| Abstrakt: |
Background: Endermologie® is a noninvasive, suction-assisted massage technique that has been advocated for body contouring and cellulite treatment. Theories with regard to the mechanism of action remain unproven. Objective: This investigation was designed to elucidate the mechanism of action by observing the physiological effects of Endermologie® based on both animal and human studies. Methods: In the SUS scorfa pig model, Endermologie® was studied by use of subcutaneous endoscopy (original magnification x 80), photography, gross tissue examination, and histologic examination. In human volunteers, Endermologie® was studied with lymphoscintigraphy, venous color-flow Doppler ultrasonography, and laser Doppler blood flow analysis of skin perfusion. Results: Endoscopic and gross analysis of treated fat failed to conclusively demonstrate that Endermologie® can actually redistribute fat in vivo, but we were able to demonstrate that Endermologie® can redistribute free, autologous fat after autologous fat injections. Laser Doppler measurements showed a 4-fold increase in cutaneous blood flow. This increase in skin perfusion peaked approximately 10 minutes after treatment and lasted for more than 6 hours. Color-flow Doppler measurements showed increases in the flow velocities of the subcutaneous veins within the adipose tissue and a concomitant decrease in flow velocities of the deep muscluar veins. These effects were also noted to be prolonged, lasting for at least 6 hours after the Endermologie® treatment was completed. Lymphoscintigraphy studies revealed a 3-fold increase in lymphatic flow in the treated limb, as compared with the untreated limb. This increase in lymphatic flow was prolonged, lasting at least 3 hours after the treatment was completed. Conclusions: We conclude that Endermologie® has a profound physiological effect that can be easily measured, but its anatomic effects are more difficult to identify. This suggests that Endermologie® may exert its effects by altering the physiological and metabolic activity of fat. Whether Endermologie® has a measurable anatomic effect of redistributing fat cells is yet to be proven. |
