N. Ugonabo, R. Ward, Anne Chapas
Jul 30, 2022
Journal of Cosmetic Dermatology
Cellulite is a significant cosmetic concern for postpubertal females and has been reported to affect 85% to 98% of postpubertal females across all races.1 The demand for treatment of cellulite has been on the rise in recent years. Recently, a multicenter clinical trial demonstrated improvement in cellulite of the upper thigh using microneedling with fractional radiofrequency (RF) to the dermal and subcutaneous area.2 It is proposed that the microneedle RF induces a wound healing response at the level of the subcuticular junction or dermis, potentially disrupting the excessive tension placed by perpendicular fibrous septae. The microneedle RF is thought to induce new collagen, elastin, and HA at the subcuticular junction, further preventing fat herniation into the dermis.2 Additionally, adding microneedling to radiofrequency enhances dermal heating by delivering energy through pins/needling that penetrate to a predetermined desired depth.3 Previously, the Morpheus8 (InMode Aesthetics, Lake Forest, CA) handpiece (24pin tip up to 4 mm depth) received FDA clearance for use in dermatological and general surgical procedures for electrocoagulation and hemostasis. The Morpheus 40body tip (InMode Aesthetics, Lake Forest, CA) with a depth of 6 mm was introduced to stimulate contraction and collagen formation while simultaneously affecting adipose tissue and fibroseptal network. However, this specific technology had not been previously published for the treatment of cellulite. Hence, our objective was to evaluate the safety and efficacy of the Morpheus8 Body 40pin tip at a depth of up to 6 mm for treatment of the thighs to improve cellulite appearance, skin laxity, and subcutaneous fat deposits. Subjects selfassessed their outcome at each followup visit using 5point Likert scales for Subject Satisfaction Scale (2: Very Satisfied, 1: Satisfied, 0: Neutral, −1: Dissatisfied, −2: Very Dissatisfied) and Subject Improvement Scale Global Aesthetic Improvement (GAI) scale (0: No change, 1: Slight Improvement, 2: Moderate Improvement, 3: Marked Improvement, 4: Significantly Marked Improvement). Similarly, investigators assessed improvement on a GAI scale (0: No Change, 1: 1%– 24%, 2: 25%– 49%, 3: 50%– 74%, 4: 75%– 100%), and a Skin Laxity/Tightening Improvement Scale (0: No tightening/firmness, 1: Slightly visible tightening/firmness, 2: Visible tightening/firmness, 3: Very visible tightening/firmness).