Quantitative & Qualitative Evaluation of the Efficacy of a 1440 nm Nd:YAG Laser With Novel Bi-Directional Optical Fiber in the Treatment of Cellulite as Measured by 3-Dimensional Surface Imaging
November 2013 | Volume 12 | Issue 11 | Original Article | 1224 | Copyright © November 2013
Bruce Katz MD
Juva Skin & Laser Center and Cosmetic Surgery & Laser Clinic, Mt. Sinai Medical Center, New York, NY
BACKGROUND: Cellulite gives the skin surface an orange peel or mattress-like appearance thought to be caused by expansion of subcutaneous
fat, fibrotic septae and, dermal laxity and atrophy.
OBJECTIVE: To evaluate the safety and efficacy of a single cellulite treatment using an Nd:YAG 1440-nm laser delivered with a special
fiber delivery system and temperature control.
METHODS: Women with cellulite on their thighs and buttocks were enrolled in a prospective Institutional Review Board–approved study.
Subjects were 15 healthy females of all Fitzpatrick Skin types with cellulite (grades II-III). A single treatment was performed with an
average of seven 5 x 5 cm squares treated per leg. Evaluations with 2D and 3D imaging, patient and blinded evaluator scales as well
as skin histology were performed at baseline, 3 and 6 months post treatment.
RESULTS: In the 2D photographs, blinded evaluators were able to identify treated photographs versus baseline in 90% of cases and
the number of sites with improvement in contour irregularities was 94%. With 3D imaging, the average decrease in skin depressions
(dimples) was 49% at 6 months and 66% of patients showed improvement in overall skin contour at 6 months follow-up. Patient and
physician satisfaction scores were high and no adverse events were reported.
CONCLUSION: The Nd:YAG 1440 nm laser with a special fiber delivery system produced significant improvement in cellulite with one
treatment after 6 months of follow up. There were no adverse events.
J Drugs Dermatol.
Cellulite is a cosmetic concern of many adult women. The
skin develops an orange peel or mattress-like appearance.
The components of cellulite are multifactoral and
include issues related to subcutaneous fat, fibrous septae and
dermal laxity and atrophy. Cellulite is thought to be characterized
by expansion of subcutaneous fat. Fat cells are surrounded by
bands of connective tissue called septae which connect muscle
to the sub-dermal layer. Fat cells held within the perimeters of
this area expand and due to fibrotic septae push up against the
lax dermis causing the irregular contours of the skin surface.1,2
Cellulite is also associated with hormonal and physical changes.
In post-pubertal women, estimates are as high as 85% who develop
cellulite particularly in areas of fat accumulation. Post-partum
women can also demonstrate an increased volume of fat in thighs
and buttocks that lead to herniations up through the dermis.1,2
Objective assessment of cellulite treatment efficacy is difficult.
Three-dimensional (3D) imaging has the advantage over
two-dimensional (2D) images of allowing precise quantitative
spatial evaluation.3,4 In 3D scanning technology light from various
directions is reflected off the surface of an object. Optical sensors detect changes in surface topography, and computer
algorithms render 3D models from a multitude of surface data
points. The 3D analysis provides a way to see more than one
plane at the same time in the same image.4 With 3D stereo photogrammetric
imaging, an evaluator is able to accurately and
reproducibly assess and quantify changes in the coordinates of
the face, thighs, buttocks and abdomen.4,5,6
The Nd:YAG 1440-nm device used in our study has been reported
to yield marked improvement in cellulite using a 3-step
approach to treat each structural component.2 In this report, we
present our experience using the Nd:YAG 1440-nm device for a
single cellulite treatment, and evaluation of outcomes by both
2D photography and 3D imaging as well as patient and investigator
Healthy non-smoking females between 20 - 55 years of age were
eligible for enrollment. Subjects had to accept the obligation not
to receive any other procedures in anatomical areas exhibiting
cellulite through the 6-month follow-up visit. Subjects had to be
logistically able to present for all scheduled follow-up visits.