Treatment of Cellulite with Vasersmooth Ultrasonic Probe

Friday, April 12, 2013
Jeffrey LaGrasso, MD, Private Practice, West Palm Beach, FL and Grant Hamlet, MB.ChB, Queen Anne Medical Center, London, England
Goals/Purpose: Cellulite affects approximately 85% of postpubertal women and is a common, continuous complaint with no definitive solution.  The author’s goal is to evaluate the efficacy, longevity and safety of the ultrasonic VASERsmoothTM probes in the treatment of cellulite.  The VASERsmoothTM probe has a dual purpose.  It works like a traditional VASER probe in that it disperses ultrasonic energy around the probe to emulsify the adipose tissue through cavitation.  The VASERsmooth probe also has a fragmented sharp edge which can be used to strategically cut through the individual thickened fibrous septae. 

Methods/Technique: 10  healthy women with cellulite of their thighs and gluteal region were treated with the VASERsmoothTM probe in a prospective trial in the author’s private clinics. All patients’ cellulite were graded using the Nurnberger-Muller scale preoperatively with photographic documentation.  The treatment area of cellulite was divided into 5cm by 5cm squares.  Depressed areas were marked in red and raised areas marked in green.   Markings were made with regard to the angisome theory of skin perfusion so as treatment was limited to approximately 50 to 75 % of the cellulitic bands marked for treatment  as not to devascularize an area.   A single procedure was performed under general anesthesia.   50 to 80 cc of tumescent solution was placed superficially into each treatment square.  The 3.7mm 3 groove VASERTM probe set on VASER mode at 60% power was then run superficially under the skin to create superficial emulsification of the fat throughout the entire treated area.   Approximately 30- to 50 seconds of Vaser time was used in each treatment square.  Afterwards, switching to the Vasersmooth probe using the same settings, the fragmented edge of the VASERsmooth probe was used to selectively cut through the cellulitic fibrous septae until a release was achieved.  Ultrasonic energy was only applied during the active cutting motion as to limit energy to the surrounding area.  If there was difficulty in cutting the fibrous septae the setting were adjusted upwards to 80% Vaser mode or if upto 80% Continuous mode if needed. Larger fibrous septae not released using the fragmented edge of the VASERsmooth probe, were treated with the 4.5mm V dissector VASERsmooth prob, grasping the band and push cutting through it.  Once the treated  cellulitc bands were released, the Hamlet sweeper cannula was used throughout the entire treatment area to redistribute the fat, minimizing band reattachment and smoothing out surface irregularities.  Incisions were closed with 5-O fast absorbing vicryl suture.  The patient was placed in a compressive garment for 6 weeks post-op.

Results/Complications: All 10 of the treated patients showed significant subjective improvement in the appearance of their cellulite.  The improvements were still persistent at 6 months following treatment.  Complications were minimal consisting of mild discomfort, edema, bruising, seroma and numbness.  Patient satisfaction was high following the treatment. 

Conclusion: :  In this study, a single treatment using the VASERsmooth probe showed marked improvement in the appearance of cellulite in all patients with high patient satisfaction which persisted at 6 months with minimal adverse effects.