Examining Cellfina in the cosmetic practice

More than two months into the much anticipated Cellfina (Merz Aesthetics) launch, we asked two cosmetic doctors to share their experiences with the FDA-cleared, minimally invasive treatment for cellulite.

This is what they had to say.

Dr. PalmDermatologist and cosmetic surgeon Melanie D. Palm, M.D., MBA, director, Art Of Skin MD, Solana Beach, Calif., and volunteer assistant clinical professor at University of California San Diego, says she treated her first dozen Cellfina patients as of May 2016.

The technology is remarkable, Dr. Palm says, but it does rely on good operator judgement, planning and technique.

"If the correct patient is selected, meaning a patient that is of stable weight, reasonably fit and has stubborn, discrete, dimple-like cellulite, the results are superb and quite visible even at a three-day follow up," Dr. Palm says. "Patients need good skin tone — too lax of skin is likely to yield less-than-ideal results. A younger population is better suited, especially those patients that remember having discrete cellulite lesions since early adulthood."

A poor candidate, according to Dr. Palm, is one who has subtle, wavy textural abnormalities on the buttocks and thighs, which are more attributable to skin laxity, and not discrete lesions of dimple-like cellulite. Those patients are better served by skin tightening modalities, according to Dr. Palm.

"Also, aggressive treatment of near adjacent lesions with too much overlap can create an unnatural result. I have not seen this in my own patients but have seen photos of others where this has occurred," she says. "… treatment in the banana roll is ill-advised. This is an extremely important anatomical structure and interrupting it is likely to result in an aesthetically unpleasing result. Again, I have not seen this in my own population but have seen results where over-judicious treatment was taken in this area. Lastly, patients that bruise easily and pigment easily (post-inflammatory hyperpigmentation) should be cautioned that bruising can be significant and its resolution slow. Encouraging these patients to avoid anti-platelet medications, and using topical or oral homeopathic remedies may prove helpful."

NEXT: A Steep Learning Curve

A Steep Learning Curve

Physicians who plan to use Cellfina should know there is a very steep learning curve, and Dr. Palm suggests that cosmetic surgeons should start treating patients soon after the comprehensive training by the company. 

"Cellfina in my hands is very easy," she says. "We have streamlined the experience so that patients are extremely comfortable. I mark the patient, my registered nurse helps with the numbing portion of the procedure, and I perform the release. I find the technology very easy to do, but the numbing can be a little time-intensive, and the company is working on adjustments to make that faster. The release itself is quite easy and quick for experienced dermatologic surgeons."

So far, patients at Dr. Palm’s practice have been extremely satisfied. She says she typically sees Cellfina patients for a 3-, 14- and 30-day follow up with long term follow ups at 3 through 6 months.

Patients often convert to other body procedures, including skin tightening with radiofrequency (RF), acoustic wave therapy and often to injectables or lasers that they learn about with exposure to Dr. Palm’s clinic. 

"I have a few patients that now are happy with the texture of their skin and now want to address a few spider veins so sclerotherapy is another procedure that sometimes marries well with Cellfina in improving the legs in general," she says.

NEXT: Marketing Insights

Marketing Insights

Dr. Palm’s practice is marketing the device. Among her marketing strategies: a practice event; internal marketing, including story boards of the practice on the practice’s flat screen TVs; web-sliders on the practice website; blog entries; and several appearances on local TV discussing the technology. 

"I also have put up several YouTube videos showing the various steps of the procedure, as well as adding to the discussion of questions surrounding Cellfina on RealSelf," Dr. Palm says. 

The Cellfina rollout was a little slow, at first, compared to Dr. Palm’s typical device roll out.

"…but I must say that some of the direct-to-consumer marketing that is starting to appear is helping the cause," she says. "In general, I think women are disenchanted and jaded when it comes to cellulite treatment. They've tried creams and devices that either don't work or have to be continued over time to yield a modest to moderate result. Demonstrating to the 90% of women that there actually is a device that remarkably and likely permanently alters the physical architecture of cellulite for long-lasting results will take time. Patient selection by physicians is paramount to the success of this treatment."

NEXT: Response Has Been Impressive

Response Has Been Impressive

Dr. SteigerBoca Raton, Fla., facial plastic and reconstructive surgeon Jacob D. Steiger, M.D., tells Cosmetic Surgery Times that he treated about a dozen patients with the device (as of the end of May). And patients are excited to learn about the procedure.

"Cellulite is a significant concern for over 80% of females. When patients learn about a technology that can help them, they call the office and request it by name," Dr. Steiger says.

Dr. Steiger says his practice has been marketing Cellfina with traditional public relations and internal marketing.

"The response has been impressive, Patients and media outlets are keen to learn more about the procedure and the results that can be achieved. Cellulite is a very hot topic today," he says.

Since the device is a minimally invasive procedure that is performed under local anesthesia, it’s performed only by physicians.

"From a technical standpoint it is similar in practice as performing tumescent anesthesia with some nuances," Dr. Steiger says.

Cellfina has been a hit at the practice, according to Dr. Steiger, with all patients to date reporting that they are extremely satisfied with their results from the time they leave the office. 

"Most patients drive themselves to the procedure and there is minimal discomfort after the procedure. The results are instant barring any swelling and bruising," he says. "It can take several weeks or longer for all the bruising to resolve. Patients definitely convert to other procedures such as Coolsculpting, Ultherapy and other plastic surgical procedures."

Words of Wisdom

"It is important to fully assess the patient's candidacy for the procedure. Cellfina specifically works on dimpled cellulite. Wavy cellulite will not respond well to Cellfina and is better treated with other modalities. Patients that have moderate to severe dimples of the buttocks achieve the most 'wow!' results," Dr. Steiger says.