The Top 5 In-Office Treatments That Help Make Stubborn Cellulite Disappear

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This article first appeared in the Fall 2020 issue of New Beauty. Click here to subscribe

Innovation in professionally administered cellulite treatments is booming as companies develop new technologies and patients demand new—and even more effective—options. These are the top dimple fighters to know about.

Radio Frequency (RF)

Quick-recovery energy treatments such as Emtone, VelaShape III, NuEra Tight, TruSculpt 3D, Evolve, BodyFX, and Venus Legacy utilize radio frequency to temporarily diminish the look of mild-to-moderate cellulite by stimulating collagen production and targeting fat. As the energy is delivered deep into the skin through a noninvasive handpiece (Evolve is hands-free), fat deposits are heated up, blood circulation surges and tissue tightening is triggered. Topical numbing cream can be used with certain treatments to make them more comfortable, and a series of sessions is typically recommended to achieve optimal results.

New York dermatologist Anne Chapas, MD favors VelaShape III for its combination approach. “It uses multiple modalities to contour the body: Vacuum pressure manipulates the skin while infrared light and bipolar RF energies gently heat fat cells and surrounding tissue,” she explains. Davie, FL dermatologist Lesley Clark-Loeser, MD prefers Emtone, which “utilizes both monopolar radio-frequency and targeted pressure energy (TPE) simultaneously to soften and remodel the fibrous bands, induce collagen and elastin production in the overlying skin, and improve local blood flow.” In a clinical three-month follow-up with a group of patients testing Emtone, 93 percent of them saw a visible reduction in cellulite.

Microneedling + Radio Frequency

The science behind the fusion of microneedling and radio-frequency energy is that it’s a one-two punch for collagen production, which improves the appearance of lumps and bumps under the skin. Two brands employing this dual tactic are Profound and Morpheus8, which deliver RF energy through tiny microneedles that create small, controlled injuries, which boost collagen as they heal. “Profound is a unique, long-pulsed radio-frequency device—the depth of needle penetration combined with the resulting temperature reached in the tissue results in collagen, elastin and hyaluronic acid production,” Dr. Clark-Loeser explains.

Thermal Subcision

A minimally invasive procedure that’s lauded for alleviating mild-to-moderate puckers, Cellulaze sends laser energy through a tiny cannula under the skin to cut the tissue bands in a process called thermal subcision (twilight anesthesia is recommended). “For larger areas with more cellulite or deeper dimpling, we always rely upon Cellulaze for optimal results,” says Vero Beach, FL plastic surgeon Alan Durkin, MD. There may be some post-procedure bruising and discomfort, as well as some minor leaking from the incision sites, so doctors may suggest wearing a compression garment to assist in the healing process. Results continue to improve over time as the body’s collagen is stimulated, and will last for at least a year.

Dermal Fillers

It may seem counterintuitive to “add” in an area you’re trying to “subtract” from, but in the case of cellulite, it can work. Injections of either Radiesse, a calcium hydroxylapatite filler, or Sculptra Aesthetic, a biostimulatory agent, can be used off-label to improve the appearance of nooks and crannies by stimulating fibroblasts, the body’s collagen-producing cells. “We have found that hyperdiluted Radiesse has been incredibly effective in smoothing cellulite on the buttocks, as it tends to induce collagen type 1, which is associated with smooth, pliant skin,” Dr. Durkin says.

Dr. Chapas typically recommends Sculptra Aesthetic “when the underlying issue of a person’s cellulite is a lack of scaffolding or volume. Or, when I can see that adding this lift, support and collagen back into the buttocks would help lessen that ‘mattress’ appearance. Otherwise, it is often better to just directly address the cellulite.”

Chemical Subcision

The newest cellulite treatment on the horizon is Qwo, the first and only injectable for moderate-to-severe dimpling in the buttocks that received FDA clearance in July, but won’t be available in doctors’ offices until spring 2021. “It’s based on an enzyme called collagenase that when injected, can release tissue bands by targeting collagen types 1 and 3,” says Dr. Durkin. According to Qwo creator Endo Aesthetics, the suggested treatment protocol is up to 12 injections per buttock in a single session, and three treatments administered 21 days apart.

Dr. Chapas calls Qwo a game changer: “Endo put years into rigorous clinical trials; in fact, the trials that evaluated Qwo for the treatment of cellulite in adult women are the largest cellulite studies ever conducted, with 845 participants,” she says. “This is just one of the reasons why there is so much excitement around it.”

Courtesy of Endo Aesthetics

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