5 Carlisle Rd, Westford, MA 01886 • (800) 886-2966 • www.cynosure.com
Cynosure Inc’s SmoothShapes XV® is an innovative energy-based system that treats the underlying causes of cellulite. It is a noninvasive treatment that addresses localized areas of cellulite using a combination of mechanical manipulation via vacuum suction and massaging rollers and laser and light wavelengths (915 nm and 650 nm) in a single device—a patented mechanism of action called Photomology®.
SmoothShapes’ 915-nm laser penetrates into tissue and is preferentially absorbed by lipids, causing a thermal effect.1 The device’s vacuum component positions the skin for optimal laser and light penetration. The device’s 650-nm light has been demonstrated to affect permeability of the adipocyte cell membranes,2 allowing treated fat to move into the interstitial space that evacuates the expressed fat and fluids into the patient’s lymphatic system.
The technology offers an effective and efficacious method to safely and effectively treat cellulite and achieve long-lasting results, according to Miles H. Graivier, MD, FACS, based in Roswell, Ga. “SmoothShapes targets the bumpy appearance of cellulite by restoring enlarged fat cells, resulting in smoother skin. It also treats the dimpling of cellulite by remodeling collagen for tighter, more flexible skin,” he says.
The SmoothShapes system’s wavelengths target the physical manifestations of cellulite—enlarged fat cells and inflexible fibrous septae. “During treatment, collagen is remodeled in order to restore fat cells and smooth and tighten treated skin,” he says. “The Photomology component gently stimulates metabolic processes to minimize the underlying causes of cellulite such as edema, impaired blood circulation, and decreased metabolism, to restore the tissue to a better state.”
The contoured rollers then move the liquefied lipids from the interstitial space to the lymphatic system for drainage, he notes.”The 650-nm wavelength, on the other hand, modifies the permeability of the fat cell membrane to allow the liquefied fat to move into the interstitial space. This transitory change does not damage the adipocytes; the integrity of the cells is maintained.”
The ideal candidate for SmoothShapes treatment is active and physically fit but with small areas of cellulite that have not improved in spite of a healthy diet and exercise—for example, popular treatment areas include the outer thigh, or saddle bags.
The prospective patient with diffuse deformities or who is moderately or severely obese is not a good candidate for treatment. During consult, physicians should clearly state that the SmoothShapes treatment is not intended for weight, but rather is ideal for recontouring small or localized fatty deposits and improving the appearance of cellulite.
A SmoothShapes XV treatment typically consists of eight sessions, twice a week for 4 weeks. In addition to this initial series of treatments, maintenance sessions will be needed in the future.
For any physician wondering what would be the impact of implementing a SmoothShapes system as part of his or her plastic surgery armamentarium, the statistics speak for themselves. For example, 85% of women over the age of 20 are affected by cellulite. That’s 75 million women between ages 20 and 54 in the US alone.3 Also, 94% of clinical study participants reported their contour improvement was maintained at 6 months post-treatment.4
In addition to its use as a stand-alone procedure, some aesthetic practitioners use SmoothShapes in conjunction with other energy-based liposuction treatments. Physicians have reported that the overall patient experience is improved with laser- or ultrasound-assisted liposuction procedures that have been combined with SmoothShapes treatments.
For example, pretreating the surgical area using SmoothShapes can raise the temperature of tissue in the area specified for treatment.
The new, lightweight SmoothShapes Petite Laser Handpiece works with the SmoothShapes XV system to deliver energy at the same level as the system’s full-size handpiece, but with new body-shaping treatment options including knees, arms, and calves; and treatment options for hard-to-reach areas and smaller patients.
- Anderson RR, Farinelli W, Laubach H, et al. Selective photothermolysis of lipid-rich tissues: A free electron laser study. Lasers Surg Med. 2006;38(10):913-919.
- Neira R, Arroyave J, Ramirez H, et al. Fat liquefaction: effect of low-level laser energy on adipose tissue. Plast Reconstr Surg. 2002;110(3):912-922.
- US Census Bureau, International Programs Center, International Data Base.
- Kulick MD, Michael I. Evaluation of noninvasive, dual-wavelength laser-suction and massage device for the regional treatment of cellulite. Plast Reconstr Surg. 2010;125(6);1788-1796.
Sound Surgical Technologies LLC
357 S McCaslin Blvd, Suite 100, Louisville, CO 80027 • (888) 471-4777 • www.soundsurgical.com
Sound Surgical Technologies’ (SST) family of ultrasound energy-based systems are complementary tools in the hands of the aesthetic practitioner. All of SST’s aesthetic devices have acquired a strong reputation in the plastic surgery community for effectiveness and efficacy.
VASER 2.0 LIPO® SYSTEM
SST’s VASER 2.0 Lipo System is a minimally invasive ultrasonic body-contouring device that provides a new level of versatility for practitioners. The system, a significant upgrade of the firm’s popular ultrasound-based device, lets you perform a wide range of contouring applications—from significant fat reduction to precise sculpting on all areas of the body.
The system uses mechanical and acoustic forces to create a suspension of fat cells within a targeted area, while preserving other important tissue structures and maintaining fat cell viability. Fat cells are removed from the body using proprietary, atraumatic aspiration cannulas called VentX.® This process increases procedure speed and efficiency while reducing trauma to the surrounding tissue.
As an all-inclusive platform for infiltration, emulsification, and aspiration, the VASER Lipo System is designed to optimize every step of the body sculpting experience for the physician and patient. You can remove small volumes of fat for precision contouring or larger volumes for rapid debulking. In addition, the system makes delicate and fibrous areas easier to sculpt. VASER-harvested fat is also optimized for subsequent fat grafting, and many physicians report it is easier to reinject than nontreated fatty tissue.
VASER® SHAPE SYSTEM
This noninvasive ultrasonic system uses ultrasound energy to affect fatty tissue noninvasively, meaning no incisions are required. The ultrasonic handheld unit uses dual ultrasound transducers to deliver a double beam of 1 MHz ultrasound frequency modulated at 20 kHz to 60 kHz. The ultrasound beams overlap and treat fatty tissue between 1 cm and 5 cm below the skin’s surface. This results in both acoustic thermal and acoustic mechanical effects that warm the treatment area and temporarily change the characteristics of the underlying tissue matrix.
The VASER Shape System received FDA clearance for relief of minor muscle aches, pain, and muscle spasms; temporary improvement in local blood circulation; and temporary reduction in the appearance of cellulite. It can be used alone or in combination with surgical body-contouring procedures to minimize postoperative pain and swelling.
Using the system’s two handpieces, practitioners can customize treatments based on body area and patient comfort. The system lets you shape and smooth the body by temporarily reducing the appearance of cellulite and improving lymphatic drainage and local blood circulation.
The TouchView System is a complete, high-performance portable imaging solution that images soft tissue layers pre-, intra, and post-treatments. The TouchView transducer images soft tissue up to 9 cm below the skin—from the dermis down to the superficial and deep fat layers. The lightweight probe lets the physician maintain touch and feel while imaging. The superior imaging capabilities of the Terason 2000+ ultrasound system allow the physician to precisely image and measure fatty tissue and muscle layers. In addition, Power Doppler technology simplifies detection of blood vessels by color coding blood flow on the ultrasound image.
The TouchView System can be used for an impressive array of aesthetic applications, including fatty tissue layer imaging, image-guided filler placement, sclerotherapy imaging, image-guided fat grafting, presurgical mapping and planning, breast implant monitoring, and postsurgical seroma detection, among others.
POWERX™ LIPO SYSTEM
The PowerX Lipo System is a new advanced power-assisted body-shaping tool from Sound Surgical Technologies.
Unlike other reciprocating power-assisted liposuction technologies, the PowerX Lipo System utilizes a rotational movement of the cannula to quickly and effectively treat fatty areas, while minimizing trauma to the surrounding tissue. The rotational mechanism allows physicians to remove fatty tissue all the way around the cannula, rather than just above or below the cannula orifice. The physician has complete control over the rotation angle (how far the cannula rotates), and the rotation speed (how fast the cannula rotates).
In deeper tissue, a higher rotation angle and speed allow for efficient debulking of larger areas. For precision sculpting, a lower rotation angle and speed can be chosen to treat more superficial layers.
3 Goodyear, Irvine, CA 92618 • (949) 716-6670 • www.syneron.com
When it comes to comprehensive experience using the VelaShape II, there is probably no more authoritative source than Hema Sundaram, MD, FAAD, a board-certified dermatologist and cosmetic surgeon based in Rockville, MD. Sundaram began treating patients with the VelaShape series around 4 years ago, and “my patients are very happy with the results,” she says.
“In body contouring, if you look at the ASAPS patient survey statistics, body contouring via liposuction is a consistently popular procedure. Also, nonsurgical procedures have emerged as a growth area for plastic surgery practices,” she adds.
Although patients recognize that liposuction is a gold standard of body contouring, increasingly they are looking for nonsurgical means of doing the contouring. “The VelaShape is the only machine that has a double FDA clearance for both temporary cellulite and also for circumference reduction, making it quite unique,” Sundaram says.
The ideal candidate is a patient who is in relatively good shape, she notes. “This is not a weight-loss treatment. Typically, my patients are within 20 pounds of their ideal body weight. And they have problem areas that are not responding to good diet and exercise. The age range is from patients in their 20s to those in their 50s.”
Sundaram presented a study on the VelaShape at the 2011 annual meeting of the ASLMS and has presented at the annual meeting of the ASDS on combining Syneron’s LipoLite, which is a 1064-nm Nd:YAG laser-assisted lipolysis system, with postoperative VelaShape therapy. “The VelaShape system is very effective for nonsurgical body contouring,” she says. “When you add it to a liposuction procedure, it seems to help in terms of achieving the best results: evening out minor lumps or bumps to get the best contour. Potentially, it may help with the healing process, too.”
How does the VelaShape II distinguish itself in comparison with other products? “The first thing we see is that it is very efficacious,” Sundaram notes. “Patients need to have only four sessions with it, and each treatment takes only 10 to 20 minutes. It is time efficient. A lot of patients will see results after the first treatment; certainly by the second treatment, the results will be quite significant.”
What should the practitioner consider when they are evaluating noninvasive body-contouring devices and deciding which one to buy? “The first question to ask is, how long does the treatment take? Is the treatment time cost effective for the office? There’s a big difference between a treatment that takes 10 or 20 minutes and a treatment that is going to tie up your examination room and office staff for 45 minutes to an hour,” Sundaram explains.
“Circumferential reduction is really the gold standard when we’re looking at body contouring of any type. You should be able to measure an area like the abdomen and be able to document the number of inches that are being reduced.”
A popular use for the VelaShape II is for women who want to regain their shape after childbirth, Sundaram says. “Good studies have been done where VelaShape treatments have been done spaced a week apart, and patients have had significant reduction of the abdomen.
Another question for physicians is whether or not the system will offer adjunctive skin tightening. “The VelaShape II combines radiofrequency and infrared energies with vacuum and mechanical tissue massage. And this combination is very effective in giving skin tightening, as well as the circumferential reduction and the cellulite improvement. And that is very important for patients. There’s no point in having a reduction if you don’t have the nice surface appearance. Skin tightening is really important on the abdomen and other areas, like the thighs—even the knees can be done,” she says.
Sundaram reports that she has not seen any complications from the use of the VelaShape II. “You can sometimes get a little temporary pinkness in the overlying skin. I’ve had maybe one or two patients over the years that have had the minimal pinpoint bruise. I haven’t had any patient who hasn’t been able to immediately go back to normal daily activity.”