NEW YORK PLASTIC SURGEON
Plastic Surgery New York, NY
Darrick E. Antell, M.D.
850 Park Avenue, New York, NY 10075
Women are shelling out up to $11,000 for a controversial—and potentially risky—new laser treatment called Cellulaze. Some doctors are hailing the new technology as a miracle cure for lumpy, dimpled skin. Others warn that the procedure is being overhyped as a permanent solution to orange-peel skin, but there’s no scientific proof of any long-term benefit and limited scientific support for claims of temporary skin smoothing.
More than 100 U.S. doctors now offer—or are training to offer—the high-tech cellulite treatment, which has attracted intense media coverage. One Florida news show in Tampa even interviewed a doctor while he performed a Cellulaze procedure on a patient. Dr. Bruce Katz, a Manhattan dermatologist and a clinical investigator, enthusiastically told the Today Show, “We think if the cellulite hasn’t come back in two years, it’s probably going to be pretty much permanent.”
Such claims, however, could be overblown, critics contend. Approved by the FDA in January for showing improvement for up to three months, Cellulaze is rapidly become one of the hottest beauty crazes, despite the hefty price, dearth of scientific data, and reports of ugly complications in some patients. To find out why patients are jumping on the Cellulaze bandwagon—and if the procedure is safe—I spoke to Darrick Antell, MD, a leading New York City plastic surgeon affiliated with Lenox Hill Hospital.
“Think of cellulite dimples as the buttons on a sofa,” says Dr. Antell. “What’s pulling them down is bands of connective tissue between fat deposits, so the goal of Cellulaze is to burn through these bands with a laser, so that bumpy areas plump up and look smoother.”
After seeing Cellulaze touted on the TV show, The Doctors, a 53-year-old bride-to-be named Selina paid $6,500 to have her cottage-cheese thighs treated before her June wedding—and that price was “a hefty discount” because she agreed to have her fat zapped during a training session for doctors, with a New York Times reporter present. The device’s manufacturer suggests that doctors charge $7,000 for treating an area the size of an 8-by-10 sheet of paper.
“The fact that it’s supposed to be permanent is definitely what sold me,” Selina toldThe New York Times, which vividly described the procedure. After her thighs were injected with anesthesia and marked with a tic-tac-toe grid, with dimples colored red and fat bulges green, the plastic surgeon made tiny incisions. He then maneuvered the tip of a laser under her skin, creating a popping sound similar to a rattlesnake, the newspaper reports. According do Dr. Antell, "The rattlesnake noise is the sound of the connective tissue popping."
As the name suggests, liposuction sucks out fat and permanently removes it, says Dr. Antell. “Because one to two liters of fat—or more—can be removed during a single procedure, liposuction can dramatically recontour a bulging belly, thighs, or buttocks.
The Cellulaze laser may dissolve tiny amounts of fat, but it doesn’t significantly reduce bulges in the treated area, adds Dr. Antell, who doesn’t use the new technology in his practice. “That’s a major drawback for many patients because people with cellulite often have excessive fat. I’ve seen photos of treated patients where it’s hard to tell which is the ‘before’ picture and which is the ‘after’ because they both look similar.”
Cellulaze technology is actually not entirely new, adds Dr. Antell. “An earlier version known as ‘smart liposuction’ used a laser to melt deep fat in the treated areas, making it more similar to liposuction. However, there were concerns about what would happen to the fat after it was zapped—and how it would affect the body—so now the laser technology is only used to treat superficial areas below the skin.”
Like liposuction, the laser procedure, which is typically performed during one doctor’s visit, can have significant complications. In one scary case, a woman who received Cellulaze treatments during a medical study developed such severe fluid buildup (medically known as a seroma) in her left leg that she had to have it drained every two weeks for months.
Four months after the treatment, according to the New York Times, the 41-year-old woman was left with dents in her leg that “looked as if holes had been carved out by a potato peeler.” And nearly 18 months later, the dents remain, and her skin still looks bruised. “You live with the consequences,” she said. And despite local anesthesia, Selina, the bride-to-be mentioned above, rated the pain at times reaching an eight, on a scale of one to 10.
The FDA cleared the procedure based on three-month results in small studies. So the manufacturer can’t promote it for defeating cellulite over the long-term. Currently, only published study reports continued improvement one year after treatment. However, that study only involved 10 patients and was conducted by a doctor who is a paid investigator and training consultant for the manufacturer.
In addition, the study was unblinded, meaning that the investigator both performed the procedures and then evaluated his own results. “I’m skeptical,” says Dr. Antell. “While there’s great excitement about this technology, until there are independent studies and long-term results, I feel it’s too soon to use Cellulaze in my practice. During my 25 years as a plastic surgeon, I’ve heard a lot of machines hyped as cutting-edge and promising, only to have serious side effects discovered later.”
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