PracticalDermatology

Affecting up to 90% of female adults, cellulite is a significant aesthetic concern that has been associated with systemic associations and a negative psychological impact on affected patients.¹ Over the past several years, therapeutic advancements have offered new options for the treatment of cellulite—welcome for a large market with significant unmet needs. Unfortunately, in my hands, I have had predominantly modest results or more failures than successes with energy-based devices and injectibles, such as biostimulators and collagenase products.

The Latest

The newest advancement in the treatment of cellulite is the FDA-cleared Avéli device from Revelle. The device reduces the appearance of cellulite on the buttocks and thighs temporarily in a one-time procedure. The one-time-use disposable device for cellulite is designed to be used in a single in-office procedure using a Targeted, Verifiable Subcision™ method. Using local anesthesia, a provider can treat both the buttocks and thighs for a variety of women across the spectrum of cellulite severity and complexity.

The device is based on the tried and true method of subcising the fibrous bands that we know contribute to the formation of cellulite. Avéli is capable of targeting mechanical lysis of the fibrous bands with immediate tactile feedback to the operator. During treatment, the operator knows when the appropriate contributory bands are lysed for each individual cellulitic dimple or undulation. 

Patient before (left) and after Aveli treatment.

In my experience to date, patients have had good results with little or no downtime. Avéli is an important option in the armamentarium for cellulite treatment. It joins other options like Qwo (Endo) and Resonic (Allergan Aesthetics). The former is a promising injectable treatment, but there is variability in results and a high rate of post-treatment purpura, which can result in long term dyspigmentation. Resonic met pivotal trial endpoints and is a promising tool for treating cellulite, but the device continues to be fine-tuned before it is brought to market.

Meeting Demand

Management of cellulite should be part of today’s cosmetic dermatology practice. Our patients are seeking solid, evidence-based treatments, and we finally have these available. Our job as cosmetic dermatologists is to evaluate and provide the most effective treatments possible for our patients.

1. Arora G, Patil A, Hooshanginezhad Z, Fritz K, Salavastru C, Kassir M, Goldman MP, Gold MH, Adatto M, Grabbe S, Goldust M. Cellulite: Presentation and management. J Cosmet Dermatol. 2022 Apr;21(4):1393-1401.