Incorporating Targeted Verifiable Subcision for Cellulite into Multimodal Surgical Treatment Plans for Rejuvenation of the Buttocks and Thighs
To present several case studies illustrating how Targeted Verifiable Subcision™ (TVS; Avéli ® [Revelle Aesthetics, Inc]) for the treatment of cellulite can be used in combination with surgical procedures like Brazilian butt lift (BBL) and other non-surgical interventions like hyperdilute calcium hydroxyapatite (CaHA) as part of a treatment approach to buttock and thigh rejuvenation. Clinical pearls and recommended treatment staging will be included alongside patient cases.
Methods/Technique:
As part of a working group of 6 experts in aesthetic plastic surgery and dermatology, convened to discuss management of cellulite in buttock and thigh rejuvenation, case studies were collected. Before-and-after images, details of patient cases, and a discussion of best practices for patient education and evaluation, treatment planning, technique, safety, and post procedure care were discussed by the group. Treatment recommendations and best practices collected are summarized alongside case studies. This presentation will also include the author’s own personal experience with lower body treatment protocols and outcomes and additional cases.
Results/Complications:
When managing the aesthetics of the lower body, obtaining optimal results nearly always requires the use of multiple treatment modalities with complementary mechanisms of action. For this area, skin quality and/or laxity, focal adiposity and/or volume deficiency, and textural issues each contribute to global appearance. For patients, who are most concerned with overall outcome, communication of how each of these issues can contribute is critical. Patients with cellulite may not realize that adding volume alone won’t necessarily eliminate dimples, and some may be unaware that there are treatment options available to address this issue. However, when patients undergo procedures like BBL or address laxity with other modalities in the buttocks and thighs, the remaining cellulite can reduce patient satisfaction with their overall results, even if cellulite was not identified as a key issue at treatment outset. Thus, management of cellulite dimples is important for buttock and thigh rejuvenation procedures to maximize results. Because TVS can be performed on the same day as fat transfer, it may be offered as part of a surgical package.
Here, several cases where TVS was used to manage cellulite as part of a multimodal treatment plan, including both surgical and nonsurgical modalities are presented along with each patient’s individual treatment plan. Follow up extends out to one year. Within these case studies TVS is combined with surgical and nonsurgical modalities, including BBL, liposuction, hyperdilute CaHA, radiofrequency with microneedling, microfocused ultrasound with visualization, fillers, and topical skincare products.
Among these cases there were no significant adverse events (AEs); however, during the presentation the author will discuss lessons learned and best practices for maximizing safety, especially when combining TVS with surgical procedures. Best practices for TVS in conjunction with surgical procedures will be discussed.
Conclusion:
TVS is a valuable tool for managing cellulite in the buttocks and thighs. The mechanical disruption of the fibrous septa which cause cellulite depressions can be performed on the same day as many surgical and nonsurgical procedures, allowing it to be easily integrated into existing workflows and treatment programs.