Dermatologist Rosalyn George, M.D., founder of the Wilmington Dermatology Center, Wilmington, N.C., was among the first practices in the Carolinas to receive and offer Cellfina (Ulthera) treatments to patients.
The FDA cleared Cellfina last year for long-term improvement of the appearance of cellulite on the buttocks and thighs, with no loss of benefit for up to two years. The technology, which has the longest FDA clearance for cellulite treatment, uses controlled subcision. Its proprietary suction applicator sucks the treated area’s skin and fat into the applicator, which stretches the fibrous bands and allows the subcision blade to precisely divide those bands. (See Cellfina 101: Everything you need to know).
We asked Dr. George to share her insights about Cellfina use in practice. Dr. George says patients have been interested in the technology, and she has performed several Cellfina treatments this year with ease.
CST: Any surprises or learning curves to share with your peers?
Dr. George: The biggest challenge is overall patient selection, as with other devices and treatments. A lot of older patients come in with more skin laxity than actual cellulite, and many patients complain of an area on the posterior thigh below the gluteal cleft where there are some fibrous bands that can’t be treated with Cellfina.
CST: Anything you wish you would have known sooner?
Dr. George: There is some significant bruising with the procedure, so it is important to make sure patients are aware that they won’t be able to wear a bathing suit and possibly shorts or skirts for several weeks after the treatment.
CST: Any tricks or insights? Best practices?
Dr. George: I think it is helpful to have two assistants in the procedure when you first start. One to stay sterile and help position the device, and another one to document the treated areas and provide patient support. …[Also] providing your patients with music and headphones during the treatment is important. The actual device makes a loud sound when it is releasing the band, and many initial patients found it disconcerting. Also, utilizing a camera system that can capture the areas being treated and can accurately show before and after pictures is a requirement.
CST: What questions do patients ask?
Dr. George: Many patients have been disappointed in previous cellulite treatments and are very skeptical. The biggest question my patients ask is if it really works. It’s wonderful to be able to finally answer yes and explain the process of why.
CST: How to you manage patient expectations?
Dr. George: I make my patients active participants in the treatment marking process. Once I mark the areas I plan to treat, we both stand in front of the mirror and confirm we have all the areas the patient wants treated. It is important to show patients areas that may not be treated, as well, so they don’t think you missed a spot. Because there is a consumable cost associated with each treatment, I want to make sure that we are treating all of the cellulite dimples. The patients also have to be aware that they will have some minor downtime with some drainage in the first few days and bruising. They should begin noticing results in as little as a month after treatment.
CST: Have you needed to do lots of patient education or marketing?
Dr. George: We have invested in marketing outside of our practice, but our initial treatments have all been from internal marketing and education. I would advise practices considering this technology to start by marketing internally and subsequently focusing outside of their practices. Once your own patients receive the treatment, and see the results, the power of those peer-to-peer referrals and recommendations are the most important.
CST: What do other doctors ask you about Cellfina?
Dr. George: Other physicians want to know about how easy it is to use, how long the procedure takes and, of course, want to know that patients are happy with the treatment. So far, this is a procedure that can be done in 45 minutes to one hour, once you get the first few under your belt. It is easy to use, and patients are very satisfied with their results.
Disclosure: Dr. George owns the Cellfina device but has no other direct conflicts.