Collaboration of methods: RSL sculpting and vacuum massage

Modern mechanical methods may simultaneously affect the main pathophysiological events related to cellulite. We are going to discuss these methods and how to choose them properly.

Cellulite (gynoid lipodystrophy, GL) is a multifactorial disease that occurs in 80- 90% of postpubertal women¹. Treatment of gynoid lipodystrophy remains a complicated task as its causes are not fully understood. Some specialists presume that GL may be attributed to high estrogen². It is also reported that GL worsens during menopause due to increased vascular permeability and decreased vascular tone. A combination of skin atrophy in affected areas, change of the state of subcutaneous tissue walls, hypoxia, increased lipogenesis, and inflammation may be responsible for cellulite development. Males rarely have GL, and it is believed to be caused by high androgens. Low androgen level in males with such conditions as Klinefelter syndrome, hypogonadism may provoke cellulite development. Cellulite in males may also develop due to antiandrogenic therapy for prostate cancer³. A number of studies showed the importance of genetical, ecological factors in GL development. For example, peoples residing in the Caucasus region are more vulnerable to GL. Genetic predisposition results in architectural distortion in walls in subcutaneous tissue, as well as in disturbance of metabolic and biochemical processes. Unhealthy lifestyle is a major contributor to cellulite development. Alcohol stimulates lipogenesis and dehydration thus promoting cellulite manifestations. Adiposity may also increase cellulite intensity. It is related to the fact that cellulite is the result of herniation of fat through perpendicularly directed collagen fiber walls, and additional pressure from underlying subcutaneous tissue further intensifies it ^4,5. Cellulite treatment should affect various aspects of etiology and pathogenesis. Morphological cause of gynoid lipodystrophy onset and development in human hypodermis is lymphostasis, or development of lymphatic edema in separate areas of the subcutaneous tissue, that leads to the tissue gradually saturating with protein coagulates that are not physically natural for it, which causes structural and functional changes in the hypodermis and skin above it. Because of it white adipose tissue gets gradually saturated with protein compounds which leads to its lipodystrophy⁶. Modern mechanical methods simultaneously affect the main pathophysiological events related to GL, such as impaired lymphatic drainage and microcirculation.

Selection of a correction method

Various pathophysiological manifestations of GL may be affected by integrated application of different physical factors, such as vibrocompression + red light and vacuum massage, in course of a single procedure. RSL sculpting procedure performed with the Beautylizer device combines the effects of vibrocompression with spheres and of 600–650 nm red light (LED therapy) on all skin layers, hypodermis, and muscles. Combination of the above mentioned factors normalizes blood flow, causes lymphatic drainage effect, triggers lypogenesis, and improves biochemical characteristics of skin7-11. During the device operation, tissues at the exposure site are subjected to short-term compression, which alternates with relaxation, resulting in a significant improvement in microcirculation. Vibration and compression strengthen vessel wall and reduce its permeability. The exposure on lymphatic system accelerates removal of toxins and breakdown products from the body. Microcirculation, oxygenation, and tissue blood and nerve supply increase leading to normalization of cell metabolism. Light exposure improves skin elasticity by 19% owing to stimulation of fibroblasts and production of TGF-β, which results in increase of collagen production^7-11.

Vacuum massage with negative pressure improves blood circulation and can affect both outmost and deeper skin layers^12-14. It also improves permeability of the dermis surface vascular network. Stimulation of the local lymph and blood flow results in decreased tissue edema and improved intercellular spaces drainage. Compression of skin nerve conductors decreases, pain and touch sensitivity recovers, arteriovenous anastomoses that facilitate redistribution of blood between skeletal muscles and skin in the application area open¹⁵.

Combining of RSL sculpting procedure and vacuum massage within one day results in enhancement of the effects of both procedures and achievement of pronounced results, which was proved in course of the clinical observation of a patient with pronounced cellulite manifestations in thigh and buttock area. It was most likely caused by the enhanced blood circulation and lymph flow by both procedures performed in sequence.

Clinical case

Patient K. S., female, age 39, came to us with complaints on cellulite on her buttocks and over all thigh upper surface, buttocks deformation. The patient is somatically healthy. There are no contraindications to the combined technique of sequential vacuum massage and RSL sculpting used in one procedure.

Procedure protocol

During the course of therapy buttocks and thighs were sequentially treated first by vacuum massage, and then the same areas of the right buttock and the right thigh by RSL sculpting. The left buttock and the left thigh were treated only with vacuum massage. The intervals between procedures are 2-3 days, the course of therapy is 10 procedures. The patient did not undergo other types of mechanical or injection treatments in these areas. The patient was recommended to adhere to her usual lifestyle and diet.

Stage 1

Vacuum massage therapy in the buttock and thigh area was performed using the Skintonic Le Skin V6 device (Fig. 1). The stimulation started with reflexotherapy, that is reflexogenous areas were treated with an applicator at weak suction mode. Then the regular active mode was switched on with the applicator traversing the entire area being corrected in straight and circular lines. After that the device was switched into pulse mode and the applicator was used to treat the areas around lymph nodes, it was being moved along the lymph flow direction and then returned to its previous positions. The total duration of the buttock and thigh area treatment was 15–20 minutes.

Stage 2

RSL sculpting procedure was performed in the right buttock and the right thigh area immediately after the vacuum massage procedure (Fig. 2). The specialist started the procedure from slow and steady lymphatic drainage technique focused on normalization of lymph outflow, decongestion, removing swelling, and restoration of the whole organism. Next, a sequential and deep treatment of the entire body was performed at increased rotational power, with additional focus on problem areas. Treatment at this stage was performed in high sensitivity mode of the handpiece to the force on the patient’s body, rotation speed 450 rpm. Throughout the procedure, the light therapy function with a wavelength of 640–650 nm was turned on to improve skin quality, duration of the procedure was 40 minutes.

Results of the correction

After a series of procedures, the quality of the patient’s skin in the treatment area has greatly improved, cellulite in the thigh and buttock area have decreased, and the tone of the gluteal muscle has increased (Fig. 3). However, the positive changes visible on the pictures and according to the patient’s report were more pronounced in the areas of the right buttock and the right thigh where the combined protocol was performed. No adverse events were recorded during the therapy. Starting from the third session the patient reported relaxation, sense of well-being, and lightness in extremities. After the seventh procedure she reported improvement of the “orange peel” appearance. After the end of the course of ten procedures, according to the patient, her closes started to “fit loosely”.