MIAMI BEACH A unipolar radiofrequency device that is not yet approved in the United States shows promise for the treatment of cellulite, Dr. David J. Goldberg said at a symposium sponsored by the Florida Society of Dermatology and Dermatologic Surgery.
The unipolar handpiece on the Accent device (Alma Lasers Inc.) heats deeper, compared with current devices that have only a bipolar radiofrequency (RF) option, said Dr. Goldberg, who is on the speakers' bureau for Alma Lasers.
In a study by a group of Mexican investigators, the deeper unipolar RF energy penetrationan estimated 26 mm deepnoninvasively heated subcutaneous adipose tissue and caused collagen fibers to contract (J. Drugs Dermatol. 2006;5:71422). In the study, 68% of 26 women demonstrated at least 20% volumetric contraction on ultrasound.
This is a "hot device right now and very popular outside the United States," said Dr. Goldberg of the department of dermatology at Mount Sinai School of Medicine, New York.
Cellulite is more common among whites, its severity increases with age, and it can be hereditary. "Eighty-five percent of women have cellulite, and the other 15% think they do, so it's a big market," he said, adding that "cellulite is going to become the hot topic in aesthetic medicine in the next 5 years."
In another study of 30 women treated with the Accent unipolar RF handpiece, 27 showed improvements in thigh circumference. The mean decrease was 2.45 cm, a finding that is "better than in other studies or with other technologies," Dr. Goldberg said. Participants underwent six treatment sessions over a 12-week period. The study was funded in part by a research grant from Alma Lasers.
Bipolar RF is superficial, but unipolar is more like ultrasound or magnetic resonance imaging. The unipolar device provides a "very high MHz frequency, almost like MRI," he said.
Investigators rated improvement of cellulite on a 14 scale. The mean improvement in the study was 2.9.
Treatment is simple and fairly painless, and patients typically get some erythema. The device's cooling tip avoids blistering of the skin. "Patients should feel some warmthnothing more," he added.
"The typical result is tightening of the skin from deep, diffuse radiofrequency," Dr. Goldberg said. Not everyone, however, is a candidate. "They cannot be fat or have a lot of muscle rippling, but you can get a nice result for loose skin," he said.
There were no significant changes in blood lipids or patient weight during the study. Similarly, MRI scans of the treated areas showed no changes. Histology showed upper dermal fibrosis and tightened collagen formation.
"This Accent device is highly effective for skin tightening," Dr. Goldberg said. "When [it is] FDA approved, it will be a potent device in the treatment of cellulite."
A patient with cellulite is shown before treatment with the Accent device.
Mean improvement among 30 patients was rated at 2.9 on a scale of 14. Photos courtesy Dr. David Goldberg