area (thigh, buttock, abdomen, arms, chin) No more than  5 sec  dwell on one site
Treatment Parameters Best results with  maximal  (3 rd ) level Reduce  IR  for dark skin or over dark tattoo Reduce  RF  on curved areas with bad coupling Reduce  suction  on sensitive areas (abdomen, inner-thigh) and on loose skin
Treatment Parameters Use lower levels for muscle aches, poor circulation and skin texture Increase levels in subsequent sessions Repeat  passes  until persistent endpoints are apparent Endpoints are general  erythema, edema  and  warmth
Treatment Tips Pretreatment -  exfoliation  and  trimming  of long hair Avoid anticoagulants (if medically permitted), as they increase the chance of bruising Use  conductive water  spray – not gel! Replenish spray only when movement of roller is affected – not when the spray appears dry
Treatment Tips Treating without spray – keep skin very clean Work in general direction of the  lymphatics  –  ONE WAY Change direction to achieve best  contact .  Keep  ONE WAY
Facilitate Lymphatic Drainage
Before and After 8 Cellulite Treatments Before After
Before and After 8 Cellulite Treatments
Fat Anchor Zones Evidence of body  contouring  by fluids redistribution in anchor zones Result =  reduction in circumference
THANK YOU!
QUESTIONS?

Velasmooth in the treatment of Cellulite

  • 1.
    “ An introductionto Velasmooth® in the treatment of Cellulite” Dr. P. Treacy Ailesbury Clinic Dublin Ireland
  • 2.
    MEDICAL DISCLOSURE: Dr.Patrick J. Treacy is a Cosmetic Doctor registered in UK and Ireland I have previously been registered in United States, Australia, New Zealand and South Africa. I purchased my own Velasmooth ® equipment. I have no financial interest or stock in Syneron I receive no additional remuneration for equipment bought by you after attendance at this lecture .
  • 3.
  • 4.
    What is Cellulite? Cellulite is a term that is used to describe fat deposits under the skin that give the skin a dimpled like appearance. It is estimated that up to 80% of women have a problem with cellulite.
  • 5.
    Cellulite isa term originally coined in European salons and spas in the 1970’s to describe deposits of dimpled fat found on the thighs and buttocks of many women The History of the term ‘Cellulite’
  • 6.
    P romotion ofthe concept in U.S. after publication of Cellulite: Those Lumps, Bumps and Bulges You Couldn't Lose by Nicole Ronsard, the owner of a New York City beauty salon that specialized in skin and body care The Concept of Cellulite Grows
  • 7.
    Fat Layer ofSkin The fat layer of the skin is located in the subcutaneous layer of tissue known as the hypodermis.
  • 8.
    Strands of fibroustissue connect the skin to deeper tissue layers and also separate compartments that contain fat cells. When fat cells increase in size, these compartments bulge and produce a dimpled appearance of the skin . The Physiology of Cellulite
  • 9.
    What happens duringCellulite? Cellulite is most often seen in women due to hormonal reasons. The fat is arranged in large chambers of macromolecules separated by columns of collagen fibres. In people who are overweight excess fat is stuffed in these fibrotic compartments causing them to bulge out.
  • 10.
    What causes the‘Dimpling’ of Skin ? The ‘ dimpling ’ is caused by modification of the texture of the subcutaneous tissue due to oedema and fibrosis secondary to impaired circulation and degradation of the tissue in this area.
  • 11.
    So what exactlyis Cellulite? Cellulite is localised fat ‘ caught in a jail’ of interstitial connective tissue Cellulite is a lack of drainage of fluid secondary to venous + lymphatic stasis because of genetic, hormonal and even environmental reasons
  • 12.
    1. HEREDITY 2.HORMONAL - premenstrual syndrome, 3. VENOUS and LYMPHATIC stasis 4. NUTRITION insufficient water intake - excess of sugars, fats What are the Causes of Cellulite?
  • 13.
    Stage 1 Problem seems to appear whenever you press skin Stage 2 Dimpling of skin only appears as the patient stands up The Different Grades of Cellulite
  • 14.
    Stage 3 ‘ Peau de orange’ is present when the patient is lying down Stage 4 You can actually feel knots in the tissue when you touch it The Different Grades of Cellulite
  • 15.
    The Physiology ofStages 1 & 2 Stage 1 and 2 The problem only appears whenever you press skin or the patient stands up. This is caused by localised oedema secondary to vascular and capillary extravasation with dissociation of the adipocytes
  • 16.
    The Physiology ofStages 3 & 4 Stage 3 ‘ Orange skin’ is seen whenever the patient is lying down. This is caused by the formation of micronodules of both normal and larger adipocytes encapsulated by a network of collagen fibres Stage 4 The problem is present at all times because the micronodules fuse together to form painful subcutaneous macronodules .
  • 17.
    1996 Dr.Neil Solomon, conducted a double-blind study of 100 people to see whether cellulite differed from ordinary fat. The pathologists found no difference between the two clinical types of fat The Medical Evaluation of Cellulite begins
  • 18.
    1998 , researchersat the Rockefeller Institute used ultrasound, microscopic examinations, and some fat-metabolism studies to see whether “cellulitic" skin and normal skin differed The Medical Investigation of Cellulite
  • 19.
    The researchers concluded(a) certain characteristics of skin make women more prone than men to develop cellulite (b) there were no differences in the appearance or function of the fatty tissue or the regional blood flow The Medical Concept of Cellulite
  • 20.
    Products include specialwashcloths; creams and gels, supplements herbs bath liquids; massagers rubberised pants; brushes; rollers; body wraps; and toning lotions . The Market for Cellulite products
  • 21.
    “ Anticellulite" productsinclude tablets that work while you are awake and others that reduce cellulite….. while you sleep! The Growing Market for Cellulite Products 135 million Europeans are overweight 50 million Europeans suffer from obesity This is an increase of 25% in ten years
  • 22.
    Body Wrapping Thewrapping causes temporary water loss by compression and by perspiration. The water is quickly replaced within 24 hours . Body wrap claims this technique works because ‘cellulite’ is really water logged fatty tissue..
  • 23.
    Herbal Product developedby Italian chemist called Gianfranco Merizzi. Ingredients include compounds clover extract, evening primrose oil, fucus vesiculosis, bioflavanoids, soya lecithin, ginko biloba, iron oxide and fish oil. Cellasene ®
  • 24.
    1998, FDAapproved a French technique called Endomologie, for temporarily improving the appearance of cellulite Endermologie ®
  • 25.
    Endermologie ® usually takes 10-20 treatments. Monthly maintenance is required to maintain these effects. Endermologie ®
  • 26.
    Procedure is unableto break down dimpling effect although it can be used in combination therapy Lipodissolve ®
  • 27.
    During 1990’s treatmentsfor cellulite remained largely unsuccessful because they targeted skin appearance. It soon was apparent that dimpling on the surface of the skin would require a deeply acting treatment . The Treatment of Cellulite
  • 28.
    VelaSmooth™ is amedical device for the treatment of cellulite. Using the combined energy technology — Bi-Polar Radio Frequency and Infrared Light — plus tissue mobilization and suction to safely and effectively re-contour the skin surface Velasmooth ®
  • 29.
    Velasmooth ® RF increases oxygen intracellular diffusion by heating adipose tissue to a depth up to 10 mm Infrared Light increases elasticity of skin and heats subcutaneous fat to a depth of up to 3 mm, while safeguarding the skin from damage Suction manipulates and smoothes out the skin
  • 30.
    Vela Smooth DesignErgonomic applicator Intuitive, simple interface Sophisticated software controlling treatment parameters
  • 31.
    Vela Technical SpecificationsInfrared (IR) range 700-2000nm RF power 30 W IR power 30 W Treated area 40x40 mm (for thighs, buttocks, and abdomen ) 25x30 mm (for arms, calf, under-chin, and face )
  • 32.
    Large Applicator 4mechanisms : IR, RF, Rollers, Skin Curving (Suction) 3 intensity levels
  • 33.
  • 34.
    Clinical Indications Temporaryreduction in circumferences Temporary reduction in the appearance of cellulite Improvement in the local blood circulation Improvement of skin texture Relief of minor muscle aches and pain
  • 35.
    Contraindications Current orhistory of cancer Pregnancy and nursing Scarring , infection, or fragile skin at the tx. area History of keloid scarring Patients with a pacemaker or internal defibrillator
  • 36.
    Contraindications Known photosensitivity to near infrared light Use of medications known to induce photosensitivity, including Accutane, and anticuagulants Diabetes (Type I or II), unless under control Varicose veins in the treated area
  • 37.
    Anatomy of CelluliteFat cells swell and push upwards as septa are rigid Blood and lymph vessels are compresses Accumulation of intracellular fluids and toxins
  • 38.
    Cellulite Treatment Fatdeposits caught in chambers of connective tissue (septae) create phenomenon of cellulite Velasmooth ® treatment destroys the fat by acceleration of metabolic process
  • 39.
    Cellulite Treatment Thisleads to an improved skin appearance after about 6-10 sessions
  • 40.
    Velasmooth ® Vacuum pinches the skin and attaches it to the rotating electrodes
  • 41.
    Mechanism of IncreasingBlood Supply 90% of blood vessels are closed at normal atmospheric pressure. Decreasing the atmospheric pressure vessel cause dilatation and increases blood flow.
  • 42.
    Mechanism of DeepHyperthermia Infrared light heats the tissue up to 5mm depth RF heats tissue from 5 to 15mm depth IR Lamp Parabolic reflector Infrared filter RF electrodes
  • 43.
    Deep Hyperthermia byIR + RF Infrared (IR) light heats the tissue down to the deep dermis RF heats tissue down to the subcutis Lamp Parabolic reflector Infrared filter RF electrodes
  • 44.
    Rollers- Mechanical effectRollers and Vacuum Suction (150 mbar or 750 mm of Hg) Massaging effect facilitates drainage of trapped intercellular fluid to lymphatics
  • 45.
    Rollers- Mechanical effectBreaking connective tissue bonds also helps to reduce volume of fat chambers in hypo-dermis
  • 46.
    Suction Helps HyperthermiaSuction brings the target closer to the IR and RF source Target is the blood vessels in the deep dermis and in the subcutaneous fat layer and the tissue around
  • 47.
    Suction Mechanism forIncreased Blood Supply 90% of blood vessels are closed at normal atmospheric pressure Decreasing the atmospheric pressure increases vessel dilation and blood flow Thinning the cell membrane also helps in increased substance exchange between fat cells and vessels
  • 48.
    Vela Smooth IdeaRe-contouring of skin surface by: Increasing metabolic rate in adipose tissue due to: Increased blood supply Increased oxygen diffusivity and exchange Between blood vessels and fat cells Reduced fat chambers size due to: Reduced size of fat cells Mechanical breakage of connective tissue bonds Intercellular fluid drainage
  • 49.
    Hyperthermia Effect onMetabolism Increases substance exchange between fat cells and blood vessels Increase rate of fat metabolic reaction
  • 50.
    Oxygen Transport Coefficientsin Water Hyperthermia increases diffusivity of oxygen and decreases skin viscosity delivering more oxygen from capillaries to mitochondrion 4.88x10 -5 0.467 60 3.99x10 -5 0.547 50 3.24x10 -5 0.653 40 1.97x10 -5 1.002 20 Diffusivity of O 2 [cm 2 /s] Viscosity of H 2 O [centipoises] Temperature O C
  • 51.
    Hyperthermia Effect onRate of Metabolism Arrhenius law for yield of chemical reaction Y=At e BT Where A and B as constant, t is time and T is temperature Rate of metabolic reaction is exponential function of tissue temperature.
  • 52.
    Treatment Schedule Numberof treatments – 8-10 Treatments frequency - twice a week Supporting treatment - Once in 1 to 3 months Treatment duration 30-40min
  • 53.
    Typical improvement curve(based on C. Lee M.D. data) Strong effect Saturating effect Moderate effect
  • 54.
    Treatment Indication CelluliteNon proportional fat distribution Post liposuction non-uniformity of adipose tissue
  • 55.
    Cellulite Treatment Numberof passes and levels of energy should be adjusted to obtain stable erythema over the treated area Slow replacement of applicator or staying on one place not longer then 5 pulses
  • 56.
  • 57.
  • 58.
  • 59.
  • 60.
  • 61.
  • 62.
  • 63.
  • 64.
  • 65.
  • 66.
    Non-proportional Fat DistributionSome parts of the body accumulate more fat and have to be treated more aggressively to improve body contour
  • 67.
    Anchor Zones Evensmall reduction of fat in anchor zones significantly improves the body contouring
  • 68.
    Treatment of AnchorZones The anchor zones should be treated at maximal settings Average number of passes applied to the anchor zones should be higher that for rest of the body at least by 2 passes
  • 69.
    Before After BodyContouring H. Akai, M.D. Tokyo, Japan
  • 70.
    Treatment of PostLiposuction Patients Improves the results Allows homogenization of adipose tissue Improve healing process Reduce loose skin Treatment technique Two passes with slow replacement of applicator or with staying on one place during 4-6 pulses Two passes with fast moving the applicator with stronger pressing the skin
  • 71.
    Dr. A. DelGiglio, Italy , Post Liposuction Treatment
  • 72.
    Hyperthermia Effect onMetabolism Heat produced by IR increases oxygen dissociation from oxy-hemoglobin in heated dermal blood vessels Heat produced by RF increases rate of oxygen intracellular diffusion by deep hypodermal heating Fat metabolic reaction in adipocytes mitochondria is increased Use of stored energy from fat cells (lipolysis) results in shrinkage of cells themselves
  • 73.
    Treatment Protocol Treatthighs, buttock and abdomen with large applicator, and arms, calf, under-chin, and face with small applicator ~ 10 Treatments performed twice a week ( Patients with lymphatic drainage problems need more sessions) Maintenance treatments done monthly, then bi-monthly Average treatment time 30-45 min ~10 mins per area (thigh, buttock, abdomen, arms, chin) No more than 5 sec dwell on one site
  • 74.
    Treatment Parameters Bestresults with maximal (3 rd ) level Reduce IR for dark skin or over dark tattoo Reduce RF on curved areas with bad coupling Reduce suction on sensitive areas (abdomen, inner-thigh) and on loose skin
  • 75.
    Treatment Parameters Uselower levels for muscle aches, poor circulation and skin texture Increase levels in subsequent sessions Repeat passes until persistent endpoints are apparent Endpoints are general erythema, edema and warmth
  • 76.
    Treatment Tips Pretreatment- exfoliation and trimming of long hair Avoid anticoagulants (if medically permitted), as they increase the chance of bruising Use conductive water spray – not gel! Replenish spray only when movement of roller is affected – not when the spray appears dry
  • 77.
    Treatment Tips Treatingwithout spray – keep skin very clean Work in general direction of the lymphatics – ONE WAY Change direction to achieve best contact . Keep ONE WAY
  • 78.
  • 79.
    Before and After8 Cellulite Treatments Before After
  • 80.
    Before and After8 Cellulite Treatments
  • 81.
    Fat Anchor ZonesEvidence of body contouring by fluids redistribution in anchor zones Result = reduction in circumference
  • 82.
  • 83.

Editor's Notes

  • #79 More important is to achieve best contact