July 24, 2002 -- If you've tried it all -- creams, pills, massage wraps, suction treatments -- and are still plagued by cellulite, here's yet another hopeful option. It's called dermolysis, and while its inventor is excited about it, other aesthetic surgeons are skeptical.
A miracle cure? "I wouldn't go that far, but it's very exciting, and it does work," says Stephen Giunta, MD, president of RejuveSkin Clinics, and an aesthetic plastic surgeon with over 30 years' experience.
Cellulite is a byproduct of gravity, he says. "The layer of fat between the skin and muscle -- which is important for insulation, protection -- is held in place against gravity by collagenous protein fibers called septae. The septae create a web-like, cheesecloth arrangement between skin and muscle, and holds fat in place."
Over time, the fibers become damaged and swollen with fat and fluid, which causes them to harden and pull down -- the dimpling of skin we call cellulite.
The procedure Giunta has invented -- what he calls dermolysis -- involves a V-shaped device that the surgeon uses to make a small puncture in the cellulite pocket. This device allows him to selectively break the connective tissue lattice, allowing the trapped fat to be released and smooth out -- creating permanently smooth skin.
He's treated 30 patients in the past three years. Who gets the best results? Women who are under 40, not overweight, physically active, says Giunta. "But the nice thing about the procedure is, uniformly, everyone has had a significant improvement. None has had less than 50 or 60% improvement in the worst cases. In the best cases, it's been up to 100% improvement."
Age is a factor because skin loses elasticity over time. Also, pregnancy plays havoc with skin. "That doesn't mean there aren't other things we can do to help those people, like thigh lifts or liposuction to help their contour," Giunta tells WebMD.
In fact, he is investigating an adjunct to the dermolysis procedure that could make it even better for older women who don't have skin elasticity. "I wouldn't advise it if I didn't think the results would be worth the effort," he says. "Even though it's a very benign procedure, it's still surgery and obviously costs are involved. You don't want to waste your time and money if it doesn't work."
"I would be very skeptical," says Seth Yellen, MD, chief of facial plastic surgery at Emory Healthcare and director of the Emory Facial Center in Atlanta.
"Breaking up the septae -- that's as old as the day is long," Yellen tells WebMD. "People tried that years ago and it didn't work. The septae reheal and the cellulite reforms. And when you get a scar contraction, you can get irregularities. I can give you selective examples of any procedure in which patients had really good results. But 30 patients, with just a few followed for three years, tells us nothing."
A procedure called endermologie is similar, because it also breaks septae but does it nonsurgically. A vacuum-like device works to smooth cellulite dimples by sucking and massaging the skin. "I'll bet you it can give as good results as [Giunta's] procedure," says Yellen.