Listen as aesthetic experts Douglas Wu, MD, PhD and William Kwan, MD share their experiences with the new Picoway® 730 nm and Resolve Fusion 532 nm handpieces from Candela.
The Use of UltraShape Power and VelaShape Body Contouring Technologies
Dr. Stacey Chimento talks to host Scott Kober about the benefits of using the cutting-edge technology provided by UltraShape Power and VelaShape at Diane Walder Dermatology in Bay Harbor Islands, FL. The practice employs both techniques by themselves and in combination to provide effective body contouring solutions. The Dermatology Times Podcast Series is brought to you by Candela, a global leader in the aesthetic medical device marketplace.
Scott: My name is Scott Kober with Dermatology Times and today we’ll be talking about the use of UltraShape Power and VelaShape body contouring technologies.
I’m happy to be joined today by Dr. Stacey Chimento, a board-certified dermatologist at Diane Walder Dermatology in Bay Harbor Islands, FL.
Dr. Chimento is a consultant and speaker for Candela.
Welcome Dr. Chimento, and thank you for joining me.
Dr. Chimento: It’s a pleasure to be here.
Scott: When you were initially in the market for the purchase of a body contouring device, what were the most important components you were looking for?
Dr. Chimento: When my practice initially started looking at body contouring options, we were looking for cutting-edge technology, something that would allow us to differentiate ourselves from other local practices. It was also important to find technology that was efficacious and customizable for our patient base down here in the Miami area, that caused minimal or no side effects, and resulted in visible results quickly.
Scott: What drove your practice’s initial interest in exploring the body contouring market?
Dr. Chimento: More than anything, it was to keep up with the Joneses. We knew that the industry trend was moving away from invasive surgical procedures and more toward non-invasive solutions for fat reduction and skin tightening. We had more and more patients who were asking us whether we offered these sorts of non-invasive procedures – many of whom were specifically referred to us by plastic surgeons in the area. As we saw the demand growing, that prompted us to explore bringing the technology into our practice.
After we did a significant amount of research and demoed a lot of the different devices on the market, we determined that UltraShape Power was the best fit for our practice. We saw that it worked and worked quickly - patients left the office feeling great. Plus, there were virtually no side effects that we noted. Seeing as those were the two primary factors we were looking for, it became a rather easy decision.
Scott: How does UltraShape Power work?
Dr. Chimento: UltraShape Power is the only FDA-cleared device that uses focused pulse ultrasound. It targets fragile fat cells with a cone of non-thermal ultrasound energy while at the same time protecting surrounding tissue, nerves, and muscle, which you typically don’t see with other cavitation devices on the market.
Scott: How does UltraShape Power compare to body contouring technologies such as cryolipolysis and laser heat?
Dr. Chimento: So as I just mentioned, ultrasound devices such as UltraShape Power use high-pressure oscillatory waves to selectively destroy mechanically fragile fat cells without temperature changes. Some of the other popular technologies on the market, including cryolipolysis and laser heat, work differently. There is also much lower risk of prolonged erythema, crusting, blistering, burn or bruise compared with other technologies.
Cryolipolysis, works via a freeze-and-thaw process that gradually destroys fat cells in a semi-selective manner as opposed to the selective fat destruction of UltraShape Power. With cryolipolysis, there can be associated bruising, soreness, numbness, shelving, or paradoxical adipose hyperplasia, all of which can be uncomfortable for the patient. There is also typically a significant amount of inflammation, and it often takes 2 to 3 months for a patient to see any notable improvement. Visible improvements occur much more rapidly with UltraShape Power.
Switching gears to laser heat technology, that works via a 1064 nm diode that results in nonselective thermal necrosis. What that means for our patients is that laser heat is only typically effective in areas such as the abdomen or flank, and not in some smaller areas that our patients may be interested in. Laser heat can also be painful for patients, and there are a variety of possible side effects, including inflammation. Once again, with laser heat it takes multiple treatments and several months before many patients will notice any appreciable results.
Scott: Your practice also uses the VelaShape, correct?
Dr. Chimento: Yes, we have the VelaShape in our office.
Scott: So how does that technology fit into the picture for patients seeking a body contouring solution?
Dr. Chimento: Unlike UltraShape, VelaShape only offers temporary circumferential fat reduction through use of what is called Elos technology, or electro-optical synergy. VelaShape combines bipolar radiofrequency and infrared technologies to promote localized inflammation. What it does is basically make fat cells more metabolically active by getting them to rub up against each other.
This process is then coupled with a vacuum that causes fibroblast proliferation and allows for deeper penetration of the radiofrequency energy. This allows you to get improvement in cellulite, tone, and texture, build collagen, and increase circulation to promote lymphatic drainage. Patients will often see an improvement in the tone and texture of their skin with use of VelaShape.
We often offer treatment package of VelaShape and UltraShape Power due to the synergistic nature of the technologies. Getting the permanent fat destruction with UltraShape Power coupled with the circumferential fat reduction thanks to VelaShape provides the improvements that a lot of our patients’ desire.
Scott: How do you determine which patients will get UltraShape alone, VelaShape alone, or a combination of both technologies?
Dr. Chimento: It mostly depends on patient concerns and overall expectations.
There are some patients who have what I call “intra-fat” that can be treated with UltraShape alone. There are other patients who are quite skinny overall and only have these very small pockets of fat that can be treated with VelaShape alone. VelaShape is also a good option for patients who have previously gone through a fat reduction procedure or been treated with a different body contouring technology such as cryolipolysis.
But I would say that the majority of the patients I see who are interested in noninvasive fat reduction are good candidates for the combination of technologies. Because they are synergistic, using UltraShape Power and VelaShape with the same patients will often produce better outcomes than the use of either technology alone.
Scott: For those patients receiving combination procedures, what is your typical treatment protocol?
Dr. Chimento: Typically, we will start with VelaShape for about 15 minutes to preheat the skin and rev up the fat cells in the targeted area. When you follow that with UltraShape Power, you are going to see better cavitation and tighter initial skin contraction.
We have some patients who will schedule a series of 2 or 3 treatments where we’ll follow that same process – VelaShape followed by UltraShape. For other patients who are more pressed for time, we may do 1 session where we’ll start with VelaShape, then go to UltraShape, and then use VelaShape again 15 minutes later.
Scott: How would you characterize the overall patient satisfaction following these combination procedures? What sorts of overall results have you witnessed?
Dr. Chimento: We’ve done thousands of cases by now, and quite honestly, we’ve had high rates of patient satisfaction. Of course, the level of improvement will vary but we have typically seen. circumferential fat reductions anywhere from 1.5 to 6.3 centimeters.
We have had some patients looking for fat reduction in, for example, their flanks, who will then come back and ask about the possibility of treating other areas since the initial treatments were so successful. This has really elevated our practice and opened new doors for us.
Scott: Are there any tips you would offer your colleagues regarding patient selection for these technologies?
Dr. Chimento: Certainly. The most important predictor of success is setting realistic expectations for your patients and determining their goals upfront. We know that these technologies are not a replacement for weight loss surgery. Patients won’t magically lose 20 or 30 pounds overnight. What I tell my patients is that they can expect to lose 1 to 3 dress or pant sizes, but it’s going to take time. They may see some initial level of improvement very quickly, but it will often take 6 weeks and a series of treatments for them to get the full results they want.
Another important component is to emphasize the importance of a proper diet and regular exercise to augment the response of treatment. I tell my patients, “If I’m going to spend money on the use of these devices to help me attain the body shape that I want, why would I go and immediately eat a cheeseburger after each treatment? That’s not the way to get the most bang for your buck.
My final suggestion is to be sure to take high-quality before and after photos with all of your patients. I just had a lady who, after she was finished with a series of 3 treatments, looked at her before photo and kept saying, “That’s not me. Who is that woman?” We really had to convince her that she was looking at her own photo from 2 months ago. Patients often don’t remember what they looked like last week much less last month or longer, so getting good “before” photos is really important to help our patients see their improvement.
Scott: Terrific. I think this has been a valuable discussion regarding new technologies that offer opportunities for dermatologists to better serve the needs of their patients.