David H. McDaniel, MDa; Jeff Lord, MDb; Keith Ash, MDb; John Newman, MDb; and Mark Zukowski, MDc
Cellulite is a common condition affecting 85% of postadolescent women. Recent advances
in aesthetic techniques have initiated a new pursuit into understanding the cause and
treatment of this condition. A recently introduced "roller massage therapy"
device, Silhouette®, was selected for evaluation in this study. Three patients were
enrolled into this private practice, medical school–affiliated, prospective pilot
project. The study objective was to identify whether the Silhouette® device could
generate reproducible reductions in the appearance of cellulite or alter body appearance,
specifically in the abdominal, buttock, and thigh regions. A secondary goal was to
evaluate the effectiveness of various measuring devices used to quantify cellulite
regression. These included serial body weights, percent body fat, relative fat
distribution, specific anatomic measurements, diagnostic ultrasound, and serial morphed
photographic analysis and laboratory data. Initial results showed that 16 biweekly
treatments produced minimal changes in body weight or percent body fat. On average, thigh
circumferences increased by 1.7 mm and 8.7 mm in the right and left proximal thighs and
decreased by 25 mm and 22 mm in the right and left distal thighs, respectively. Diagnostic
ultrasound scans showed trends that may provide further insight into a possible mechanism
of action. Relative fat distribution values taken from four selected sites proved the most
significant finding with selected treatment sites improving on average from 0.8 to 2.1
units (mean 1.5 units/site).
This technique provided safe yet modest improvement in the appearance of cellulite. The
mechanism of this improvement remains unknown. Further research is needed to determine the
mechanism of this improvement, its longevity, optimum treatment parameters, and whether
maintenance therapy is needed.
From the Laser Center of Virginia,a Virginia Beach, VA, Eastern Virginia
Medical School, Norfolk, VA; the Department of General Surgery,b Naval Medical
Center Portsmouth, Portsmouth, VA; and the Zukowski Center for Cosmetic Plastic Surgery,c
Wilmette, IL.
The opinions or assertions expressed herein are those of the authors and are not to be
construed as official or as reflecting the views of the Department of the Navy, the
Department of Defense, or Naval Medical Center Portsmouth, VA.
Dr. McDaniel received financial support for this project to partially cover out-of-pocket
expenses, staff training and loan of a Silhouette® device from the Luxar Corporation (ESC
Medical Systems), the manufacturer of Silhouette®. In addition, a resident author (Dr.
Lord) received travel expenses and a small honorarium to present data at a private
ESC-sponsored symposium.
Accepted for publication Mar. 31, 1998.
Reprint info Reprint requests: David H. McDaniel, MD, Laser Center of Virginia, 933
First Colonial Rd., Suite 113, Virginia Beach, VA 23454-3101.
Copyright © 1998 by Mosby, Inc.
Manuscript number: 70/1/90775
CopyrightClearance Center number: 190-820x/98/$5.00 + 0
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