January 22, 1999

Study documents effects of cellulite-smoothing technique

Study documents effects of cellulite-smoothing technique

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Melissa Carter demonstrates the Endermologie technique, which uses a system of rollers to manipulate the skin to smooth cellulite. (Photo by Donna Jones Bailey)

Endermologie, a technique of using a system of rollers and a vacuum device to manipulate the skin, may work to smooth cellulite, but it does not cause a reduction in fat or promote the growth of new blood vessels, a VUMC study shows.

"This study is the first scientific evidence that Endermologie does something," said Dr. R. Bruce Shack, professor and chair of Plastic Surgery, who conducted the study along with Lillian B. Nanney, Ph.D., professor of Plastic Surgery, and others in the department.

Anecdotal evidence from both Europe, where the Endermologie device was invented by a French company about 10 years ago, and the U.S. had indicated a lessening of the appearance of the "cottage-cheese-like" appearance on the skin of those who underwent a series of treatments. But there had been no scientific evidence of how this apparent effect was achieved.

The findings of the VUMC study, which were based on studies with Yucatan mini-pigs, were published in the November/December edition of the Aesthetic Surgery Journal.

"The pig has long been known to be the best model for human skin," Nanney said. "It doesn't have any fur, and it's relatively fat."

The most commonly advanced theory about how Endermologie achieves its apparent effects was that the machine, which resembles a high-tech vacuum cleaner with rollers on the hose nozzle, broke up fat, which was excreted, and also led to the formation of new blood vessels.

"We found nothing of the kind," Shack said. "There was no evidence of fat metabolism or excretion, no decrease in the thickness of the subcutaneous tissue that we could measure, and there was no evidence of new blood vessels.

"What we saw was an absolute and total surprise to all of us. There was the creation of collagen bands that run parallel to the surface of the skin."

Shack said the formation of these bands was more marked in the pigs who were treated more often, adding weight to the idea that the changes were the result of the Endermologie treatments.

"We're convinced that this response we are seeing in the pigs is real, we just don't know what it means," he said. "If this collagen is deposited in the deep layers of the skin running parallel to the surface of the skin, as that collagen contracts, and if there has been a loosening of the fat-fascial interface, you could speculate that that might have a smoothing effect on the surface of the skin."

Dr. David Adcock, a research fellow in Plastic Surgery who worked with Shack and Nanney on the published study, noted that the skill of the machine's operator could have a great deal to do with the effectiveness of the treatment.

"Nobody has done anything to measure the force that's exerted on the tissue," he said. "It's the kneading itself that generates the most force on the tissue."

Shack said future studies on both pigs and clinical studies on humans are being planned to investigate issues such as the role of the operator in the effectiveness of treatment, and how long effects of treatments last. Elsewhere, Endermologie is also being investigated for its possible use in treatment of burn scars and lymphedema.