SELINA, 53, did not want to worry about her lumpy thighs before her wedding in June. So when she heard a host on “The Doctors,” a syndicated TV show, say that a new treatment called Cellulaze can “banish cellulite,” she paid $6,500 for it. “The fact that it’s supposed to be a permanent solution was definitely what sold me,” said Selina, who got a hefty discount because she agreed to be Exhibit A for a doctor-training session.
In March, Selina grimaced as Dr. Barry DiBernardo, a plastic surgeon in Montclair, N.J., injected anesthetic liquid into her thighs, which had been marked with a tick-tack-toe grid: dimples colored red and bulging fat green. After making a few tiny incisions, Dr. DiBernardo passed a side-firing laser with a red-lighted tip under her skin in various directions as five other doctors watched. It made a muffled pop-pop-pop sound, not unlike a rattlesnake, as Selina’s fat cells broke. Periodically, as the laser scorched a connective fiber anchoring skin into a dimple, Dr. DiBernardo, a clinical investigator, would exclaim, “Oh, there, that was good, that got a good release.”
Trying to banish cellulite has long been one of women’s Sisyphean struggles. Previous remedies, like caffeinated creams or massage with laser therapy (sometimes costing thousands of dollars), could make bumpy skin look smooth. But the fixes were always temporary because they did little to tackle the structure of cellulite. And liposuction works on deeper fat levels, not just under skin where cellulite exists.
Now Cellulaze, which requires only one doctor’s visit, is being breathlessly hailed by many as a bona fide solution. Cleared by the Food and Drug Administration in January for showing improvement after three months, Cellulaze says that its laser technology attacks all three problems responsible for cellulite: bulging fat, too-thin skin, and the connective tissue that tugs at skin and creates dimples.
More than 100 doctors now offer — or are training to offer — the treatment, which has drawn attention from TV news shows nationwide. One morning show in Tampa even interviewed a doctor in scrubs as he treated a woman’s thighs. It’s been featured in Harper’s Bazaar, Self and Marie Claire. On NBC’s “Today” show, Dr. Bruce Katz, a Manhattan dermatologist and a clinical investigator, said, “We think if the cellulite hasn’t come back in two years, it’s probably going to be pretty much permanent.”
Many physicians are promoting Cellulaze as a long-lasting fix, with some even claiming that the results are permanent, even though the only published study, in Aesthetic Surgery Journal in 2011, had just 10 subjects, who had improvement a year after treatment. Such claims are powerful marketing tools for the doctors, who charge $2,500 to $5,000 for both buttocks or outer thighs, and thousands more for added areas. (Cynosure even suggests charging up to $7,000 for the first area the size of an 8-by-11-inch piece of paper.)
But the F.D.A. clearance stipulates that Cynosure, the maker of Cellulaze, “can only make statements based on our decision on the three-month data,” according to Erica Jefferson, an F.D.A. spokeswoman, who added, “The indication should be for ‘short-term improvement.’ ” The F.D.A. does not police the claims of doctors who use the treatment.
Cellulaze hasn’t yet earned credibility for its claims in peer-reviewed journals, though it said multiple studies, some with follow-up as far as three years, are being prepared for submission. The Aesthetic Surgery Journal study was unblinded, meaning it was performed and evaluated by Dr. DiBernardo. He is one of five paid clinical investigators and a training consultant for Cynosure who has taught 70 doctors.
“All of the important pieces of information from the study were objective,” he said, adding that ultrasounds showed that skin got thicker, and also that a skin-elasticity-measuring device indicated that loose skin got tighter.
“At the end of the day, we cannot go on a small study that was unblinded,” said Dr. Molly Wanner, an instructor in dermatology at Harvard Medical School and an author of an evidence-based review of cellulite treatments in 2008. At a recent conference, Dr. DiBernardo presented six-month blinded data that “provides more evidence Cellulaze may be a viable treatment,” she said.
Dr. Z. Paul Lorenc, a plastic surgeon with 15 years of laser experience, is not convinced that the connective fibers destroyed by Cellulaze won’t grow back together, creating hills and valleys once more. “The jury is still out,” he said.
The side effects noted in the 10-person study also gave Dr. Wanner pause. “It is fairly significant to have three months of prolonged discomfort, bruising, swelling and numbness,” depending on severity, she said.
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