Effects of cellulite treatment with RF,IR light,mechanical massage and suction treating one buttock with the contralateral as a control

Background and objectives: A system that combines bipolar radio frequency (RF) and intense infrared light (IR) together with mechanical massage and suction has recently been reported as being efficient for cellulite treatment. The present split study was designed to evaluate the efficacy of such a system through various treatments of cellulite located on the buttocks. Methods: Ten patients were enrolled for 12 sessions of 30 minutes each performed over one buttock, the other buttock serving as an untreated control. Sessions were conducted twice a week for a period of 12 weeks. Clinical photography and profilometry were carried out to assess textural changes before (baseline) and 2 months after the final treatment. Histopathology was performed at baseline, 2 hours after the first session, and just before the 12th session and 2 months thereafter. Results: All patients noted improvement in the treated buttock before the final session, which was maintained at the 2‐month assessment. Improved skin appearance was noticed after the first session and was maintained throughout the study. All patients were satisfied with the results and requested further treatment in order to balance the results in both buttocks. Random histological analyses suggested dermal firmness, fibre compaction and tightening of skin layers, including the subcutis, as possible reasons for the effects achieved. The authors recognize that the small number of participants limits the statistical power of the study. Conclusions: Treatment sessions with the combined RF, IR light and mechanical massage and suction system were complication free, produced improvements in the overall cellulite appearance and skin condition, suggesting that further treatment sessions for maintenance could sustain patient satisfaction index (SI) and lead to lasting results. Based on the good results in the limited trial population, further studies with larger patient populations are warranted.     

Cellulite treatment using a novel combination radiofrequency, infrared light, and mechanical tissue manipulation device.

BACKGROUND: Most post-pubertal women exhibit cellulite, particularly in the thigh and buttock regions. The prevalence of cellulite has led to many attempts at treatment, including a variety of topical solutions, massage-based therapies, and surgical techniques--most with suboptimal clinical effects. The purpose of this controlled study was to evaluate a novel combination device involving radiofrequency, infrared light, and mechanical tissue manipulation for the treatment of cellulite. METHODS: Twenty adult women (ages 25-57 years) of various skin phototypes (I-V), and with moderate bilateral thigh and buttock cellulite, received eight biweekly treatments to a randomly selected side (the contralateral side serving as a non-treated control). A combined bipolar radiofrequency, infrared light, and mechanical suction-based massage device was applied at 20 watts RF, 20 watts IR (700-1500 nm) light, and 200 millibar vacuum (750 mmHg negative pressure). Patients were evaluated using standardized digital photography and circumferential leg measurements at baseline, prior to each treatment session, and at one, three, and six months after the final treatment. Clinical improvement scores of comparable photographs using a quartile grading scale (0 = or < 25%, 1 = 25%-50%, 2 = 51%-75%, 3 = or >75% improvement) were made independently by two masked medical assessors after the series of treatments. Final post-treatment body weight and patients' subjective evaluations were recorded. RESULTS: Ninety per cent (18/20) of patients noticed overall clinical improvement, and 17 of these 18 patients reported that they would pursue treatment of the contralateral thigh. Side effects were limited to transient erythema in most patients, and bruising was observed in 2/20 patients after the first couple of treatment sessions, but not as the treatment series progressed. Clinical improvement scores averaged 1.82 (corresponding to approximately 50% improvement) after the series of treatments. Circumferential thigh measurements were reduced by 0.8 cm on the treatment side. CONCLUSIONS: Cellulite can be significantly and safely reduced with the use of a noninvasive device that combines bipolar RF, infrared light, and mechanical massage. The effects of treatment appear to be prolonged, but maintenance treatments may be necessary to further enhance the clinical results achieved.     

Efficacy of multipolar radiofrequency with pulsed magnetic field therapy for the treatment of abdominal cellulite

Introduction: 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 from self-reported questionnaires revealed a significantly high level of patient satisfaction (60%). Assessments by a blinded investigator at one, four, and twelve weeks after the final treatment demonstrated a significant improvement in cellulite appearance. No adverse effects were reported and the treatment was well tolerated. Conclusion: This study demonstrates the safety, efficacy, and subject satisfaction of multipolar RF with pulsed magnetic field therapy in the treatment of abdominal cellulite.     

Effective epilation of white and blond hair using combined radiofrequency and optical energy.

OBJECTIVE: The present study examined the long-term photoepilatory effect on blond and white hair of a combined intense pulsed light (680-980 nm) device with a bipolar radiofrequency component producing electrical current at a depth of 4 mm. MATERIALS AND METHODS: Thirty-six adult women with white and blond hair (skin phenotypes I-V) were included in the study. The chin and upper lip were treated with four treatment sessions over 9-12 months with long-term follow-up performed at month 18 (6 months after the last treatment). The level of RF energy was 20 J/cm3, while optical fluences varied from 24 to 30 J/cm2. Hair counts and photographic evaluation of some sites were obtained at baseline, months 1, 3 and 5 and the final treatment session. RESULTS: An average hair removal of 48% was observed at month 18 (6 months following the final treatment session). A slightly higher photoepilatory efficiency was noted for blond hair (52%) versus white hair (44%) treatment sites. CONCLUSION: Combined radiofrequency and optical energy technology may produce effective photoepilation of blond and white hair phenotypes.     

Cellulite treatment using a novel combination radiofrequency,infrared light,and mechanical tissue manipulation device

Background. Most post‐pubertal women exhibit cellulite, particularly in the thigh and buttock regions. The prevalence of cellulite has led to many attempts at treatment, including a variety of topical solutions, massage‐based therapies, and surgical techniques—most with suboptimal clinical effects. The purpose of this controlled study was to evaluate a novel combination device involving radiofrequency, infrared light, and mechanical tissue manipulation for the treatment of cellulite.

Methods. Twenty adult women (ages 25–57 years) of various skin phototypes (I–V), and with moderate bilateral thigh and buttock cellulite, received eight biweekly treatments to a randomly selected side (the contralateral side serving as a non‐treated control). A combined bipolar radiofrequency, infrared light, and mechanical suction‐based massage device was applied at 20 watts RF, 20 watts IR (700–1500?nm) light, and 200 millibar vacuum (750?mmHg negative pressure). Patients were evaluated using standardized digital photography and circumferential leg measurements at baseline, prior to each treatment session, and at one, three, and six months after the final treatment. Clinical improvement scores of comparable photographs using a quartile grading scale (0 = <25%, 1 = 25%–50%, 2 = 51%–75%, 3 = >75% improvement) were made independently by two masked medical assessors after the series of treatments. Final post‐treatment body weight and patients' subjective evaluations were recorded.

Results. Ninety per cent (18/20) of patients noticed overall clinical improvement, and 17 of these 18 patients reported that they would pursue treatment of the contralateral thigh. Side effects were limited to transient erythema in most patients, and bruising was observed in 2/20 patients after the first couple of treatment sessions, but not as the treatment series progressed. Clinical improvement scores averaged 1.82 (corresponding to ～50% improvement) after the series of treatments. Circumferential thigh measurements were reduced by 0.8?cm on the treatment side.

Conclusions. Cellulite can be significantly and safely reduced with the use of a noninvasive device that combines bipolar RF, infrared light, and mechanical massage. The effects of treatment appear to be prolonged, but maintenance treatments may be necessary to further enhance the clinical results achieved.     

Use of a novel combined radiofrequency and ultrasound device for lipolysis,skin tightening and cellulite treatment

Introduction: Skin laxity and excessive subcutaneous fat are growing cosmetic concerns. The objective of this study is to evaluate the efficacy and safety of a novel radiofrequency and ultrasound workstation for lipolysis, circumference reduction, treatment of skin laxity and cellulite. Materials and methods: Two hundred seventy-five (235 women and 40 men) patients were enrolled into the study. Each patient received 3 treatment sessions, each session comprising Ultrasound and Radiofrequency treatments, at two-week intervals. Some received treatment for the abdomen, some for the thighs and some for both. Efficacy was assessed accordingly by measuring changes in abdominal circumference, thigh circumference and appearance of cellulite. Any adverse effect was noted. Result: Paired t-test between measurements at baseline and 4 weeks after 3rd session was significant amongst all the groups, showing that most patients showed improvement in abdominal and/or thigh circumferences. No significant adverse effects were noted during or after the treatment. Conclusion: A combination of alternating hot and cold module Ultrasound and Radiofrequency technologies is a safe and effective modality for lipolysis and to treat skin laxity and cellulite.     

Use of the microdialysis technique to assess lipolytic responsiveness of femoral adipose tissue after 12 sessions of mechanical massage technique

Background Adipocytes in femoral areas are known to be metabolically ‘silent’. Changes related to fat cell hypertrophy may be involved in the formation of cellulite. A mechanical massage technique, with circulatory and dermotrophic properties, has been shown to have an impact on clinical evaluations (i.e. changes in morphometric measurements) in cellulite areas. Whether this technique affected lipolytic responsiveness in subcutaneous adipose tissue of cellulite areas was not known. Objective Using a microdialysis technique in subcutaneous adipose tissue, a study was carried out to test the in situ incidence of a mechanical massage technique in terms of adipose tissue responsiveness to a lipolytic challenge. Materials and methods Nine healthy women volunteers with cellulite (grade ≥ 2) were included and treated with 12 sessions of mechanical massage technique (Endermologie®). Microdialysis has been carried out in the femoral adipose tissue in order to assess lipolytic responsiveness via glycerol determination following perfusion of a lipolytic agent (0.1, 1 and 10 µm isoproterenol). Clinical evaluations (measurements of waist, thighs and skin fold) were carried out in parallel. All evaluations were performed before and after treatment. Results The studied intervention lowered resting dialysate glycerol levels in femoral adipose tissue. The lipid‐mobilizing effect of isoproterenol was enhanced after 1 month of treatment. In addition, a clear decrease of morphometric measurements (mean decrease on thighs perimeter: 3.1 to 3.3 cm, P < 0.01) was observed. Conclusion These results suggest an increase in the lipolytic responsiveness of femoral adipose tissue in women with cellulite having undergone 12 sessions of mechanical massage.     

Effective epilation of white and blond hair using combined radiofrequency and optical energy

OBJECTIVE: The present study examined the long‐term photoepilatory effect on blond and white hair of a combined intense pulsed light (680–980?nm) device with a bipolar radiofrequency component producing electrical current at a depth of 4?mm.

MATERIALS AND METHODS: Thirty‐six adult women with white and blond hair (skin phenotypes I–V) were included in the study. The chin and upper lip were treated with four treatment sessions over 9–12 months with long‐term follow‐up performed at month 18 (6 months after the last treatment). The level of RF energy was 20?J/cm³, while optical fluences varied from 24 to 30?J/cm². Hair counts and photographic evaluation of some sites were obtained at baseline, months 1, 3 and 5 and the final treatment session.

RESULTS: An average hair removal of 48% was observed at month 18 (6 months following the final treatment session). A slightly higher photoepilatory efficiency was noted for blond hair (52%) versus white hair (44%) treatment sites.

CONCLUSION: Combined radiofrequency and optical energy technology may produce effective photoepilation of blond and white hair phenotypes.     

High‐frequency ultrasound evaluation of cellulite treated with the 1064 nm Nd:YAG laser

Objectives: To investigate non‐invasive laser treatment for cellulite using the 1064?nm Nd:YAG laser and to correlate clinical results with high‐frequency skin ultrasound images. Methods: Twelve individuals of normal weight were treated on either the left or right posterior side of the thigh with the following parameters: fluence 30?J/cm, 18?mm spot size and dynamic cooling device pulse duration of 30?ms. Three treatments were performed at intervals of 3–4 weeks, and followed‐up 1 and 3 months after the last session. Photographs and ultrasound imaging were assessed before each session. Results: The 1064?nm Nd:YAG laser resulted in a tightening of the skin and an improvement in cellulite. No side effects were reported. High‐resolution ultrasound imaging showed a significant improvement in dermis density and a reduction of dermis thickness. The method is described in detail in Appendix 1. Conclusion: Infra‐red lasers may constitute a safe and effective treatment for cellulite and high‐frequency ultrasound imaging provides a quantitative and objective measurement of the treatment efficacy.     

Circumference reduction and cellulite treatment with a TriPollar radiofrequency device: a pilot study

Background  A wide variety of treatments for circumference reduction and cellulite are available, but most procedures offer suboptimal clinical effect and/or delayed therapeutic outcome.
Objective  To determine the safety and efficacy of the TriPollar radiofrequency device for cellulite treatment and circumference reduction.
Methods  Thirty-nine females with cellulite received eight weekly TriPollar treatments. Treatment areas included the abdomen, thighs, buttocks and arms. Subjects were evaluated using standardized photographs and measurements of body weight, circumference, subcutaneous thickness, and skin elasticity of the treatment sites at baseline, immediately after and 4 weeks after the final treatment. Physicians' evaluation of clinical improvement scores using a quartile grading scale was recorded.
Results  Thirty-seven patients (95%) completed the treatment protocol. There was significant circumference reduction of 3.5 and 1.7 cm at the abdomen ( P  = 0.002) and thigh ( P  = 0.002) regions, respectively. At 4 weeks after the last treatment, the average circumferential reductions of the abdomen and thighs were sustained. No significant circumferential reductions of the buttocks and arms at the last treatment visit compared to baseline were demonstrated ( P  = 0.138 and 0.152, respectively). Quartile grading scores correlating to approximately 50% improvement in cellulite appearance were noted.
Conclusions  Tripollar radiofrequency provided beneficial effects on the reduction of abdomen and thigh circumference and cellulite appearance.

Conflict of Interest

The authors have no financial interest in this article.     

Hair removal using a combination of conducted radiofrequency and optical energies--an 18-month follow-up.

OBJECTIVE: Multiple lasers and intense pulsed light sources have been shown to provide long-term hair removal; however, the management of all dark skin phenotypes and light-colored hair remains problematic. The present study examined the long-term photoepilatory effect of a combined intense pulsed light (IPL) (680-980 nm)/radiofrequency (RF) (10-30 J/cm3) light source and its efficiency for the treatment of multiple skin phenotypes and varied hair colors. METHODS: Forty adult patients (skin phenotypes II-V) with varied facial and non-facial hair colors were treated with a combined IPL/RF technology. Four treatments were carried out over a period of 9-12 months at 8-12-week intervals. Light energy ranged from 15 to 26 J/cm2, while RF energy varied from 10 to 20 J/cm3. Hair counts and photographic evaluation of skin sites were obtained at baseline, and months 1, 3 and 5 after the final treatment session. H&E biopsies were examined at 1 week in five randomly selected study cohorts. RESULTS: Maximum hair reduction was observed at 6-8 weeks after each treatment. An average clearance of 75% was observed in all body locations at 18 months. No significant adverse sequelae were reported. Results showed no significant dependence on skin color: lighter and darker skin types responded similarly to treatment. Histologic evaluation revealed thermal damage to hair follicles with vacuolar degeneration. CONCLUSION: The combined IPL (680-980 nm)/RF light source with contact cooling is a safe and effective method of long-term hair reduction in patients of diversified skin types and varied hair colors and is associated with excellent patient safety.     

Pilot study of dermal and subcutaneous fat structures by MRI in individuals who differ in gender, BMI, and cellulite grading

BACKGROUND/AIMS: Puckered, dimply skin on the thighs, hips, and buttocks is known as cellulite. The cause of cellulite is not known, although there are a number of different hypotheses. In this study, we use magnetic resonance (MR) micro-imaging to study cellulite skin. To the best of our knowledge, this is the first reported MR study of cellulite. METHODS: High-resolution in vivo MR images of the postlateral thigh skin of two male groups and four female groups were obtained. Subjects were grouped according to their body mass index (BMI) and cellulite grade. A qualitative assessment of how MRI can be used to differentiate skin tissue at different levels of cellulite grading was performed. RESULTS: We found that changes in skin architecture with cellulite can be visualized by in vivo MR micro-imaging. The skin fat layers beneath the dermis and down to the level of muscles are well visualized in the images. Also, the diffuse pattern of extrusion of underlying adipose tissue into dermis is clearly imaged, and was found to correlate with cellulite grading. We also show that other skin tissue parameters such as (a) the percentile of adipose vs. connective tissue in a given volume of hypodermis and (b) the percentile of hypodermic invaginations inside the dermis are correlated with cellulite grade. CONCLUSION: MR images can be interpreted to measure tissue parameters correlated with cellulite. Considering that we had only three subjects in each group, the achievements of this pilot study were highly satisfactory. We have shown that the in vivo micro-MR is a technique able to detect the effects of cellulite and gender. This study can be extended for further investigations of drugs and/or medical devices for cellulite treatment.     

Successful removal of freckles with the bipolar radiofrequency and optical energy

Objectives: Freckles are melanocytic lesions frequently seen on the face with red or blond hair. We aim to determine the effectiveness of combined bipolar radiofrequency (RF) and optical energy. Methods: Thirty patients with facial freckles received four treatment at 3-week intervals with RF and optical energy, combination of broadband light (580–980 nm) + bipolar RF energy 100 J/cm³. The improvement of the freckles was evaluated using the Freckles Area and Severity Index (FASI), and physician and patient assessment at the end of the sessions, at Months 3 and 12 after the treatment. Results: By the end of the study, assessment of results by physician for 83% at Week 12 and by patients for 70% at Week 52 was excellent or good. On the other hand, 88% at Week 12 and 76% at Week 52 of the patients reported that they were extremely or very satisfied. FASI was noted to be 65.15 at pre-treatment, 25.60 at 12th week, and 27.40 at the end of the follow-up (one year). Mean improvement rate (n = 30), as determined from the difference in mean FASI score, was 70% at 3 months and 66% at 12 months. Conclusion: Bipolar radiofrequency and optical energy can be accepted as an alternative treatment modality for the therapy of freckles with few adverse effects and high satisfaction levels.     

Evaluation and efficacy of carbon dioxide therapy (carboxytherapy) versus mesolipolysis in the treatment of cellulite

Background: Cellulite is an irregular alteration of the skin surface giving it cottage cheese appearance. Carboxytherapy is transcutaneous infusion of carbon dioxide into the affected site. Mesolipolysis aims to remove cellulite and improve skin texture. Aims: To verify the efficacy and safety of carboxytherapy versus mesolipolysis using phosphatidylcholine (PPC) in treatment of cellulite in thighs area. Methods: Forty-eight female patients with different grades of cellulite at thighs area were enrolled in this study. They were classified into two groups: group A received subcutaneous infusion of carboxytherapy, and group B was treated with mesolipolysis using PPC. Each group received six sessions at weekly intervals. sessions. The outcome measures and clinical assessment were based on cellulite grading scale and thigh circumference measurements. Standardized digital photography was taken before and after treatment. Patients were followed up for 6 months. Results: After treatment, there was significant reduction in thigh circumference measurement p < 0.01 and cellulite grading scale p < 0.001 in both groups. The difference in cellulite grading scale and thigh circumference measurement in both groups was insignificant. Conclusions: Carboxytherapy and mesolipolysis are safe and effective in cellulite treatment. Carboxytherapy is a promising alternative therapeutic modality for cellulite treatment.     

A prospective clinical study to evaluate the efficacy and safety of cellulite treatment using the combination of optical and RF energies for subcutaneous tissue heating.

BACKGROUND: There have not been any published studies on the use of radiofrequency (RF)-light-based technologies for the treatment of cellulite. Only preliminary results have recently been reported (ASDS Proceedings, September 2004).OBJECTIVE: This two-center study investigated the safety and effectiveness of combined energies for cellulite treatment using the VelaSmoothtrade mark system.METHODS: Thirty-five female subjects with cellulite and/or skin irregularities on the thighs and/or buttocks were treated with the VelaSmooth device. Patients received from eight to 16 treatments twice weekly. All patients maintained their normal lifestyle, and diet and fluid consumption. The circumference of the right and left medial thighs was measured at both baseline and approximately 4 weeks after the last treatment. During the last follow-up visit, the physician graded the level of improvement in skin smoothing and/or cellulite improvement using pre- and post-treatment photographs. Three patients provided biopsy specimens for histological assessment.RESULTS: All study patients showed some level of reduction in thigh circumference after 8 weeks of treatment; indeed, 70% of all patients showed such a reduction after 4 weeks of treatment. Also, 100% of all patients showed some level of improvement in skin texture and cellulite. The mean decrease in circumference was 0.8 inches. Some patients demonstrated reductions of more than 2 inches. There were minimal complications associated with treatment.CONCLUSION: This preliminary study demonstrates that the VelaSmooth system can have a beneficial effect on cellulite appearance. Further studies are needed to better define the mechanisms by which RF and light energies affect subdermal tissues and develop a method of quantified cellulite analysis.     

A pilot study of the efficacy of the POLARGEN® ultrahigh-frequency electric field (40.68 MHz) radiofrequency device in the treatment of facial contouring

Background: Various radiofrequency (RF) devices are used to treat skin laxity and face contouring, but few studies have examined ultrahigh-frequency (UHF) electric field (40.68 MHz) RF devices. Objective: To evaluate the efficacy and safety of a UHF electric field (40.68 MHz) RF device for skin tightening and face contouring. Methods: Ten patients each underwent four sessions of UHF electric field RF device treatment at 2-week intervals. Clinical improvement was evaluated with the patient satisfaction score using a six-point scale, and clinical photographs taken at every visit and 2 months after the RF treatment were assessed. Skin biopsies were obtained from one patient before the first treatment and immediately after the last treatment. Adverse reactions were recorded at every follow-up visit. Results: All patients were women with a mean age of 51.7 ± 7.2 years. The mean satisfaction score was 4.5 ± 0.9 immediately after the last treatment session. Cheek, jawline, and neck enhancement and tightening were apparent in all patients. Side effects were minimal, and there were no burns or major complications. Conclusions: The UHF electric field RF device was effective for skin tightening and facial contouring, without significant adverse reactions.     

The treatment of keloids with pneumatic technology: a pilot study

Background  Keloid scars derive from abnormal fibrous wound healing when the mechanisms controlling tissue repair and regeneration malfunction. Previous studies have reported a reduction in hyaluronic acid among fibroblasts cultured from keloid tissue compared with the levels in normal skin. Here, we evaluated the efficacy and safety of subdermal minimal surgery using hyaluronic acid as a novel treatment in keloid scars. Objective  To evaluate the clinical efficacy and safety of subdermal minimal surgery technology in the treatment of keloids. Materials and methods  Ten Korean patients (Fitzpatrick skin type II–IV) with keloids on the upper arms were enrolled in this study. All patients underwent three sessions of subdermal minimal surgery at three‐week intervals. Scar assessments were performed at baseline, before each treatment session, and three months after the final treatment, with three different assessment methods. Specifically, in addition to the Vancouver Scar Scale (VSS), two independent physicians performed global assessment evaluations regarding the final cosmetic results. As a final form of assessment, participant satisfaction was assessed using a four‐point scale. Results  All volunteers completed three treatment sessions, and nine of 10 patients were satisfied with the procedure. The average VSS score decreased three months after the final treatment, and global assessment showed clinical improvement of the scars. No adverse events occurred, except transient spot bleeding at entry points and slight post‐procedure edema, which resolved within 48 hours. Conclusion  Subdermal minimal surgery technology may help to improve keloids on the upper arm without noticeable adverse effects.     

A novel method for real-time skin impedance measurement during radiofrequency skin tightening treatments

The thermal effects of monopolar and bipolar radiofrequency (RF) have been proven to be beneficial in skin tightening. Nevertheless, these effects were frequently partial or unpredictable because of the uncontrolled nature of monopolar or unipolar RF and the superficial nature of energy flow for bipolar or tripolar configurations. One of the hypotheses for lack or predictability of efficacy of the first‐generation RF therapy skin tightening systems is lack of adaptation of delivered power to differences in individual skin impedance. A novel multisource phase–controlled system was used (1 MHz, power range 0–65 W) for treatment and real‐time skin impedance measurements in 24 patients (EndyMed PRO?; EndyMed, Cesarea, Israel). This system allows continuous real‐time measurement of skin impedance delivering constant energy to the patient skin independent of changes in its impedance. More than 6000 unique skin impedance measurements on 22 patients showed an average session impedance range was 215–584 Ohm with an average of 369 Ohm (standard deviation of 49 Ohm). Analyzing individual pulses (total of 600 readings) showed a significant decrease in impedance during the pulse. These findings validate the expected differences in skin impedance between individual patients and in the same patients during the treatment pulse. Clinical study on 30 patients with facial skin aging using the device has shown high predictability of efficacy (86.7% of patients had good results or better at 3 months’ follow‐up [decrease of 2 or more grades in Fitzpatrick’s wrinkle scale]). The real‐time customization of energy according to skin impedance allows a significantly more accurate and safe method of nonablative skin tightening with more consistent and predictable results.     

Painless,safe, and efficacious noninvasive skin tightening,body contouring,and cellulite reduction using multisource 3DEEP radiofrequency

In the last decade, Radiofrequency (RF) energy has proven to be safe and highly efficacious for face and neck skin tightening, body contouring, and cellulite reduction. In contrast to first‐generation Monopolar/Bipolar and “X ‐Polar” RF systems which use one RF generator connected to one or more skin electrodes, multisource radiofrequency devices use six independent RF generators allowing efficient dermal heating to 52–55 °C, with no pain or risk of other side effects. In this review, the basic science and clinical results of body contouring and cellulite treatment using multisource radiofrequency system (Endymed PRO, Endymed, Cesarea, Israel) will be discussed and analyzed.     

Imaging of the skin and subcutaneous tissue using classical and high‐frequency ultrasonographies in anti‐cellulite therapy

Background: The development of ultrasonography allowed for skin imaging used in dermatology and esthetic medicine. By means of classic and high‐frequency ultrasonographies, changes within the dermis and subcutaneous tissue can be presented. Objective: The aim of this study was to show the possibilities of applying classic and high‐frequency ultrasonographies in esthetic dermatology based on monitoring various types of anti‐cellulite therapies. Methods: Sixty‐one women with cellulite were assigned to two smaller groups. One group was using anti‐cellulite cream and the second group was a placebo group. The ultrasound examination was carried out before the initiation and after the completion of the treatment and evaluated epidermal echoes, the thickness of the subcutaneous tissue and the dermis, dermis echogenicity, the length and surface area of the subcutaneous tissue fascicles growing into the dermis, and the presence or absence of edemas. Results: After the completion of the treatment, a statistically significant difference was observed. The most useful parameters were as follows: the thickness of the subcutaneous tissue, echogenicity, the surface area and length of the subcutaneous tissue, as well as the presence of edemas. The discussed changes were not observed in the placebo group. Conclusion: Classic and high‐frequency ultrasonographies are useful methods for monitoring anti‐cellulite therapies.