Taking Aim At Cellulite With An Exciting New Laser: A Conversation With Dr. Theodore Diktaban
Cellulite isn’t any girl’s best friend. What exactly is it?
Connective tissue bands beneath the skin, called fibrous septae, are arranged in a crisscross manner in normal skin. When they are oriented in a parallel manner from birth, they allow the fat to bulge up against the skin’s thinner surface, creating a rippling, lumpy look. Some septae also harden and contract as women age, which causes more bulging and dimpling by pulling the skin surface inward.
What causes cellulite and is it preventable?
We’re not sure of the exact causes, but they’re believed to be genetic and hormonal. Cellulite can’t be prevented, but staying thin makes it look less pronounced. The fat cells get larger or increase in number with grossly overweight people, which cause them to push up against the thin skin. The skin cannot contain their force. When you lose weight, they shrink, but don’t disappear.
Where is cellulite most likely to appear?
The lower buttocks and back of the thighs are definitely the most common areas. The abdomen, inner thighs, front of the thighs, and even the upper, outer arm can be affected.
How has cellulite been treated?
All treatments up until now have been non-invasive. There were lotions and potions but they didn’t work. Heating and vacuuming or suction massage caused temporary improvement at best. The reason these external treatments cannot work is because we can’t heat the skin enough to be really effective and the suction isn’t powerful enough to disrupt the fat or divide the fibrous sepate bands. Cellulaze is a one time treatment in contrast to the external devices that require 8 to 12 treatments over a number of weeks, which cause a little bit of swelling, but then they go back to looking the way they were.
Tell us about Cellulaze, the new treatment we’ve been hearing about?
The FDA approved the treatment about five months ago. It’s a minimally invasive, one-time procedure that uses smart lipo laser technology. It works with a 1440 mm wavelength that has the greatest affinity for fat and water. Besides its ability to be fired straight ahead, the laser can be aimed off to the side and directed right down at the fat, up against the skin, as well as sideways at the fibrous septae. This multidirectional laser treatment allows us to finally be able to correct the anatomy that causes cellulite.
How does it work?
We work with a plastic grid with 12 squares, each measuring 2 by 2 inches, and we completely mark out the area affected by cellulite.
We give patients a couple of valiums and painkillers to get them nice and relaxed and then inject a thin layer of liposuction liquid under the skin. Following that, we make a small pinpoint puncture to let the angel hair size laser enter. Each of the squares will receive a calculated amount of energy to the bulging fat, contracted septae and the thin skin. After the calculations, it’s time to go to work. We aim the red laser sideways to cut the septae; straight down to melt the fat, and then up against the undersurface of the skin to directly tighten and thicken it. Once all of the laser energy is delivered to the squares, the melted fat and liquid is gently rolled out. The patient is placed in an elastic garment and then sent home shortly after.
How does the patient feel after the procedure?
Patients should take two days off to relax and let the oozing subside. The patients can take a shower the day after their treatment and then put the elastic garment back on.
Is there bruising?
Bruising and swelling have been mild. Some patients are taking one painkiller a day to ease the discomfort. Initially, we were concerned about using the laser close to the skin, but numbness has been minimal.
When can the patient resume normal activity?
Patients can exercise after a couple of weeks, but other than that, they can return to normal activity after a few days rest.
When do the results show?
It takes about six months to see the full effects of the Cellulaze treatment. The skin also needs to be massaged while it’s contracting.
It depends on how many squares we need to work on, but let’s say $4,000 and up.
What are the most common procedures you perform?
Breast augmentation, liposuction (traditional and Smartlipo), Cellulaze and rhinoplasty, otherwise known as nose jobs.
What has been the most challenging surgery you’ve performed?
Microsurgeries on two memorable patients are the most challenging that I’ve experienced. One gentleman, who almost lost his leg in a motorcycle accident, was able to fully walk after a 15-hour operation. I transferred a muscle from his back to cover exposed bone in his leg.
The other case was a young diabetic woman who developed a chronic infected foot wound after cutting it on glass at the beach. I transferred a muscle from her abdomen to restore support and close the large gaping wound. There was a special conclusion for this patient who was perilously close to having an amputation before her microsurgery. She literally came and danced at my wedding later on.
Dr. Theodore Diktaban
635 Madison Avenue, 4th Floor
New York, New York 10022
Tel: (212) 988-5656
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