Highlights from

AAD 2021

American Academy of Dermatology Virtual Meeting Experience 2021

Virtual 23-25 April 2021

Subcision for the treatment of cellulite

Summary: Subcision is a minor surgical procedure used for treating depressed subcutaneous scars and wrinkles. This safe surgical technique also offers a solution for women with cellulite. In addition to the traditional forms, chemical and acoustic subcision have been introduced and come with benefits as no needles or scalpels are involved.

Subcision is a surgical technique that has been used for the treatment of cellulite. Prof Mathew Avram (Massachusetts General Hospital, US) reminded the audience that treatments for cellulite and for acne are distinct.1 Cellulite is best thought of as a female secondary sexual characteristic without associated morbidity or mortality. It arises from structural changes that happen during puberty. Prof Avram brought to the attention that it has little to do with diet or exercise.

Subcision treatment consists of repetitive shearing movements to smoothen the contour of the cellulite. Prof Avram guided the audience through three subcision techniques.

Traditional subcision performed with a scalpel or a large-bore needle. This classical technique is used for the treatment of dimples, not for cellulite. It exists of a single treatment with controlled anaesthetic infiltration. Controlled mechanical subcision uses a device for similar purposes and is more precise than a needle.

Chemical or enzymatic subcision is composed of two bacterial collagenases that hydrolyse type 1 and 3 collagen. The side effects are similar to the other types of subcision, including injection site bruising, pain, nodule, swelling, and discolouration. Phase II data demonstrated a significant improvement in moderate-to-severe cellulite on the buttocks.

Acoustic subcision consists of rapid acoustic pulses, also known as shock waves, that are transmitted through the skin to rupture the fibrotic septa. It is a non-invasive procedure of 20-30 minutes without any recovery nor anaesthetics.

These methods are all FDA-approved and can provide long-term effective treatment for dimpling and cellulite. There are several subcision-based treatments, with the expectation of many more non-invasive techniques to follow in the future.

  1. Avram M. Advances in treating cellulite. Session S018: What's New and True in Energy Based Devices. AAD VMX 2021, 23-25 April 2021.

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The content and interpretation of these conference highlights are the views and comments of the speakers/authors.