HOW CAN WE TREAT CELLULITE?
The treatment of cellulite must follow a multidisciplinary approach,
including the modification of dietary/hygienic habits and the application of different therapies.
How Is Cellulite Treated?
In the first consultation, a complete medical history is taken. Predisposing factors are systematically assessed and the patient’s height and weight are recorded. Next, the patient is given hygienic and dietary recommendations, phytotherapy recommendations and the treatment is outlined, instructing the patient to follow a course of action that includes diet, mesotherapy and endermology, depending on the case to be treated.
1. Dietary/Hygienic Measures
1/ Physical Activity:
Aimed at increasing cardiopulmonary capacity, physical resistance, and muscle tone, and to improve the overall state of health of the patient by benefiting from its psychological effects. Patients must exercise regularly (at least 3 times a week and for at least 45 min.). Recommended sports are: swimming, cycling, mild body-building, and aerobic.
2/ Stress:
Physical and psychical stress will be avoided as much as possible. Sufficient undisturbed sleep at night should be ensured and tranquilisers should be avoided.
3/ Clothing And Footwear:
The use of very narrow or high heel shoes that modify the natural statics of the feet and vertebral column should be avoided.
4/ Body Posture:
Body patterns that alter the physiological curvature of the vertebral column should be modified. A fixed posture standing, sitting down without walking or sitting down with your legs crossed over a long period of time should be avoided.
5/ Elimination Of Toxic Habits:
Coffee, tobacco and alcohol should be avoided.
6/ Regulation Of Intestinal Transit:
You should take large amount of natural dietary fibre (fruits, vegetables, grains, and cereals) or therapeutic fibre, should be it needed. Laxatives and purgatives should be avoided. Large amount of liquids are recommended (1.5-2.0 l of water, juices, infusions or broths).
7/ Nutrition:
There are no miraculous diets capable of eliminating cellulite by themselves, although a good diet can delay its progression or improve its appearance. If cellulite is present but the patient is not overweight, it is recommended to follow a balanced diet, with regular meal times and avoiding prolonged periods of time on an empty stomach. It is advisable to limit (but not eliminating) the consumption of red meat and refined sugars. If there is associated excess body weight, a hypocaloric balanced diet would be recommended.
8/ Phytotherapy:
It uses the same therapeutic principles contained in vegetables and plants, either in the form of infusions, oral supplements or skin application. Some products have draining and detoxifying effects, others stand out for their antioxidant and anti-inflammatory activity, and others are used for their high content in oligoelements. Worth pointing out are: Salvia (female hormone regulation), fennel (anti-inflammatory, diuretic and digestive activity), nettle (detoxifying action), birch (diuresis), pineapple (due to its high content of bromelaine that favours diuresis and digestion as well as the mobilisation of fat), Lion’s tooth (depurative plant with strong diuretic and draining action, activator of liver activity and digestion), Queen of the Meadows (rich in salicylates and flavonoids, with strong anti-inflammatory and diuretic activity), Indian Oak (antiedematous, facilitates venous return), Ruscus (rich in saponides that act by strengthening the vascular wall, it is also anti-inflammatory and antiedematous), Ginko Biloba (revitalising action and vascular tonifier), Asiatic Centella (vascular tonifier and regulator of fibrous tissue, improves skin appearance and condition).
Algae (focus and spiruline algae) are very rich in vitamins, minerals and oligoelements, and with a high proportion of protein; they stimulate defences and metabolism, promote diuresis; nonetheless, some of these plants must be used with caution and in minimal quantities given their high iodine content and if used unsupervised they can cause thyroid function alterations. Consumption of red tea and green tea has a diuretic, antioxidant and slightly stimulating effect.
2. Local Treatments
These include therapies applied at the problematic area and surrounding areas, such as topical treatment with creams, massaging, mesotherapy, Endermologie® and liposuction.
a/ Creams, Gels And Essential Oils:
A wide range of creams, gels and oils is available for application onto the skin. The main activity of these products is to hydrate and soothe the skin. They also provide an anti-inflammatory effect (menthol, citric products, ivy, algae) and, in some cases, due to their content in caffeine, a mild lipo-reducing effect.
Caffeine, applied in the form of hydro-alcoholic gel at 5%, penetrates well into the coetaneous tissue spreading homogenously and reaching weak blood concentrations without systemic effects. The efficacy and tolerance to topical caffeine has been proven. The topical application of Aminofiline was considered an effective therapeutic arm against cellulite, although this has not been confirmed in more rigorous studies.
b/ Massages And Other Variants:
Massages produce a positive effect on venous return and lymphatic flow and tone the skin by improving the absorption of topical ointments.
-Manual lymphatic massage: Different from the classical massage in that it exerts its main action on lymphatic activity thanks to the mild mobilisation of the skin. The massage is applied gently without any aggressive movements. All movements mimic the physiological movement of the lympha in the vessels, acting on the nervous system of the muscle wall of lymphatic vessels. Its action mechanism takes place at three levels: sedative, stimulating and tonifying. Due to its pumping mechanical action, it produces the following effects:
(i) Oedemas: Action on the lymphatic system, on blood vessels and on the lymphatic load.
(ii) Nervous system: Sedation effect with pain, action on the vegetative system.
(iii) Muscle system: Action on the skeletal muscle, blood vessels and intestinal activity.
(iv) Immune system: Stimulates immunological structures.
The most common indications are related with the presence of oedema in cellulite with chronic venous and/or lymphatic insufficiency. Lymphatic drainage is not indicated in well localised cellulite or in initial venous insufficiency.
Reflexology: It is based on the principle that each part of the body is reflected en a given area of the foot sole. Pressure on a given area stimulates circulatory drainage and eliminates toxins.
Presotherapy: It is performed by means of boots or pneumatic pants that exert a mild massage. It improves venous-lymphatic circulation increasing the drainage of liquids and toxins; it relaxes the muscles and induces a relaxing effect. The duration of the session is approximately 30 minutes. Two weekly sessions are recommended with 20 minute cycles, depending on the patient´s progress.
c/ ULTRACAVITATION
Ultracavitation is one of the most efficient treatments for the improvement of orange-peel skin’s appearance and to combat superficial fat and localised fat accumulation.
It consists of applying ultrasounds to the skin’s surface to produce pressure and temperature changes in the adipose tissue’s interstitial fluid.
This new therapeutic device uses higher penetration frequencies that compress the liquids without increasing the temperature. In this manner, Ultracavitation is defined as a painless, safer and more efficient treatment.
The results obtained from Ultracavitation are manifest by a progressive improvement in the aspect and quality of orange-peel skin. It is evident from the first sessions and by the reduction in accumulated fat volume, which is visible several days after the first session.
In order to obtain good results, the number of session should be between 8 and 12, applied weekly or fortnightly.
Each Ultracavitation session lasts for 30 to 50 minutes depending on the areas treated (abdomen and trochanters, respectively).
The Ultracavitation transmitter is applied to each area with conductive gel. It is painless and there is no need to shave the treated area.
Immediately after ultrasound application, an intense drainage of the area is recommended with either Endermology or Pressotherapy techniques for approximately 15 minutes.
In certain cases of lipodystrophy and in cases where the specialised physician recommends, it is possible to increase the results by employing a low-saline concentration hydrolipoclasy technique which causes the adipocytes to absorb the liquid as they are more sensitive to the waves emitted from the Ultracavitation device.
The expert’s opinion:
What are the benefits of Ultracavitation?
Does Ultracavitation have any side effects?
It has no side effects or health risks for three basic reasons:
1. The frequencies used only affect the fat deposits, leaving the other areas of tissue unscathed.
2. The breakdown of fat cells occurs in short-chain free fatty acids. This favours metabolization and elimination of fat without increasing the triglycerides in the blood.
3. The contact device applied to the skin is designed to prevent heat damage.
Is Ultracavitation the most efficient treatment method for the elimination of cellulite?
Ultracavitation results are very close to those obtained from surgery, but on some occasions, neither of these two methods are valid substitutes to other treatments. For example, in the case of localised microcirculation disorders with fluid retention, Ultracavitation will eliminate the accumulated fat; but it should be combined with a complementary treatment to improve veno-lymphatic return, such as Endermology, Pressotherapy or the innovative Icoone.
Is the increasing use of technology in Cosmetic Medicine beneficial?
Application of new technologies in the field of cosmetic and general medicine is extremely beneficial; since the results obtained are less and less invasive, faster and safer.
D/ Mesotherapy
Considered as the classic of Aesthetic Medicine, it consists in the intradermal or subcutaneous administration of different homeopathic substances at small doses by way of multiple injections (by means of a gun or manual injection) applied in the area to be treated. The main therapeutic effects of mesotherapy in cellulite are:
In cellulite, the activity of mesotherapy has been clearly shown as fast acting and of long lasting effect (not defined yet). An average of ten sessions are required (1 session per week) lasting approximately 10 to 15 minutes each, depending on the area to be treated, the type of cellulite and the time from onset. Once the initial treatment is completed, regular booster or touch up sessions are recommended, usually with a frequency of once a month. Mesotherapy must be applied by healthcare personnel adequately trained in the technique and under medical supervision, under aseptic conditions (preparation of the skin to be treated with antiseptic, sterile gloves, and disposable, single use, material.
Under strict asepsis conditions and care, complications are rare (excepting post-administration marks on the injection sites and occasionally small haematomas that will fade away spontaneously). On occasions, some of the substances injected can cause a minimal allergic local reaction that improves a few days after with adequate treatment. The identification of the product responsible for the allergy and its omission from following sessions is necessary.
e/ VIRTUAL MESOTHERAPY
Virtual mesotherapy is based on electroporation, a technique consisting of both the superficial application of active substances and high voltage electric pulses which produce specific changes in the cell membrane. This creates pores that help the substances penetrate into the cell.
The advantages of virtual mesotherapy are many:
• A non-invasive treatment, not requiring needles or piercing objects
• Reduces cellulite and non-volumetric fat deposits
• Improves flaccid skin, retenses it and restores its natural luminosity and glow
• May be applied to any part of the body
• Painless treatment, requires no anaesthesia
• No hospitalisation or post-treatment downtime
• It is a “lunch time treatment”, lasting approximately 35 minutes
• Does not require compression garments
• Does not cause haematomas or bleeding
• Extremely well tolerated technique with no side effects
The Specialist Physician at IML evaluates patient expectations case-by-case, personalises the selection of substances or the protocol which will be applied on the skin using a roll-on applicator. Some of the active substances used by IML for virtual mesotherapy are:
• Caffeine: It stimulates the central nervous system, increasing cell metabolism and aiding in the destruction of fat cells.
• Fucus: It increases body temperature and contributes to the destruction of fat cells. Its high iodine content stimulates production of thyroxine, a hormone which aids combustion of nutrients, increasing the metabolic rate and regulating growth and development.
• Carnitine: An amino acid derivative which acts in the metabolism and fatty acids by accelerating the combustion of lipids.
• Lecithin (phosphatidylcholine): It emulsifies the fat and gives it an oily texture which facilitates its elimination.
• Aloe: Rich in vitamins, mineral salts and trace elements, aloe provides the skin with numerous beneficial properties.
• Chestnut: Corrects blood vessel permeability and tones the vascular walls.
F/ Subdermal Therapy
lso referred to as Endermologie® or Siluette therapeutic massager, is a technique that employs a high technology device which, through an aspiration system with rollers, that firmly massages the skin and subcutaneous tissue. Cellulite is treated by acting on hypodermal conjunctive tissue layers, stimulating circulation and drainage of lymphatic vessels, mobilising conjunctive structures and by facilitating tissue homogenisation. Thus, subdermal therapy reduces liquid retention, favouring circulation and improving lipolysis. It also reshapes or remodels body contour, improving the silhouette and reducing volume. At the level of the epidermis, its exfoliating effect restores smoothness, tone, firmness and shine to the skin.
To obtain the best results, it is recommendable to undergo a minimal number of sessions that ranges from 15 to 20. These sessions are applied one or twice per week and last approximately 35 minutes. Sessions must be applied by trained personnel. Therapy is applied through a mesh (stocking type garment) that covers the entire body so that there is no damage or trauma to the skin.
The technique is useful to prepare and smooth out subcutaneous connective tissue prior to liposculpture. It is also used postoperatively to improve the results, facilitating the elimination of oedema and residual ecchymosis, improving, in many instances, possible asymmetries.
ICOONE: Cutaneous alveolar restructuring
The human body is exposed the force of gravity and it is developed to maintain itself in that environment with the energy vectors that give it stability and movement. The body has a network of myofascial or connective tissue that surrounds the muscles, organs and bones and which arranges the skin’s structure. This network arrangement is known as cutaneous alveolar structure.
Instituto Medico Laser uses the Icoone system, a new treatment based on AMMS (Alveolar Multi-Microstimulation) technology. It consists of the application of suctioning pressure generated by microstimulations through two perforated rollers that achieve a perfect fit to the skin’s connective microvacuolas. These rollers fragment the void effect, returning the skin to its natural state.
The Icoone treatment program can be adapted to each patient’s skin features, controlling the roller rotation, void pressure. It also has specific male programs, adapted to the differences between male and female skin types. It also has the possibility of using two contact units that work in unison to cover the skin with symmetrical movements, ideal for connective tissue mobilisation.
The cosmetic application of Icoone is indicated for improving:
Cellulite
Localised adiposity
Anti-ageing skin treatment
Skin laxity
With this non-traumatic skin treatment, several daily sessions can be carried out in case of haste to undergo treatment, but at IML we recommend a maximum of three weekly sessions.
G/ VELASHAPE
VelaShape™ is a new technology that combines the power of radiofrequency and infrared (Elōs) with vacuum therapy and mechanical massage to reduce body circumference and cellulite. This non-invasive and virtually painless technique is the first of its kind approved by the FDA (US Food Drug and Administration) for the treatment of cellulite and reduction of body circumference. VelaShape™ combines Elōs technology (radiofrequency plus infrared) with vacuum therapy and mechanical massage to increase cell metabolism and lymphatic drainage, thus reducing fat deposits. Results obtained are:
Reduction of body circumference
Lymphatic drainage
Reduction of fat deposits
Smooth and taut skin
VelaShape™ treats both deep tissue and surface skin layers. It can act on multiple areas with one pulse and in approximately 30 minutes. A slight heat sensation on the treated skin is normal after application as well as a light reddening that disappears after a few hours. It is a safe, efficient and virtually painless treatment that requires no downtime.
H/ LIPOSONIX: NEW NON-SURGICAL LIPOSCULPTURE
It is currently possible to effectively sculpt the body through non-invasive technology with LipoSonix, a new system that eliminates adipose tissue and reaffirms the skin with a combination of mechanical and thermal effects produced by the application of ultrasounds.
Advantages of LipoSonix:
How does it work?
LipoSonix is based on H.I.F.U. technology (High Intensity Focalised Ultrasounds). This technology can focus the energy on a precise point and to a specific tissue depth, distributing the ultrasounds in the treated areas without damaging the tissue outside the treatment area.
The ultrasounds produce a cavitation effect that activates the interstitial fluid molecules and increases their friction and pressure. This friction generates a thermal effect that destroys the adipocytes whilst it contracts the collagen and generates new collagen and elastic fibres.
The destroyed adipocytes are eliminated from the body by macrophage cells that engulf and metabolise the lipids that contain the debris fat cells. This natural process does not increase the triglycerides or total cholesterol profiles.
Instituto Medico Laser recommends one to three approximately 30 minute treatment sessions.
I/ Muscle Electrotherapy
Hypotrophy of a muscle group, gluteus, or arms, frequently determines or exacerbates unaesthetisms due to muscle flaccidness -tegumentary- resulting in the so called false cellulite.
Hypertrophying muscle electrotherapy is based on the utilisation of devices that achieve involuntary contraction of the muscle. This type of therapy does not substitute active exercise. However, since it is difficult for the patient to selectively obtain the contraction of a given muscle group, the use of this therapy is justified when it is included as part of a therapeutic association with other methodologies. Sessions last approximately 30 minutes (2/3 times per week for three months, depending on the progress).
J/ Radiofrequency (Accent) For Flaccidness
In the last few months we have witnessed an increasing interest and subsequent thorough study of a subject that concerns aesthetic doctors and patients alike, as a result of the introduction of radiofrequency, a new effective, safe and simple therapeutic alternative (Accent device) applied to treat cellulite and body flaccidness.
Radiofrequency (Accent) generates an electrical field that changes from positive to negative, which causes a rotational movement of molecules and that generates heat.This deep heating of the skin and subcutaneous cell tissue triggers a cascade of reactions that improves both these pathologies. Before we go on to explain how cellulite and muscle flaccidness are improved, we must first understand both these conditions.
Cellulite has been defined as vasculopathic skin disorder (a skin disorder of a vascular origin) that affects 90% of women and that is usually accompanied by a fat overload and flaccidness. The physiopathology of cellulite includes several phases of instauration: a phase of oedema in which the walls of the vessels leak, filtrating liquid and aggressive substances around adipocytes (fat cells). Adipocytes in this toxic environment cannot perform their metabolic exchanges properly and increase in size becoming surrounded in the last stages of conjunctive fibres that strangle them. Adipocytes also become surrounded by lymphatic cells incapable of catching toxins. This cascade of reactions closes a vicious circle retrofeeding on itself in which radiofrequency (Accent) has been found to act at different levels.
Flaccidness is defined as a skin dysfunction inherent to the natural or accelerated aging process. Initially there is a decrease in cell metabolism, as a result of a descending collagen and elastin biosynthesis. The number of fibroblasts goes down and the dermis looses its normal tropism, becoming of less quality and loosing its natural replacement capacity. The network of collagen and elastin, united to dermal papilla and underlying tissue, supports the epidermis. The failure of this complex organic mechanical structure (collagen, elastin and fundamental substance) detaches –to a greater or lesser extent- the epidermis from the dermis.
Radiofrequency (Accent) produces a deep heating of the skin and subcutaneous fat tissue. Such heating favours lymphatic drainage and decreases the levels of toxins and liquids in which adipocytes in the affected tissue are embedded. There will also be increased circulation in the area, thus improving metabolism in the subcutaneous fat tissue and appearance of the accompanying skin. And last, but not least, radiofrequency prompts the formation of new collagen in the skin and in the subcutaneous tissue, making it possible for the tissue to acquire firmness thanks to the reorganisation of fibrous septa and thickening of the underlying dermal layer.
The decrease in volume is evidenced by a reduction of oedema and by the compactation through connective tissue. A hypothesis whereby a third mechanism involving the rupture or lysis of the membrane around fat cells contributing to the reduction in volume, is yet to be demonstrated.
In terms of treatment duration, treatment last a variable length of time depending on the area to be treated. Small areas such as arms or abdomen are usually treated in about 25 to 30 minutes, larger areas such as trochanter areas (saddle bags) can extend to 45 to 50 minutes per session.
The procedure is simple. Prior to the session, the area is marked in a criss-crossed pattern with a surgical pen. Next, the skin is cleansed with aromatic oil and the energy applied by means of a treatment head that is moved constantly over the skin. Each square requires from three to four passes until an adequate temperature is researched capable of prompting the changes discussed before. Once the session is completed, aloe gel is applied onto the treated areas and the patient can resume his or her daily activities without delay, avoiding sun exposure and UVA for the following 24 to 48 hours.
The number of sessions varies, but between 8 and 12 sessions at a minimal interval of one week is necessary. Results can be seen past two or three months, although the patient is likely to notice some transitory improvement over the first few weeks after the session, due to initial contraction of collagen and in part due to a small inflammatory reaction due to the aggression of the procedure that will disappear after 3 or 4 days.
The procedure is well tolerated and does not need anaesthesia. There is a feeling of heat and in people with severe cases of cellulite; there might be pain due to the friction with the treatment head. Secondary effects are reddening and oedema after the session (transitory but present nearly all the time) and small ecchymosis in areas of capillary fragility (not frequent). Radiofrequency is contraindicated in pregnancy, breastfeeding, pacemaker or metallic prostheses carriers, and individuals suffering from severe cardiopathies as well as connective tissue and neuromuscular diseases. Patients with excessive body weight are not good candidates either.
In synthesis, radiotherapy (Accent) is a new therapeutic alternative for the treatment of cellulite and flaccidness. It is a method that produces a deep and controlled heating of the skin and subcutaneous cell tissue triggering a cascade of reactions that cause collagenesis (tightening of the skin and fibrous septa), lymphatic drainage of fat, and improved circulation in the skin and subcutaneous tissue. This all results in an improvement of unflattering orange peel skin, improving flaccidness and reducing volume of the treated area. These two pathologies are rather complex, achieving the best results when other techniques are used in combination.
Accent XL: Large Unipolar Module
AccentXL is a new non-invasive treatment that eliminates orange peel skin, flaccidity and fat deposits with one sole device.
The new AccentXL Large Unipolar Module reaches temperatures as far a 3 cm2 deep, acting on the adipose tissue and reducing its volume. It can work on larger surfaces, producing controlled heating of the dermis and the adipose tissue, without affecting the epidermis.
It has multiple applications:
This new application method has the following advantages:
-It works on three different levels:
1. Superficial (Bipolar): tensing the dermis.
2. Mid-layer (Unipolar): treats skin texture on a superficial level
3. Deep layer (Unipolar Large): transfers heat to a larger number of deep tissue and attacks the multilocular fat found in the trochanter lipodystrophies, sides and buttocks.
-Tissue reaches the optimum temperature faster, leaving more time for an efficient therapeutic phase.
-Higher and more efficient intensities that avoid the sensation of pain or burning as well as temperature peaks.
-Collagen is remodelled, providing a smooth and contoured appearance.
-Allows for simultaneous treatments on different body areas.
Radio Frequency: What is Skin Tightening?
Introduction: It has been an acknowledged surgical treatment for over 70 years. Invented by Dr. T Bowie (Harvard). In Cosmetic Medicine, the Unipolar and Bipolar modes are used.
RF basis: it is defined as electromagnetic radiations, located within the spectrum, between Infrared Radiation and Long Waves. The therapeutic range which we refer to is between the Medium and Short Wave. When applied to the tissue, it causes rapid oscillations of the electromagnetic fields, causing movement of the charged molecules, resulting in an increase in the tissue’s temperature. The thermal effects are determined by the type of RF applied, the level of energy, duration of the treatment and the type of tissue treated.
The type of RF applied (unipolar or bipolar) and the size and shape of the electrode also influences on the physiological effect.
The optimum temperature of the tissue heating is between 55 and 62ºC (this is the range in which the describe effects take place).
First, the RF produces heating of the adipose tissue. This increases the Lymph and Arterial Venal System stimulation of the tissue. Likewise, a heating at skin depth is produced due to the spreading of heat, improving the skin quality and stimulating collagenesis.
The collagen goes through an immediate contraction and reshaping over time. Also, an increase in vascularization is observed in the cellulite tissue, which allows for an improvement in the cellular metabolism.
Insofar as the collagenesis is concerned, this occurs due to the formation of Heat Shock Proteins (HSP) that synthesizes with certain stimuli and initiate tissue repair. Specifically with the RF treatment, HSP-47 is synthesized. This protein resides in the Endoplasmic Reticulum and clearly identifies the Collagen Triple Helix. The Type I collagen molecules can only be correctly assembled in tridimensional form in the presence of this HSP-47 protein.
Properties and effects of RF:
RF depth of penetration is subject to:
1-The tissue’s electrical characteristics (directly proportional to its resistance).
2-Type of handpiece: Unipolar-Bipolar.
3-Wave frequency.
Electrical characteristics of the tissue: the greater the tissue’s resistance as the RF passes, the higher temperature generated (fat has a resistance of 2180 Ohms, 10 times higher than that of the skin).
Handpiece type:
a) Bipolar: the electrical range is between two electrodes at a fixed distance. Both electrodes are applied to the treatment area. And the prolongation of the electrical current is limited between both electrodes.
b) Unipolar: The Unipolar or Monopolar system emits energy through one electrode with a sole contact point on the treated area. Heating depth is variable. There may be an inductive electrode and a return electrode (eg. Thermacool®) or a ground pad return electrode (eg. Accent®). With the Thermage® System, we can choose the type of heating produced, either superficial, mid-depth or deep; according to the treatment tip used (1.5 cm², superficial, 1.5 cm² mid-depth, 3 cm² mid-depth; 0.25 cm² superficial and 3 cm² deep).
The higher the wave frequency, the deeper the penetration.
RF is indicated for: localised adiposity, cellulite and flaccidity.
Main contraindications: patients with dermal alterations, pacemakers, defibrillators or cardioverters or metal implants in the area to be treated.
Side effects: intense heat sensation for a few minutes, erythema which will disappear in 1 to 2 hours and burns on very rare occasions (this is usually due to a poor application technique).
RF: Conclusions:
Gold Standard for flaccidity (whether associated or not to mesotherapy, carboxitherapy and/or vibrotherapy).
It is also used in treating cellulite and false cellulite (which accompanies flaccidity), nearly always combined with the treatments described above.
In cases of localised adiposity, treatment is usually combined with ultrasounds and/or Mechanical Massage.
K/ Laser Lipolysis: a combination of laser and liposuction
Instituto Medico Laser presents a new Laser Lipolysis treatment. A minimally invasive procedure that improves small localised lipodystrophies.
It is performed by introducing a laser probe in the tissue through a small incision aimed at destroying the adipocytes.
Laser Lipolysis is specially indicated in fat elimination of:
Laser Lipolysis presents a number of innovations on traditional liposuction:
1. No hospitalisation needed. No compression garments are used and neither is major sedation.
2. The patient can resume normal activity 24 after treatment
3. Reduced bleeding
4. The skin is contoured and collagen generation is stimulated
5. The minimal infiltration prevents asymmetries
6. Less tissue trauma
7. Less scarring and bruising
8. Reduction of pain and postoperative inflammation
L/ Ultrashape-Contour1, Non-Surgical Liposculpture
Instituto Médico Láser has just incorporated UltraShape to its technological platform for treatment of cellulite, eliminating fat deposits and remodelling body contour, without the need for surgery.
This is the first and only medical device capable of performing an ultrasonic –non-surgical- remodelling of body contour. Its technology is based on a focalised ultrasound beam that destroys fat cells, without damaging surrounding tissues. This video-assisted procedure ruptures the adipocyte membrane by ultrasonic vibration and uses an ultrasound guidance system that enables visualisation of corporal changes in real time. Ultrashape meets the standards of European Directive 93/42 relating to medical devices.
Advantages
Comfortable: painless treatment that is carried out in the office; no anaesthesia, no girdles.
Safe: only a predetermined amount of ultrasonic energy is aimed accurately at the desired area inside the adipose panicle. Adjacent tissue remains undamaged and unexposed.
Selective: only adipocyte membranes are broken down. There is no dermal lesion.
Results
Upon completion of the treatment, there is a discrete decrease of volume. The loss of volume is observed later on, as the fat destroyed starts to get eliminated from the body.
One session achieves a 2.5 cm reduction of body contour, on average. Some patients, however, have achieved even a bigger reduction reaching up to 6 cm in the perimeter of saddle bags area in just one session.
Duration
Slightly over 2 hours per each area selected.
Number of sessions:
As many as necessary, provided they are administered at 4 week intervals.
M/ Carboxytherapy
Carboxytherapy is one of the best therapies to fight cellulite, flaccidness and localised fat deposits.
Carboxytherapy is a non-invasive method consisting in small infiltrations of carbon dioxide into the affected tissues.
This therapy originates from the Royat Thermal Waters resort in France in the 50’s when a group of cardiologists began to apply the therapy to patients suffering from different diseases with deficit in blood flow as a common feature.
Cellulite has been defined as a vasculopathic dermopathy, that is a skin condition of a vascular origin. It is a very complex process whose common physiological denominator is a local microcirculatory disorder. Adipocytes are not drained properly and consequently debris and impurities start to accumulate in a liquid form initially becoming thicker later or (or gel). The presence of this gel with non-drained toxic substances causes irritation of the fibroblasts that respond by producing collagen resulting in cicatricial bridges that traction and strangle the vessels. This chain of events further worsens the metabolism of the affected tissue creating a vicious circle that results in the formation of “cellulite”.
The CO2 injection produces an improvement of gas exchange in the circulation, re-establishing microcirculation, increasing the amount and speed of blood flow and breaking the vicious circle that occurs in the affected vessels.
This improvement in gas exchange makes it possible to use O2 for metabolic reactions including fat combustion (a mechanism that reduces the size of adipocytes, a physiological lipolytic oxidative process). This is also helped by a decrease in tissue volume between adipocytes thanks to the previously explained mechanism. This results in improved skin quality, decreased volume in the affected area and amelioration of the symptoms that accompany cellulite such as bloating.
The technique is very simple. It is carried out using a specially designed system that controls flow velocity and the injection time and monitors the dose administered. Several injections are applied with a small needle, smaller than that used for insulin shots. The gas spreads rapidly to surrounding tissues. The technique does not present any side effects, with the exception of a mild and transitory pain in the application area and mild reddening lasting only for a few minutes. A slight degree of ecchymosis might appear at the punch site that will fade away in a few days.
Once the session is completed, it is usually complemented with pressotherapy or LPG to enhance the diffusion of gas into the adjoining tissues. The number of sessions varies, although a minimum of 15 applications 2 or 3 times a week is recommended.
After the session, the patient is able to resume his or her normal routines but should avoid sun exposure for the following 24 to 48 hours.
N/ Galileo: Vibrational Platform
| This technique was developed in a quest to find a type of physical exercise that would prevent astronauts losing muscle mass and bone density whilst in space under zero gravity conditions. From then on, these types of platforms have been recommended for several different situations in which its interesting benefits have been noted, both for sports, recovery health and wellbeing. |  |
Basically, the Galileo Fitness platform creates a variable frequency oscillating movement that produces an involuntary reflex of the muscles with contractions that stimulate the fibres to the limit of their contraction speed which is at about 25 to 30 per second. If this is compared with conventional exercise, we can see that muscular contraction in conventional workouts affects a maximum of 30% of the fibres whereas the articulations, ligaments and tendons suffer greater wear.
This type of exercise with the Galileo Vibrational Platform allows a workout on all the muscular structures of the body with more power and intensity and less articular suffering in a very limited time scale as each session is 10 minutes long.
Its application is interesting from several points of view. At IML we combine this treatment with lipolytic treatments in which the liberation of fatty cell content is essential and is obtained with treatments such as Ultrashape, Narl or Radiofrequency where fat is consumed immediately by the individual so it is not absorbed and stored as fatty tissue. It is a way of assuring an immediate burning of calories after the previous treatment.
Besides the cosmetic outcome of this treatment, it has other interesting good points:
Helps to firm body areas via the effect of muscular toning
Helps to lose weight through the calorie burning that accompanies the treatment
It helps to fight cellulite through direct stimulation of muscle group vascularization as well as the skin in the area.
It helps to increase secretion of the GH Hormone, responsible for basal burning of calories, maintenance of muscle nutrition and maintaining the remaining hormonal axis actives.
It is also interesting because it helps to combat stress, increases elasticity and muscular strength, improves general blood flow and corrects posture. It is extremely helpful in rehabilitation processes after lesions, helping to maintain the patient’s physical shape. Helps to prevent degenerative neuromuscular diseases, avoids osteoporosis and is a good tool in the recovery treatment of muscular injuries.
O/ Narl: Noradrenaline Release
| The aim of Narl (Noradrenaline Release) treatment is to induce lipolysis (dissolution of fat) in areas where there is excess accumulation. Lipolysis The fatty cells distributed throughout our bodies in differing sizes and densities take care of absorbing sugars and fatty acids that carry nourishment from the blood stream and store them. Those cells that are loaded with materials high in calories make up the fatty tissue. |
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Insulin is the hormone responsible for regulating the function of fat cells. When a person has a meal, a secretion of insulin is produced that induces the phase of fatty acid and sugar absorption towards the fat cells. An hour after consumption, this effect is slowed down and the lipolysis or liberation of energetic elements into the blood stream phase begins. The level of lipolysis adjusts to the needs of each person, controlled by thermogenesis and by the level of physical effort that generate a need for more energy. The consumption of food in a disorganised manner causes continual liberations of insulin that induces the storing phase in the adipose tissue and encourages the effect of “fattening”.
After 5 years of clinical studies, a system that induces the desired lipolysis phase has been developed (dissolution of the adipose tissue cells) through the stimulation of local Noradrenaline release.
Using an ultrasound emission device, at the average frequency of 517 KHz and emission density of 110 mW/cm2, Noradrenaline release is induced in the adipose tissue area where the treatment is applied locally. The Noradrenaline unites with the Beta-3 receptors in the fat cells around the area and this unchains a chemical process that leads to lipolysis, liberating fatty acids and triglycerides to the blood stream.
After liberating these substances into the blood stream, it is vital to insure that the patient immediately burns these liberated substances. Therefore, we recommend the patient to carry out either 20 minutes of exercise straight after the procedure or a 10 minute treatment session on a Vibrotherapy Platform.
P/ Vela Smooth
Vela Smooth is a conceptual combination of the ideal tools for the treatment of orange-peel skin in a measurable way according to the patient’s needs. It combines four different technologies in one as it applies a deep tissue massage using rotating rollers, whilst it performs a light sucking pressure on the skin that helps eliminate the vertical cellulite tracts. Added to this synergy is the treatment of collagen and elastic fibres via the application of radiofrequency and ending the treatment with an infrared light emission that heats up the skin and induces vascularization. Vacuum therapy obtains a mobilization of the vertical elastic and collagen fibres that anchor the dermis to the muscular fascia and creating the “orange-peel” effect. |
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By increasing the distance between the subcutaneous plane and the skin we produce an important cosmetic improvement. Vacuum therapy or suction pressure produce an increase in peripheral blood circulation and stimulates the lymphatic circuits. The results in skin with cellulite that suffers poor peripheral vascularization are excellent.
Infrared light causes a heating of the skin that modifies its resistance. The higher the temperature is, the lower the resistance to the electric current circulation and therefore creating greater impedance. The changes in temperature aid the radiofrequency circulation in focusing on the previously heated areas. At the same time, the application of infrared and its heat deposit is followed by and activation of the basal cellular metabolism in the dermal tissue and the adipose tissue. This creates greater oxygenation of the cells and improved metabolic interchange that is translated into a notable reduction of the cellulite.
Radiofrequency is a treatment by which electric currents are applied to the skin structure, its aim is twofold: on the one hand, a direct lipolytic effect is obtained through direct heating of the fat cells and due to the adipose tissue’s sensitivity to an increase in temperature. The internal heating of the deep dermis layer starts a metabolic chain reaction in the fibroblasts. This is definitive in the case of radio frequency since the fibroblast cellular elements of the skin synthesize the collagen and elastic fibres, responsible for forming skin structure. With greater fibroblast activity, the skin’s appearance is improved as far as laxity and structure is concerned.
Radio frequency supplies internal heating of the deep dermis and stimulates the metabolism, obtaining a lipolytic effect. It main function is fibroblast stimulation to produce collagen and elastin and increase the tissue tone and therefore augmenting firmness.
By combining these treatments, the orange-peel skin is diminished; the figure becomes more shapely and reduced and the critically lax regions are attack with great efficiency.
The areas recommended for this treatment are the thighs and buttocks, knees and internal area of the arms. Treatment of double chins can also be very useful applying the special headpieces for small body regions.
IML proposes 10 to 20 treatments with Vela Smooth and carried out a study of the ideal therapeutic combinations with complementary treatments according to each patient’s individual needs.-
Q/ Ballancer Pressotherapy
| Pressotherapy is a therapeutic resource used in cosmetic medicine as well as in physiotherapy, angiology and phlebology.
Pneumatic Ballancer Pressotherapy bases its treatment on introducing the area to be treated in an inflatable chamber that adapts to the volume of the body shape. A control system measures the patient’s volume and adapts the pneumatic structure to the patient’s body. The area is then given a centripetal massage, which is from the distal to the proximal areas. |
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An important symptomatic improvement is noted in all the pathologies associated with fluid retention, primary lymphedemas, secondary postmastectomy lymphedemas and vein disorders of the lower limbs. It’s also very interesting in post cosmetic surgery recovery.
There are 10 different programs available with a variety of pressures and centripetal drainage effect that allow us to adapt the characteristics to each patient’s needs.
The increase in external pressure that the system generates increases the interstitial fluid flow to the lymphatic and blood vessels which induces reabsorption of oedemas. In addition, the sliding centripetal massage stimulates ascending displacement of lymphatic and veined vessel content which greatly improves return blood flow.
These improvements are important in treating cellulite and localized fat.
This kind of treatment is recommended on large body areas since fluid retention correction, improvement in the venolymphatic and cellulite structure affect large regions as a network structure is being treated.
IML recommends Pressotherapy in a context of therapy combined with carboxitherapy or mesotherapy for the treatment of oedematose and lax cellulite. In a large number of occasions, we recommend pressotherapy together with organic silicon infiltration treatment.-