Paul M. Parker, M.D., F.A.C.S., medical director of the Parker Center for Plastic Surgery in Paramus, N.J. believes the best available option for reducing cellulite is Cellfina (Ulthera), a motorized reciprocating blade that releases fibrous bands associated with cellulite.
However, candidates first need to be carefully evaluated to ensure that “they indeed have cellulite rather than some loose skin,” Dr. Parker tells Cosmetic Surgery Times. “What Cellfina does well is treat the dimples of cellulite; hence, when examining the patient, you want to carefully examine and stretch their skin. When stretching the skin, the dimple should not go away. This tells you that the dimple is held in place by a shortened fibrous band.”
Dr. Parker, who paid $65,000 for the cart-based device 1 year ago, has treated about a dozen patients, all female and between the ages of 25 and 65. The two most popular treatment sites are the buttocks and the thighs.
Major components of Cellfina are a holder for an intravenous bag that is filled with local anesthesia or wetting solution, tubing to transmit the fluid into the patient, a vacuum chamber to hold the tissue in place, and a plastic guidance platform attached to the vacuum chamber, which has grooves for both a 22-gauge spinal needle to introduce the anesthesia fluid and for a 0.5 mm reciprocating blade to release the bands. The only hardware is a motor that connects to the blade.
Cellfina Treatment Protocol
The treatment protocol is for the patient to first stand, while the clinician meticulously marks all areas of cellulite to be treated, ranging from as few as eight areas to as many as 30.
Patient expectations are then managed by the patient looking in a mirror and Dr. Parker detailing what will happen during the procedure.
Most cases of the 45-minute surgery are done under local anesthesia, with the patient lying down in a prone position.
“What is cool about Cellfina is that we use a vacuum chamber that looks like a petri dish, which is placed on the skin,” Dr. Parker explains. Next, the vacuum chamber is connected to a suction device.
After connected, the vacuum chamber is locally anethesitized with a 22-gauge needle, which expands the fatty tissue and fibrous bands. The chamber is then moved from spot to spot until all sites are completed anethesitized.
Next, the 0.5 mm reciprocating microblade is placed in the vacuum chamber. “The beauty is that with the vacuum pressure, the tissue is held in place,” Dr. Parker observes.
The plastic platform or guide track connects to the vacuum chamber, so the microblade is able to release each and every fibrous band, 6 mm beneath the skin. “It does this very precisely,” Dr. Parker says. “The guide track really controls the depth of release and the amount of release. Releasing the band causes the skin to pop up to a normal position.”
The only patient discomfort is some burning during injection of the fine needle. However, the needle is so fine that no stitches are required. Patients are up and walking the same day of surgery, although they ooze fluid and most are slightly sore for 1 to 2 days.
Results are usually noticeable within 2 days, when the swelling subsides, and complete results are expected at 3 months.
Related: Cellfina results last 3 years
Cellfina is FDA approved to treat cellulite for 3 years. “A major clinical study found patient satisfaction rates of 94% at 2 years after treatment,” reports Dr. Parker, who has no financial interest in Cellfina. “What certainly got our attention is that this is something that is long-lasting. Once you effectively cut and release those bands, they do not appear to recur.”
The procedure is “truly straight forward and can be performed by one clinician, but patient selection is key,” Dr. Parker emphasizes.
Cellfina vs Other ‘Options’
In essence, Cellfina is a sophisticated form of surgical subcision, “yet more precise,” Dr. Parker says. “Cellfina is probably slightly simpler to execute, due to its automation, and I think results are more predictable. We also know that liposuction tends to make cellulite worse, so I would not recommend that modality.”
And comparing Cellfina to topicals, “is like night and day,” Dr. Parker notes. “I do not recall ever coming across a topical peer-reviewed study that works for cellulite. As a surgeon, I cannot imagine how topicals would release fibrous bands.”
Similarly, laser requires multiple sessions and “patients are not completely satisfied,” Dr. Parker says. He is also unconvinced that radiofrequency can achieve the release of fibrous bands.
The Parker Center for Plastic Surgery promotes Cellfina through word of mouth, mentioning that some staff members have undergone the procedure.
“Fortunately, our patients have been very happy,” Dr. Parker conveys. “A procedure like Cellfina should hopefully stand the test of time and become more popular because it clinically works in one treatment session with limited downtime.”