Body Shaping: Two Devices to Meet All Your Patients' Needs

Consumer interest in non-invasive body sculpting and fat reduction continues to be high. According to the annual statistics from the American Society of Plastic Surgery, non-invasive body contouring procedures that target fat and reduce sagging areas increased nine percent in the last year. And the VelaShape and UltraShape Power devices have been workhorses in my practice to meet patient demand.

I started using the VelaShape II device in 2006—my initial interest in the device stemmed from its ability to improve the appearance of cellulite, which it was indicated for, and also for its potential for body contouring. Working with Lori Brightman, MD and Roy Geronemus, MD, we performed a trial to investigate how to use the VelaShape for body contouring, and we found some really fascinating things—it could be used to improve the appearance of the stomach, as well as the arms and the legs. I then purchased the VelaShape® III device when it was first release a few years ago. This novel device, effective for body contouring as well as for cellulite, is a much higher power device than its predecessor and allows us to do what we were doing in a much more efficient way, offering faster and more effective treatment. It's a great device for my practice.

Figure 1. Overlay is 12 weeks post final UltraShape treatment. Patient underwent three treatments spaced two weeks apart. Each treatment size was 9 FTZs.

Figure 2. Overlay is 12 weeks post final UltraShape treatment. Patient underwent three treatments spaced two weeks apart. Each treatment size was 10 FTZs.

I added the UltraShape Power® device to my practice about two years ago and have primarily been using it for contouring the entire abdomen and flanks with nice success for patients who really need a full cosmetic unit treatment. A significant benefit to the UltraShape Power device is that it can be customized to any body shape, and it can deliver a full treatment in less than one hour for those patients. As part of Candela-sponsored trial of UltraShape Power, we treated 10 patients with the device at my practice, and I was very impressed that all 10 patients saw results. Some had more significant results than others, but for a non-invasive treatment, which often is very dependent on each individual patient's fat composition or body shape, to have a device that was successful on all of those 10 patients was really remarkable. That really speaks to the technology as well as the way that it so precisely delivers the energy to the fat layer that we're trying to contour. The overall results of the study showed the device demonstrated an average 32 percent reduction in fat layer thickness via ultrasound measurement at 12-week follow up, representing significant fat destruction.

I've found the UltraShape Power device is very efficient and ideal for treating large areas. It's effective for removing that fatty layer right beneath the surface, whereas I utilize the VelaShape more for cellulite or for contouring smaller areas. Part of it has just to do with the way the machines are made, and it's just more efficient to do larger areas with the Ultra Shape device.

The UltraShape Power uses a selective, pulsed, focused mechanical ultrasound energy for effective fat cell destruction. The energy is focused selectively on fat cells, protecting surrounding tissue including blood vessels, nerves, and muscles, offering a safe and comfortable treatment experience. Because energy is delivered in a pulsed fashion, the rise in temperature is minimized to within 0.8o C within and around the targeted tissues. This is great because it's not painful, but when you have a device that is that gentle with such minimized effect on temperature of the skin, sometimes there isn't as much improvement of skin tone as we would like.

For patients who desire to improve skin tone and quality as well as body contouring, I've been treating them with VelaShape and UltraShape at the same session.

The Vela product line combines four different technologies including infrared (IR), Bi-Polar radio-frequency (RF), and mechanical tissue manipulation using pulsed vacuum and massage rollers. The combination of the IR and vacuum coupled RF technologies causes deep heating of the connective tissue including the fibrous septae, which promotes an increase in collagen depositing and local cellular metabolism resulting in a localized reduction in skin sagging and volume. The mechanical tissue manipulation increases circulation and lymphatic drainage, both essential components for healthy skin structure.

I also use the VelaShape III a lot for cellulite, which effects 90 percent of women in this country. Cellulite is such a difficult condition, because it's not only a fat problem—we need to address skin tone and fibrous bands. VelaShape can address the multiple factors that affect cellulite in a very comfortable 30-minute treatment, so it's been my go-to cellulite device for a long time. There are other treatments for cellulite, but this is our workhorse in practice for cellulite.

Figure 3: Pre-treatment for cellulite (left). Three months after four VelaShape III sessions, RF:3, IR: 1, V: 1, 30 minutes (right).

Figure 4. Pre-treatment for cellulite (left). One month after four VelaShape III sessions RF:3, IR: 1, V: 1, 30 minutes (right).

Patient Selection and Treatment Protocols

The ideal candidates for any type of body contouring treatment are patients who are relatively fit, who maintain a healthy lifestyle, and are close to their ideal weight. Patients also need to understand that they will need to maintain healthy habits post-treatment to maintain results. It's important that patients understand these treatments are not an excuse to suddenly fall off the wagon.

When treating cellulite, I find that VelaShape works best on patients with mild to moderate cellulite. There are patients with very severe puckering type cellulite, who are not the right patient type for this treatment. For most patients who have mild to moderate cellulite, they are ideal candidates for VelaShape treatment.

Treatments with UltraShape Power and VelaShape III are very comfortable for patients and there is no need to pre-medicate. Most patients report that they have no pain. I tell my patients that the VelaShape feels like a hot stone massage and the UltraShape Power treatment feels like a cell phone vibrating on your stomach—it is quite mild for the results patients can expect.

Typically, patients undergoing treatment with UltraShape Power are treated every two weeks for three sessions. Each treatment takes less than hour—about 45 minutes. For VelaShape, most patients are treated every two weeks for three to five sessions. Treatments take about 30 minutes at each session.

There is no downtime after treatment with either device—patients can go right back to their normal activities and are encouraged to do so. There are no restrictions after the procedures.

Meeting a Practice's Needs

In my practice, body contouring is highly demanded. VelaShape can treat many areas that may need contouring and have appearance of cellulite. The UltraShape treatment is effective on the abdomen, thighs, and flanks. With these two devices, I'm really able to address the needs of 100 percent of my patients who are really trying to have a great looking body, in and out of clothes, and feeling more confident about their appearance.