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130 G. Campiglio Figure 5. Pre and post treatment view of the thigh with improvement of the skin surface in the poster-lateral region. Figure 8. Same patient of the previous figure. In this view the improvement in the posterior thigh is shown. Journal of Plastic Dermatology 2010; 6, 2 Figure 6. Pre and post treatment view of the thigh with reduction of the circumference and improvement of the skin contour. Figure 7. Pre and post treatment view of the inner thigh with smoothering of the skin contour in the suprapatellar area.
C onclusions The preliminary data obtained with the use of photomologyTM in the treatment of cellulite showed a positive effect on the most important and frequent symptom of this disease such as skin irregularity. Almost all the patient subjectively reported an improvement of the skin quality, already after the first session of treatment. This data confirm the results of previous and more sophisticated studies. In 2008 Lach reported the results of a vacuum massage and dual wavelength (650 and 915 nm) low level laser energy to improve the appearance of cellulite 5 . In his cases each patient received a double treatment: one thigh was circumferentially treated with massage alone whereas the other thigh underwent to the dual beam laser energy treatment, followed by a mechanical massage. Each patient received a mean of 14 treatments, one to three per week for a total of 4-6 weeks. A series of magnetic resonance imaging measurements obtained in 65 patients before and after the last treatment showed a significant reduction of fat thickness in the leg treated with laser and massage. More recently Kulick (2010) published an interesting study performed on 20 women (BMI 29 or less), aged 25-45 years, affected by mild to moderate cellulite of the postero-lateral aspect of the thigh 6 . The results were gathered using standard digital photographs and a complex three dimensional camera system (VECTRA, Canfield, USA) which depicts skin contour independent of incident lighting. The mechanism of this improvement could be probably secondary to the lipolityc effect of the laser energy on superficial fat tissue, located immediately below the dermis. In fact, the typical skin irregularities observed in the cellulite, are due to accumulation of fat at this level: enlargement of these adipocytes causes a stretching of the fibrous septa which connect the hypodermis to the deep tissue with formation External laser lipolisys in the treatment of cellulite: preliminary data of the classic dimples on the skin surfaces. Suction and massage are also important in this mechanism as showed by the fact that they are integral component of two other cellulite treatment devices worldwide used. In this case suction and massage help in the disruption of the sclerotic fibrous septa when cellulite evolves in its chronic phase. Although the positive results of our study further investigations are necessary in order to better verify the positive effects of external laser lipolysis in the treatment of cellulite, using a wider sample of patients, a more reproducible protocol of treatment (taking care for example also the total laser and mechanical energy transmitted to a defined treatment zone) and a more objective method of evaluation of the results. r eferences 1. Curri S. Adiposità localizzata e panniculopatia edemato-fibrosclerotica. Sepem Ed. 1990. 2. Anderson R, Farinelli W, Laubach H. Selective photothermolysis of lipid rich tissue: a free electron laser study. Laser Surg Med, 2006; 38:913-919. 3. Neira R, Arroyave J, Ramirez M. Fat liquefaction: effect of low-level laser energy on adipose tissue. Plast Reconstr Surg 2002; 110:912-922. 4. Jackson R, Roche G, Butterwick K, et al. Low level laser assisted liposuction: a 2004 clinical study of its effectiveness for enhancing ease of liposuction procedure and facilitating the recovery. Am J Cosmet Surg, 2004; 21:191-197. 5. Lach E. Reduction of subcutaneous fat and improvement in cellulite by dual wavelength, low level laser energy combined with vacuum and massage. J Cosmet Laser Ther 2008; 10:202-209. 6. Kulick M. Evaluation of non invasive dual wavelength laser suction and massage device for the regional treatment of cellulite. Plast Reconstr Surg 2010; 125:1788-1796. D isclosure The author has not financial interest with the production or sale of the device. Journal of Plastic Dermatology 2010; 6, 2 131
Page 1 and 2: Periodico quadrimestrale - Spedizio
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