Cellulite Treatment Program
Why Choose SpaMedica?
SpaMedica in Toronto is Canada’s oldest, most recognized, respected and experienced cosmetic dermatology clinic. It’s the first and only place you should look for your cellulite treatment program.
Dr. Mulholland and his SpaMedica clinic in Toronto has been a leader in significant cellulite removal technology for over 15 years. You will receive the most updated and revolutionary treatment technologies, such and Cellfina, CelluTite, and Cellulazer, for the best possible and longest lasting results.
Your program will combine the most appropriate, minimally invasive procedure for your advanced cellulite; combined with our non-invasive outpatient technologies, such as: BodyFX, Venus Legacy, Venus Freeze, Excilis, Cellutone, Velashape and Smoothshapes. Your program is customized based on the level of your cellulite and your goals and expectations.
No other clinic in Canada offers this wide array of leading edge cellulite treatment technologies. This enables us to offer the best possible results.
Request your consultation with Dr. Mulholland or the SpaMedica team in Toronto by filling out the online consultation request form or call SpaMedica now at 877-695-2835.
Before & After
What is Cellulite?
Cellulite is characterized by lumpy, bumpy, irregular, “cottage-cheese” appearing skin.
The nodular swellings result from swollen clumps of fat that push up against the under-surface of the skin. These swollen clumps of fat must be addressed by a reduction technology in order for the skin to appear smoother.
Cellulite is also characterized by deep pits that are caused by a contraction of vertical fibrous tissue in the cellulitic fat. These cellulitic pits need to be treated by therapeutic intervention as well.
The orange peel-type skin results from thinning of the cellulitic skin with fat bulging into the superficial aspects of the skin, called the dermis. This third factor – thinning of the skin – needs to be part of your program and selected technology integration.
Figure 1. Toronto Cellulite Reduction patients present with various degrees of the 3 physical characteristics of cellulite, Nodules, Pits and dermal fat herniation. To improve skin texture, the technologies must release and smoothen the pits (Cellfina), reduce nodules and tighten the skin (Venus Legacy, BodyFX, Excilis, Cellutone, Smartlip and Cellutite). During your consultation, the best combination of technologies will be decided upon and your customized treatment reviewed.
What Causes Cellulite?
The precise etiology and cause of that “orange-peel” texture is unknown, but it is believed to be an abnormality of the microcirculation of the skin. Relatively poor blood flow and oxygenation to the cellulite-prone areas of the body results, over many years, in swelling and edema within the superficial fat, which in turn compromises blood flow to the skin.
The chronically poor oxygenation in the fat and swelling within the tight fat compartment leads to inflammation. The inflammation leads to fibrin formation and, over years, the growth vertical fibrous bands. The swollen fat, trapped in the tight compartments begin to “bulge up” forming the characteristic nodules. The vertical fibrous are attached under the surface of the skin and begin to shorten and pull the skin down creating the deep pits seen in advanced nodulo-pitted cellulite.
Finally, the dermis of the skin thins and the fat begins to herniate into the dermis causing significant dermal thinning. The causes are felt to be a combination of hereditary factors, hormonal factors (estrogen, which is why men don’t seem to suffer from cellulite), as well as circulatory. Weight and exercise appear to play little if any role in its genesis.
Figure 2. The cause of cellulite is likely micro-circulatory compromise, fat lobule swelling (nodules), inflammatory fibrous bands pulling down the skin (pits) and herniation of fat into the skin and thinning of the skin.
Where Does Cellulite Occur?
Cellulite occurs on certain “cellulite prone” areas of the body and is seen most frequently on the following regions.
#1. The buttocks
#2. The Posterior thighs
#3. The front of the thighs and above the knees
#4. The lateral or sides of the thighs
On occasion, cellulite can also occur on the upper abdomen and upper arms
Figure 3. Patients most commonly present with dimpled skin on the buttock, back of thighs, side and front of thighs. Above is a patient who has been marked just prior to her Cellfina reduction treatment. Cellulite can less commonly present on the upper arms and upper abdomen.
How Common is Cellulite?
It is very, very common. It is estimated that 100 million women in the USA between the ages of 20-54, complain of dimpled skin. Over 10 million women in Canada report they would get their cellulite treated if it was effective, with little to no risk of complications, was affordable, and long lasting. This describes the SpaMedica comprehensive treatment program.
After Successful Treatment, How Long Will It Last?
Cellfina, SpaMedica’s premier cellulite treatment system offers long lasting results – with patient satisfaction reported at 93% after 3 years. SpaMedica also offers monthly maintenance treatments if the doctor determines this is your best course of action. SpaMedica offers custom solutions based on your specific situation and goals – the best way to get your answers is to consult with the SpaMedica team and discover the details of your custom plan.
- Cellulite impacts about 90% of women at some point in their life.
- It is a myth that toxins in your body are the cause.
- A decrease in estrogen as women age seems to be the cause of worsening skin texture over time.
- Cellulite is genetic and you are more likely to get it if your mom had it.
- If you do exercise to decrease the appearance, strength training is important, as it helps tone and tighten. Cardio alone won’t do it.
- There is almost no evidence that creams or scrubs with caffeine, ginger, and green or black tea help long term. Your only solution for true reduction is seeing a doctor that is experienced in reduction treatments.
- Liposuction is not a solution (it may be part of an entire treatment plan, but lipo on its own will not treat dimpled skin successfully).
- Diet alone won’t help reduce it but eating healthy foods, especially foods with a high water content will help you lose weight and look and feel healthier. It will also keep your connective tissue strong and supple.
- Clothing does not help nor worsen your condition. Tight clothing for activity may help keep the “jiggle” in place but once you remove the clothing, the benefit is gone.
- Smoking will worsen the appearance of cellulite.
Figure 4. Cellulite is very common. It is estimated there are over 10 million Canadian women and over 100 million American women between the ages of 20-54 who complain of mild, moderate or server celluite. Cellulite on the thighs of celebrities has become an annual issue reported upon by the tabloids.
What Kinds of Cellulite are there?
Cellulite can be classified according to its severity.
Mild Grade 1 cellulite is characterized by stippling of the skin, or Peu d’orange or orange peel skin, without deep pits of large nodules.
Moderate Grade 2 cellulite is mild to moderate sized nodule formation with occasional superficial pits.
Severe Grade 3 cellulite exhibits very deep and numerous pits and large, visibly elevated nodules.
The more severe the dimpling, generally the more difficult and aggressive the treatments need to be in order to effect a noticable cellulite removal. The more advanced concerns will require internal, minimally invasive reduction treatments (Cellfina, CelluTite and Cellulazer), while the more moderate cellulite will be offered the completely non, invasive, external program and treatments (BodyFX, Venus Legacy, Venus Freeze, Excilis, Cellutone, Velshape, and Smoothshapes.)
Figure 5. Patients can be classified into Grade 1-3 which represents the severity (mild, moderate of severe) of the appearance of the nodules and pits. Grade 1 and 2 patients; generally respond well to completely non-invasive external skin treatments such as BodyFX, Excilis, Venus Legacy, Cellutone and Velshape. A series of non-invasive, no downtime weekly treatments result in a significant improvement. Grade 3 patients are offered Cellfina to reduce the pits, and CelluTite or Cellulaser to tighten skin and reduction nodules. In general, the more severe the cellulite, the more aggressive the treatment options need to be in order to achieve a significant improvement. Dr. Mulholland his SpaMedica plastic surgery center and Toronto based medical spa have pioneered many of the most successful cellulite treatment and reduction technologies. One of the unique benefits of getting your treatments done at SpaMedica is the ability to have different combinations of technology, ensuring the best possible cellulite reduction and improvement.
What are your Cellulite Treatment Options?
(i) Home Creams and Topical Formulations
There are a large number of over-the-counter topical creams and lotions that are sold with the claim of “cellulite removal”. Generally, the efficacy of these creams are minimal to modest and are temporary in nature. There is often an active ingredient in very small concentrations, such as Aminophylline, which is larger doses (not present in the product) can be shown to cause vasodilation and increased blood flow to the cellulite. These products, while not harmful, rarely result in long term removal, but may be valuable for a short-term improvement in appearance or used in combination with in-office high energy devices.
Figure 6. Toronto cellulite reduction patients will find a number of topical creams that claim to improve the appearance of dimpled skin. There are often active ingredients, such as aminophylline, that in higher doses would increase blood flow to the cellulite but in the concentration offered there is little long term effect.
(ii) Oral Treatment Supplements
There are several oral supplements sold online and in health food stores that claim to improve circulation and treat cellulite from the “inside out.” There is no proven benefit from the supplements and, unfortunately, there is no “magic bullet” oral pill for cellulite treatment. The organic ingredients in nutritional supplements can be strong, even if not pharmaceutical, and patients need to be careful taking them in large quantities.
Figure 7. Topical cellulite creams and oral supplements offer no proven long term benefits in the appearance of cellulite.
(iii) Home Energy Based Devices
There are a number of home energy devices that offer some mild to moderate improvement. Unlike topical creams and oral supplements, there is good evidence that these home heating devices are safe and provide some improvement in the appearance of mild to moderate cellulite. In general, these home devices need to be used daily for years and will show slight improvement in only very mild cases of cellulite. Home energy based treatment devices can be very useful when used to “protect your investment” after doctor, in-office treatments at SpaMedica Toronto.
Figure 8. Home energy based devices heat the cellulite, improving blood flow and, when used daily for many months, can show improvement in mild cases. It is easier to treat the side and front of thigh cellulite, but more difficult for patients who attempt to treat their own buttock or posterior thigh
(iv) Doctor, In-Office High Energy Cellulite Treatment devices
A. External: “Top Down” Devices
There are many external, top down, in-office, doctor devices that use radiofrequency, ultrasound, shock waves or laser energy, with or without suction coupling to cause a significant heating, mobilization and stretching of the cellulitic skin. These physician owned external treatment devices are best for treating mild to moderate grades of cellulite and can attack all 3 of the underlying causes.
Suction couple rollers on the applicators increase lymphatic drainage of the cellulitic skin reducing the nodules and improving the “smoothness” of the skin and appearance of the cellulite. The Suction coupling also stretches out the contracted fibrous septae, lessening the depth of the pits and smoothing the appearance of the lumpy-bumpy skin.
Finally, we can preform bulk heating of the skin to 42-45 degrees Celsius and sustainin that bulk heating for 10 minutes or more. Each treatment will result in thermally induced collagen production in the skin and thickening the dermis over time, thus reducing the herniation of fat into the skin. The various top-down, in-office high energy devices used in the SpaMedica program are outlined below. We own all the most effective external cellulite reduction technologies, including BodyFX, Venus Legacy, Excilis, Cellutone, Velashape and Velasmooth. During your consultation the best combination of treatment technologies will be determined for your cellulite.
Figure 9. Toronto cellulite treatment patients receive a comprehensive program, that integrates various external, “top down” devices like this BodyFX treatment above. The BodyFX suctions the cellulitic skin into the applicator, RF energy is passed into the skin, killing the fat, which reduces the appearance of the nodules. The suction results in stretching the vertical fibrous septae and lessening the deep cellulitic pits and the skin is heated making more dermal collagen and reducing the thin skin with fat herniation’s. There are a number of these energy based, outside in energy devices, such as the BodyFX, Velashape 3, Excilis, Venus Legacy, Venus Freeze, FORMA plus, and CelluTone that can be deployed in combination to get the best possible result. It is the SpaMedica integration of these different technologies that gets you the best possible reduction.
Figure 10. After a series of non-invasive, external, “top down” energy devices, there is a visible reduction in nodules, the depths of the pits are lessened and the skin is thickened, resulting in smoother looking cellulite skin.
B. Internal: “Bottom UP” Non Thermal Devices
One of the biggest innovations in the treatment of moderate to severe cellulite has been the evolution of internal energy devices that are applied under the skin and directly attack the anatomic causes. The foundation of our minimally invasive treatment program is Cellfina.
- What is Cellfina? The most revolutionary new cellulite treatment device that works from the “inside out” is Cellfina. It is a minimally invasive procedure that uses tissue stabilized, guided subcision. Cellfina is Health Canada approved and FDA cleared for long lasting reduction results.
Figure 11. The Cellfina, Tissue-Stabilized, guided micro subcision device.
What is the Cellfina procedure?
The procedure involves identifying and marking out the deep dimples on the buttock and back of the thigh. With the patient lying face down on a massage bed, local anesthesia is gently infiltrated under the indented dimples to be released painlessly. Once the dimples are rendered painless, each dimple is placed under the Cellfina suction coupled, stabilization device which holds the vertical bands elongated and in one place. A tiny micro-probe and blade is passed horizontally across the cellulite at 8 and 10 mm deep, dividing and releasing the vertical bands that cause the dimple. With the bands divided, there is a release of the soft-tissue which “pops back up” smoothing the skin. The procedure takes on average 45-60 minutes, patients are very comfortable and leave the clinic immediately after.
Figure 12. The 3 step Cellfina procedure involves marking out and mapping the cellulite dimples. (top), followed by gentle local anesthesia infiltration and finally, Tissue-Stabilized, guided microsubcision and release.
Figure 13. The Cellfina suction coupled Tissue-Stabilized device, secures and stabilizes the cellulite dimples within the capture chamber (top panel). Then, a guided micro subcision probe is passed painlessly across the cellulite dividing the shortened septa that cause the dimples , releasing the dimples and soft tissue resulting smooth skin. (bottom panel)
What is the Recovery after Cellfina?
There is a moderate degree of swelling and a mild bruised discomfort for 24-48 hours following Cellfina. Patients can return to normal activities immediately. Return to sporting activities can resume the following day. There is moderate swelling and a mild bruised discomfort for 24-48 hours. In large multi-centered studies there have been no serious complications reported. Mild greenish-yellow bruising may occur in a minority of patients and usually completely resolves over 10-14 days. Prolonged recovery from bruising occurs rarely.
What Results Can You Expect?
Most patients can see immediate smoothing within the first 3 weeks. In the pivotal Cellfina study, there was 85% patient satisfaction at 3 months, increasing to 88% at 6 months, 94% at 1 year, 96% at 2 years and there was even a 93% patient satisfaction score at 3 years.
Figure 14. Buttock Cellullite before (left) and 3 years after (right) Cellfina treatment.
Figure 15. Cellulite of the buttock before (left) and 2 years after Cellufina release and treatment (right).
What is the Post Cellfina treatment program?
To get the quickest possible improvement and best possible results for Cellulite patients who undergo Cellfina, SpaMedica includes at no additional cost a comprehensive post Cellfina non invasive cellulite treatment program. SpaMedica has Canada’s largest array of cosmetic lasers, RF (Radiofrequency devices), ultrasound systems, shock wave platforms and energy based devices. Following the Cellfina procedure, a treatment program is instituted to deliver non-invasive, external, “outside -In” treatments to ensure the smoothest cellulite result and the tightest skin. Starting several weeks follow Cellfina, weekly, 30-60 minute, non invasive, external, outpatient treatFments using radiofrequency suction coupled, non invasive energy devices such as the BodyRX, Venus legacy, Venus Freeze, Excilis, CelluTone and Velashape 3 are performed on the buttock and back of thigh. These weekly, non invasive, external, energy based treatments help improve, smooth and tighten the new Cellfina soft tissue and tighten and thicken the overlying skin. These treatments are combined with Cellutone, as shock wave system that assists in break up and improve the appearance of the cellulite tissue.
Is there Long term Cellfina maintenance required?
The cellulite reduction results of Cellfina alone are long term. Without any additional treatments, there is 93% patient satisfaction at3 years following a single Cellfina treatment alone. However, to help maintain the long term cellulite reduction results for many years, SpaMedica offers a post Celllfina maintenance program that uses RF devices (Venus Legacy, Venus Freeze, VelaShape 3, BodyFx, Excilis) Ultrasound (Excilis-RF-Ultrasound) and Shock wave treatments (Cellutone) to prolong, maintain and protect the Cellfina results. These single treatment sessions are recommended every 3-4 months, (or at the same time as your Botox injectable treatments)
C. Internal: Bottom- Up Thermal-heating “inside out” energy devices:
In patients with very lax skin and cellulite on the front and back of the thigh, buttocks, upper arms, and upper tummy, internal, minimally invasive thermal-heating devices are used after Cellfina to ensure the best possible results. Like Cellfina, these internal “heating devices” are preformed as an outpatient, are minimally invasive, and performed under local anesthesia. The advantages of the internal heating devices, is that they can release the vertical bands, shrink nodules, and most importantly tighten skin significantly. These devices can be either a laser, such as the Cellulaser from Cynosure, or radio frequency such as the CelluTite, or Bodytite from Inmode. These procedures (Cellulase, or CelluTite) are performed painlessly with the use of local anesthesia. The Cellulase laser probe or the CelluTite radiofrequency probes apply heat directly to the cellulite and the vertical contraction bands, the bulging nodules, and the skin laxity. The high intensity internal heating results in three clinical and pathological effects:
(i) Thermal Nodule Reduction: The coagulation of the fat inside the nodule result in immediate nodule reduction
(ii) SeptoThermoLysis: the thermal V-Dissector effect at the end of the Cellulase or CelluTite, divides the contracted vertical fibrous septae and releases the contracted septae. Like Cellfina, the release of the bands, allows the dimples to “pop up” and smoothen the skin.
(ii) Dermal Thickening: The under-surface of the skin is heated to 70 degrees, resulting in significant collagen production, thickening of the skin, and a reduction of fat herniation.
Figure 16. The “Bottom Up” internal thermal devices are used by physicians and include the Cellulase and CelluTite. The end of these probes release thermal energy and heat. The heat coagulates and reduces the nodules, while the v-dissector at the end of the probe thermally lyses and divides the vertical septae, releasing the dimples and the dermis is thickened by thermal stimulation of collagen production. The above figure shows the thermal V-dissector of the CelluTite, inducing a thermoseptolysis, with division of the shorten, vertical fibers and releasing the dimples.
How does the Cellulase work and who performs the procedure?
The Cellulase is a laser fiber, manufactured by Cynosure, that is inserted directly into the cellulite. The dimpled skin is injected with local anesthesia so that there is zero-pain or discomfort during the procedure. The Cellulase has a special CO2 laser polished tip that emits two beams, one 90 degrees to the other, resulting in a laser V-Dissector.
The Cellulase is a simple three step procedure:
Step 1 = Nodule Reduction: The Cellulase fiber is inserted into the cellulite and the laser beam coagulates the nodule, bringing it down.
Step 2 = Divide the Vertical Bands. Vertical fibrous band thermolysis and division results in a release of the pits and smoothing of the cellulite.
Step 3 = Thickening the skin. The Vertical laser beam is run directly under the skin, heating it to 45-50 degrees and producing new collagen.
Cellulase is a single treatment and there is no suctioning, only heating. The treatment results can last for years.
Figure 17a. Cellulase reduction of the Cellulite Nodules
Figure 17b. Celluase thermal lysis and division of the vertical fibrous septae releasing the pits and smoothing the skin
Figure 17c. Cellulase heating of the sub dermal tissue resulting in more collagen, thicker, tighter skin and reduction of fat herniation.
Figure 18. Before and after the Cellulase or CelluTite. The Nodules have been thermally coagulated and reduced, the PITS are improved by releasing thermally the contracted vertical fibrous septae and the skin thickened with more collagen. After the treatment, the vertical orientation of the Fibrous septae has been altered and is now multi-directional, which greatly reduces the risk of recurrence of the pits and nodules.
How Does the CelluTite Work in Cellulite Reduction?
The CelluTite is an applicator that comes with the BodyTite device, from InMode. Unlike the Cellulase, the CelluTite emits RF (radiofrequency) not laser energy and the applicator measures skin temperature at all times and will cut off the RF energy when the end points are met. The strong RF coagulation reduces the cellulite nodules and the V-dissector releases the Vertical fibrous Septae, freeing up the pits and smoothing the skin. Additionally, the RF probe heats the dermal skin tissue directly, thickening the actual cellulitic skin.
Like the Cellulase, the CelluTite is single treatment with a 3 step procedure performed in approximately 1 hour. The area to be treated has local anesthesia injected, rendering the CelluTite treatment painless.
Figure 19. Step 1: Nodule Reduction. The CelluTite RF (radiofrequency) applicator is used to first coagulate and flatten the nodules. The RF energy from the tip melts the fat under the nodule, reducing and eliminating the nodule.
Figure 20. Step 2: Thermal SeptoLysis. The CelluTite V-dissector is then used to lyse and divide all the vertical fibrous septae, resulting in a release of the Vertical fibrous septae, allowing the pits to “pop up” and smoothing of the skin.
Figure 21. Step 3; Thicken the Dermis The CelluTie RF probe is used under the skin, heating the dermis to up to 70 degrees and resulting in more collagen, and thicker, tighter skin.
Figure 22. Toronto patients can expect a very noticeable result after a Cellulase or CelluTite RF treatment. There is a thermal Nodule reduction, a thermal septolysis of the vertical fibrous septae, with release of the Pits and a thickening of the dermis and skin with a reduction in fat herniation. Cellulite reduction of 30-70% can be achieved in a single Cellulase or CelluTite treatment, with results that last several years.
What is the External & Nonsurgical Treatment Program?
SpaMedica and Dr. Mulholland in Toronto have combined the best possible technologies that are directed towards the long-term reduction in the appearance cellulite, or that lumpy, bumpy irregular skin, cottage cheese skin. Patients with significant cellulite and dimples of the buttock and back-of-thigh and reasonable skin tone and tightness would be offered Cellfina.
Patients with significant dimples, nodules and lax skin, would also be offered Cellulase or CelluTite treatments. Patients who have completed the these treatments, as well as all those patients with very mild to moderate cellulite, are offered the multiple-technology, multiple visit, completely non-invasive reduction program. Combination technologies will be applied to your area of cellulitic skin to optimize and improve its appearance. The treatment program involves treatments once weekly for a number of weeks. Each treatment are completely non-invasive, lasts less than an hour and is painless. In selecting the technologies that best reduce the appearance of your dimpled skin, Dr. Mulholland has been at the forefront in pioneering both the radiofrequency, ultrasound, shock wave and laser diode technology that is shown to have the best possible long-term therapeutic benefits.
Cellulite is characterized by lumpy, bumpy, irregular “cottage-cheese” appearing skin. The nodular swellings of the skin result from swollen clumps of fat that push up against the undersurface of the skin and these swollen clumps of fat must be addressed by the technology in order for the cellulite to appear smoother. It is also characterized by deep pits that are caused by contraction of vertical fibrous tissue in the cellulitic fat and these cellulitic pits need to be addressed with a therapeutic intervention as well. The orange peel-type skin results from thinning of the cellulitic skin with, bulging of fat into the actual superficial aspects of the skin, called the dermis. Again, this third factor – thinning of the skin – needs to be addressed during your program.
Thus, three pathological processes – nodules, pits and skin thinning – are all treated during your comprehensive, non-invasive SpaMedica cellulite treatment program. You will have two options: After your consultation and depending upon the severity and location of the cellulite and degree of overlying skin laxity, you may be a candidate for:
- Cellutite and/or Cellulase and/or
- The SpaMedica non invasive external, cellulite reduction program
Cellulite Treatment FAQ
What is the post Cellulase and CelluTite recovery like?
A single “internal” Cellfina, Cellulase and/or CelluTite procedure under local anesthesia, will have some swelling and bruising and, following Cellulase/CelluTite you will need to wear a cellulite garment for 4 weeks after treatment. Cellfina requires no garment and little to no recovery. Alternatively, you can undergo a completely non-invasive program with “top down” cellulite treatment devices. SpaMedica combines technologies that both permanently reduce the swollen fat cells causing the nodules, as well as thickening the skin, minimizing the orange peel appearance and stretching the vertical fibrous septae, or fibrous tissue, that result in the pits.
How do I achieve the best possible reduction?
Following an internal release using Cellfina, CelluTite, or Cellulase a post care, non-invasive external program will be offered for additional improvement and results that will last many years. In order to achieve the highest probability of the successful smoothening appearance of your cellulite, Dr. Mulholland and SpaMedica will combine the most advanced bulk heating, radiofrequency, ultrasound and shock-wave technology in your treatment program. Radiofrequency technology uses a high-frequency oscillating electrical current to heat both the skin and underlying tissue. These bulk heating devices include the Venus Legacy, Venus Freeze, BodyFx, VelaSmooth™, the VelaShape 2™ as well as the Accent® and, more recently, the Cellutone, Excelis and VelaShape 3®. Cellutone will use gentle but effect “shock waves” to break up and smooth the appearance of your skin. These devices have all been proven to be excellent bulk heaters, but have not been proven to provide permanent fat reduction, but are excellent at stimulating collagen in the skin and reduction of the herniated fat seen in cellulite. Permanent fat reduction superficially is important to improve the appearance of the nodular swellings of cellulite. At SpaMedica, Dr. Mulholland will deploy two technologies – the BodyFx™, which not only provides bulk heating of the skin and thickens the dermis by 20% to 25% and increase its elastin and collagen content, which will decrease the orange peel appearance of the skin, but it will also result in permanent reduction of fat cells leading to reduced nodular appearance. (see Figure 11.) The BodyFx™ also has a suction-couple component, which is important because the vertical fibrous septae, or the fibrous tissue, that are contracted and cause the pits, need to be stretched in order to lessen the appearance of the pit themselves. (Figure 11.)
Figure 23. The BodyFX applicator will suction couple the cellulite into the applicator, where Bulk Heating Radiofrequency heating with stretch the fibrous septae and thicken the dermis. Electroporation energy will result in fat cell death and cellulite nodule reduction.
In your SpaMedica, external, non-invasive celluite combination program, the Venus Legacy, and Venus Freeze and the FORMA are also deployed and these bulk heating radiofrequency devices are excellent devices for skin heating that results in, again, thickening of the dermis and reduction in the herniation of cellulitic fat. By combining these technologies and, in some resistant cases, even SmoothShapes®, SpaMedica can customize a multi-applicator and multiple technology assault on your cellulite to optimize the probability that you will achieve acceptable improvement. CelluTone uses gentle Shock Waves to help disrupt cellulite fibers and improve blood supply and is often included in the SpaMedica comprehensive , multiple technology program. (Figure 25.)
Figure 24. The Venus Legacy (above) uses suction coupled RF (Radiofrequency energy) and PEMF (Pulsed Electromagnetic Fields) to suction stretch the vertical bands, heat and reduce the herniated fat and nodules and tighten skin. (below)
Figures 25. The Cellutone uses gentle shock waves to disrupt the cellulite, help remove cellulite edema and swelling, improve blood supply and smooth the appearance of cellulite.
SmoothShapes is a gentle suction coupled laser. The suction coupling stretches the fibrous septae, lessening the appearance of the pits, the suction rollers mobilize the edema and lessen the nodules, which the gentle laser heating thickens the skin and reduces the appearance of cellulite.
Figure 26. Undersurface of the Smoothshapes applicators showing the rolers and laser. The laser suction rollers reduce the nodules, stretch the contracted fibrous sepate and laser heating of the dermis results in thickening the skin and improving the appearance of the skin.
How is the non-surgical program performed?
The SpaMedica non-surgical cellulite treatment program uses a combination of external, non-invasive, non-surgical applicators, both high-frequency bulk heating radiofrequency, ultrasound and shock wave devices and suction-coupled laser diode technologies that are applied on the surface of the cellulitic skin. Treatments are performed once weekly. A small ultrasound gel is often deployed, but no local or topical anesthesia is required and the treatment is very well-tolerated. Each treatment is less than one hour for 1-3 sites, is painless and has no downtime. The number of treatment will vary depending upon the severity of the cellulite, but 4-8 weekly treatments are common.
Who is a candidate for non-surgical cellulite reduction?
Good candidates are those patients that have a realistic expectation of 20% to 50% reduction in the appearance of their cellulite after a series of completely non-invasive, high tech treatments. There are very few contraindications to treatment, but a patient who is pregnant, a patient with a heart pacemaker or inflammatory, infected lesions or skin cancers in the area of treatment are contraindications to a SpaMedica treatment program.
What kind of anesthetic is used?
There is no topical or local anesthetic required for any of the applicators deployed in the SpaMedica permanent reduction program, as the treatments are very comfortable and patients experience no pain or discomfort.
How long does the procedure and program take?
The most common areas of cellulite include the posterior thigh and buttock, as well as the outer thigh and front of thigh. Rarely, the upper abdomen and arm may be involved. Each zone takes approximately 20 to 30 minutes to treat. The SpaMedica, external, non-surgical, reduction program is just that – a program. Treatments occur once a week for 4-8 weeks, the average number of treatments is 6. At the end of six weeks, generally 20% to 50% or more improvement is generally achieved.
Is there any recovery and how long is the recovery following each non invasive treatment?
None of the external, non-invasive applicators used in the SpaMedica cellulite treatment have any significant downtime or risk. Modest swelling or redness can sometimes occur and in individuals on aspirin, some bruising might also occur after the treatment, but this is unusual. Patients can return to activities of daily living, to high-impact aerobic activity and may wear any clothing.
What kind of results might I expect following the program?
Toronto cellulite reduction patients can expect an average of 20% to 50% improvement after a series of non-invasive, external treatments. Most patients achieve at least 30% reduction following the program. It is important that patients are realistically selected, as there is a range of improvement and some patients achieve better than 50%, but some patients achieve less than 20% improvement. There are opportunities to apply a significant portion of your procedure fees against a minimally-invasive, Internal Cellfina™, Cellulaze™ or CelluTite™ program if your results are sub-optimal, or you desire a better result.
Figure 27. Nonsurgical, non-invasive, external cellulite reduction program can result in an improvement of 30-50% after a series of treatments.
What are patients saying about their program?
Treatment and reduction patients are realistic patients who have been selected based upon the understanding that a good result is a 30-50% long-term reduction in appearance of their cellulite. As such, patients are generally happy when they meet ,or even exceed these expectations. For those individuals that want better than 30-50% reduction, or achieve poor clinical out comes with the completely non invasive, external, “top down” cellulite reduction program, it is always suggested that they undergo a Cellfina™, CelluLaze™ or a CelluTite™ procedure. Patients can apply a significant amount of money invested in the nonsurgical program against a Cellfina, Cellulazer – Cellutite procedure with at any time.
How long will my results last?
The results following your non-surgical, external, non-invasive treatment program are long-term in nature, meaning that if you have no maintenance treatment, generally improvements can still be noted 12 months or more following your treatment program. However, it is important to remember that cellulite, like diabetes or hypertension, is a chronic disease and, just like diabetes or high blood pressure, if you stop taking your insulin or Blood pressure pills the underlying problem will come back. The same occurs with cellulite. Without protecting your investment with maintenance treatments, your underlying cellulite will return. It is recommended that a single maintenance treatment is performed every three to four months to maintain your improvement and enhancement. This is because the skin thickening will degenerate with age and time and maintaining optimal skin thickness with a single bulk heating radiofrequency treatment every three to four months is recommended. In addition, any tendency towards developing subsequent edema to swollen fat cells will be mitigated with a single maintenance treatment once every three to four months.
How much will my SpaMedica program cost?
The costs of the cellulite reduction program are dependent upon the number of zones treated and the size of the zones. However, in general, the most common zones – posterior thigh and buttock – generally will cost $2,000 -$3,000 or less for the treatment program. If more than one zone is included in the treatment, the cost for the 2nd and 3rd zone is greatly reduced in cost. In general, individuals that have achieved a satisfactory result will go into their once every three to four month maintenance program and those individuals that want to achieve an even better result may one day apply a significant proportion of their non-surgical reduction of cellulite fees against a minimally-invasive, internal technique such as Cellfina™, CelluLaze™ or CelluTite™ internal procedures that has been developed by Dr. Mulholland.
Why choose SpaMedica and Dr. Mulholland?
By choosing SpaMedica Toronto, you are choosing a centre that continues to be at the forefront of permanent and long-term reduction programs and you will receive the best possible combination technologies to achieve the best possible improvement and longest-term reduction in the appearance of your cellulite. In addition, if the non-surgical, external, non-invasive cellulite treatment program does not achieve the kind of results you desire, you may apply a significant amount of your procedure fees against a Cellfina™, CelluLase™ or CelluTite™ single treatment performed by Dr. Mulholland, or one of his delegees.