Pablo Naranjo García discusses cellulite treatment of a unique instance with high energy radial shockwave therapy from Zimmer MedizinSysteme (ZWave®).s.
Cellulite is a common topographical alteration in which the skin acquires an orange-peel or mattress appearance. In this condition, alterations occur to the adipose tissue and microcirculation that result from blood and lymphatic disturbances causing fibrosclerosis of the connective tissue. It is considered a non‑inflammatory, degenerative phenomenon that provokes alterations to the hypodermis producing irregular undulations on the skin overlying affected areas. Cellulite is certainly not a serious condition from the medical point of view, but it does represent the most widespread and least tolerated aesthetic complaint among women. The condition is well-known as a result of intense publicity campaigns in the mass media and cosmetics industry, targeted at increasing the market for cosmetic creams, electro‑medical equipment, and therapeutic fantasies that often lack a scientific basis, although they do sometimes improve the aesthetic aspect of the problem. A few treatments supported by some evidence are available today, such as mechanical therapy with suction, bipolar radiofrequency, carboxytherapy, mesotherapy, and recommendation of exercise and weight-loss, for example. Shockwaves applied locally to the skin with cellulite may be an effective non‑invasive therapy combined with any of the other treatments.
High Energy Radial Shockwave Therapy (HERST)
Shockwaves transmit mechanical energy from the place of generation to distant areas. They display a single, mainly positive pressure pulse
of large amplitude that is followed by comparatively small tensile wave components1. When using shockwaves for therapy, effects that
make the pressure pulse even steeper as a result of non‑linearities in the propagation medium, as well as phenomena such as refraction and diffraction at acoustic interfaces, must be taken into consideration. The fact that shockwaves selectively effect acoustical interfaces (connecting two media, each with a different density; e.g. oil/water) and pass through homogenous elastic tissue without damage to the majority of the area is medically important. Unfocused extracorporeal shockwaves radially spread with an energy flow density per pulse smaller than 0.1 mJ/mm2 2,3, which decrease the power by one third for every centimeter that penetrates into the tissue.
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