So Long, Cellulite

From Scene Bay Area

Whatever the shape of your figure – whether goddess or zaftig or something in between – cellulite is likely a frustrating fixture. Only about 15 percent of women escape the scourge of bumpy, lumpy skin on their buttocks and thighs. It even shows up on our arms and stomach. Unfortunately, that cottage cheese or orange peel texture can form as early as one's teen years.

But good news, ladies: Cellulite may finally have met its match. In January, a laser called Cellulaze received the approval of the U.S. Food and Drug Administration for use in correcting the three causes of cellulite: bulging fat, skin laxity and the connective fibers that pull skin down to form those dreaded dimples. Cellulaze, according to its maker, Cynosure, "reduces cellulite by restoring the normal structure of the skin and the underlying connective tissue."

Thanks to its extraordinary promise, people like board-certified dermatologist Dr. William Ting of San Ramon are happy to offer Cellulaze, especially given the FDA's imprimatur. "There is a straightforward formula that every surgeon has to adhere to," he says. "The protocol is very stringent."

Moreover, according to Dr. Daryl K. Hoffman, a board-certified plastic surgeon with offices in Palo Alto and Campbell, what's revolutionary is that "not only does Cellulaze change the anatomy, it's done in just one treatment. With other cellulite treatments, the effect is short-lived and once you stop doing them, the improvement in appearance goes away."

During the procedure, which involves local anesthesia and a few small incisions, a laser fiber is inserted under the skin, gently heating it and melting the fat. Next, the laser releases the fibrous bands that create dimpling and, finally, it stimulates collagen production to increase skin elasticity.

Because Cellulaze is so new, Cynosure is able to tout results – based on almost four years of clinical research – as lasting only at least one year. However, many physicians already are claiming that benefits can endure far longer since the root causes of cellulite are addressed.

"In plastic surgery, nothing is permanent," Hoffman says, "but I think the changes that are created here are really long-lasting and stable. Once you improve it, you have a whole new baseline. You've corrected some of the anatomical problems that cause cellulite."

Just don't be in too big a hurry to see a noticeable gain. "Sometimes it can actually look worse after a month than it did before treatment," Hoffman warns. This is because skin thickening doesn't take place until collagen has had time to grow, a process that takes about three months. He also cautions patients to expect a lot of bruising "because we're working right beneath the skin, disrupting little varicose veins."

"The best results are seen at three months, and will continue to get better up to one year," Ting says. "Most of my patients are satisfied four weeks afterwards."

The best candidate for Cellulaze, according to Ting, is someone looking to be rid of the rippling on her buttocks and thighs – not a reduction in body size. A patient with "saddlebags," for example, is better off opting for SmartLipo, which gets rid of localized pockets of fat.

Dr. Fred Suess, a board-certified plastic surgeon with offices in Walnut Creek and San Francisco, says that liposuction can be performed in an area of the body treated with Cellulaze, just not at the same time. He says ideal Cellulaze candidates "are healthy, do not have stretch marks in the area with cellulite, and should be within 20 pounds of their normal weight."

For his part, Hoffman says a prospective patient "needs to have appropriate expectations. Cellulaze will improve skin and get rid of dimples, but it won't be night and day."

The procedure itself takes approximately two hours for one area, such as the backs of both thighs. Although it's possible to go to work the day after, every patient must wear compression garments for several weeks. In addition to heavy bruising, there could be swelling and various degrees of discomfort. Because no suction is involved, one possible serious side effect is seroma, where fluid collects under the skin and may need to be drained afterward.

So, what's the price of being able to strut around fearlessly in a bikini and not worry about close-ups? About $5,000, depending on the area to be improved. Figure an area to be the size of your hand, times two, which would take care of the cellulite on, say, the outer thighs.

For an in-depth look at what Cellulaze entails, check out RealSelf , "a community dedicated to helping people make the right health and beauty choices," according to its website. Patients share diary-type revelations about their experiences, the good and the bad, plus before-and-after photos. Out of 69 reviews from across the country as of this writing, the procedure got a 94 percent positive rating.

Bottom line (no pun intended), the early outlook on Cellulaze is highly encouraging, even without the knowledge of long-term results – although studies are being readied for submission to peer-reviewed medical journals. In the meantime, practitioners such as Ting are already on board in a big way. "This may be the holy grail we've been chasing for decades," he says.


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Wednesday: 9:30 a.m.–5:00 p.m.
Tuesday, Thursday, Friday: 9:00 a.m.–5:00 p.m.
    Daryl Hoffman MD