Non-ablative Radiofrequency for Cellulite (Gynoid Lipodystrophy) and Laxity

Abstract

Cellulite, also known as gynoid lipodystrophy, is a multifactor disorder of the dermis, epidermis, and subcutaneous cellular tissue (Goldman et al. Pathophysiology of cellulite. New York: Taylor & Francis; 2006). In most cases, this alteration occurs in postpubertal women with a prevalence of 80--90% (Goldman and Hexsel. Cellulite: pathophysiology and treatment. 2nd ed. Florida: Editorial Informa, Healthcare; 2010; Emanuele. Clin Dermatol 31(6):725--30, 2013). Clinically, cellulite presents irregularity of the skin surface with depressions, lumps, and nodules associated with laxity. Usually, cellulite is located in the abdomen, buttocks, and lower limbs, but it can also occur on the arms and the back. Histologically, cellulite is caused by subcutaneous herniated fat within the fibrous connective tissue (Rossi and Vergnanini. JEADV 14: 251--62, 2000; Khan et al. J Am Acad Dermatol. 62(3):361--70, 2010; De Peña and Hernández-Pérez. Rev Cent Dermatol Pascua 3:132--5, 2005). An increase in the thickness of the subcutaneous cellular tissue is also observed. Although cellulite is still considered as an unclear etiological condition, there are many hypotheses trying to explain this disorder. Treatments can be invasive and noninvasive. Invasive methods include subcision and mesotherapy, as well as liposuction when patients also want to remove excessive localized fat. Noninvasive treatments include topical treatments, controlled diets, cryolipolysis, focused ultrasound, endermology, laser, and non-ablative radiofrequency. In this chapter we are going to discuss the treatment with non-ablative radiofrequency. Radiofrequency (RF) contracts collagen and stimulates neocollagenesis by thermal heat, promoting thickening of the dermis, avoiding fat herniation. It can also promote improvement in local circulation due to the vasodilatation and lymphatic drainage. Clinically it improves the laxity and the irregularity of the skin surface (Coringrato et al. Radiofrecuencia ablativa en dermatología quirúrgica: Una revisión, Rev. dermatología argentina, vol. XIV, Julio--Septiembre 2008, Número 3; Brightman et al. Lasers Surg Med 41:791--8, 2009).